Objective:To construct a nanoparticle vaccine displaying the prefusion F (preF) protein of respiratory syncytial virus (RSV) using the I53-50 protein nanoparticle platform, and to systematically evaluate its immunogenicity and protective efficacy.Methods:The RSV preF trimer antigen was genetically fused to I53-50A and assembled in vitro with I53-50B to form preF-I53-50 nanoparticles, theoretically displaying 20 preF antigens per particle. The structure and purity were characterized by size-exclusion chromatography, SDS-PAGE, and negative-stain electron microscopy. BALB/c mice were intramuscularly immunized with varying doses (1 μg or 5 μg) of preF antigen or an equimolar amount of preF-I53-50 nanoparticles. Humoral immunity, B-cell responses, and protective efficacy were assessed following intranasal viral challenge.Results:The preF-I53-50 nanoparticles self-assembled into spherical structures (50-60 nm in diameter) with uniformly arrayed antigens. The nanoparticle vaccine enhanced RSV-specific IgG1 and IgG2a antibody responses, promoting a Th1-biased immune profile. At equimolar preF doses, the neutralizing antibody titers induced by 1 μg and 5 μg nanoparticle formulations were 2.8-fold and 2.3-fold higher, respectively, than those elicited by preF alone ( P<0.05). Notably, even the low-dose nanoparticle group outperformed the high-dose preF group (1.6-fold increase). Viral challenge experiments demonstrated that preF-I53-50 effectively suppressed pulmonary viral replication, mitigated pathological damage, and induced stronger germinal center and memory B-cell responses, suggesting enhanced B-cell affinity maturation and long-term immune memory. Conclusion:The preF-I53-50 vaccine improves the immunogenicity and protective efficacy of RSV preF through multivalent antigen display.

Objective:To investigate the safety of Holmium laser enucleation of the prostate (HoLEP) and bipolar plasma resection of prostate (BPRP) in the treatment of large volume benign prostatic hyperplasia (LV-BPH), and to analyze their long-term follow-up results.Methods:Two hundred patients of LV-BPH admitted to Cangzhou Hospital of Integrated TCM-WM·Hebei from January 2022 to January 2024 were retrospectively selected and divided into BPRP group and HoLEP group according to different treatment methods, with 100 cases in each group. Patients in BPRP group were treated with BPRP, and patients in HoLEP group were treated with HoLEP. The clinical data, perioperative indicators, postoperative complications and long-term follow-up results were compared between groups. Measurement data were expressed as mean±standard deviation ( ± s), paired sample t-test was used for intra-group comparison, covariance analysis or independent sample t-test was used for inter-group comparison, and analysis of variance of repeated measurement data was used for multi-time node comparison. Count data were expressed as the cases and percentage, and Chi-square test was used for comparison between groups. Results:The operation time [(31.46±13.47) min vs (40.25±15.33) min], clearance time [(28.14±12.94) min vs (37.16±13.15) min] and the decrease in hemoglobin [(5.14±1.93) g/L vs (7.92±2.45) g/L] of patients in the HoLEP group were lower than those in the BPRP group, and the clearance efficiency [(1.58±0.19) g/min vs (1.30±0.10) g/min] was higher than that in the BPRP group, and the differences were statistically significant ( P<0.05). The incidence of postoperative hematuria (1.00% vs 8.00%) in HoLEP group was lower than that in BPRP group, and the difference was statistically significant ( P<0.05). There were no statistically significant differences in the incidence of other complications and total complications except hematuria between BPRP group and HoLEP group ( P>0.05). The results of covariance analysis showed that there were no statistically significant differences in serum sodium, prostate specific antigen (PSA) levels, maximum urine flow rate (Qmax), postvoid residual urine (PVR), international prostate symptom score (IPSS) and quality of life (QOL) score at different time points after the operation ( P>0.05). The analysis of variance of repeated measurement data showed that the group effects of the above indexes were F=0.91, 0.52, 1.30, 0.40, 0.02, 0.63, respectively, all P>0.05, and the time effects were F=18.57, 104.31, 814.68, 1 106.64, 1 894.37, 555.31, respectively, all P<0.001, and the interaction effects were F=2.79, 0.75, 1.22, 1.20, 0.02, 0.72, respectively, all P>0.05. Conclusions:The application of HoLEP and BPRP in LV-BPH patients are beneficial to improve prostate symptoms and quality of life, with equal safety and effectiveness. However, compared with BPRP, HoLEP applied to LV-BPH patients has the advantages of short operation time, high clearance efficiency, small decrease of hemoglobin and low risk of postoperative hematuria.

Objective:To understand the negative conversion of syphilis-specific antibody in follow-up in 0-18 months-old children born to pregnant women with syphilis in China in 2021 and analyze the related factors.Methods:The basic information of pregnant women with syphilis and follow-up information of their children in 2021 were extracted from the National Management Information System for the Prevention of mother-to-child transmission of HIV, syphilis and Hepatitis B. The logistic regression model was used to analyze related factors of negative conversion of syphilis-specific antibody.Results:In 2021, a total of 34 201 children was delivered by syphilis-infected pregnant women, and 23 592 (68.98%) children were included in this study. Negative conversion of syphilis-specific antibody occurred in 21 076 (89.34%) children, but not in 2 516 (10.66%) children. Multivariate logistic regression analysis identified several factors associated with a higher probability of the negative conversion of syphilis-specific antibody: prophylactic benzathine penicillin injection at birth (a OR=1.35,95% CI:1.10-1.65), mother's age 26-30 years (a OR=1.22,95% CI:1.01-1.46), 36-40 years (a OR=1.34, 95% CI:1.09-1.64), other ethnic groups (a OR=1.19,95% CI:1.04-1.36), non-syphilis-specific antibody titers less than 1∶8 during pregnancy (a OR=1.56,95% CI:1.37-1.78), penicillin treatment (a OR=1.56,95% CI:1.23-1.98) and standardized treatment (a OR=1.21,95% CI:1.11-1.32). Conclusions:In 2021,the level of syphilitic-specific antibody negative conversion in follow-up in children born to pregnant women with syphilis was high in China. According to the factors associated with syphilis-specific antibody negative conversion, it is necessary to develop the follow-up strategies for the children born to pregnant women.

Objective:To understand the negative conversion of syphilis-specific antibody in follow-up in 0-18 months-old children born to pregnant women with syphilis in China in 2021 and analyze the related factors.Methods:The basic information of pregnant women with syphilis and follow-up information of their children in 2021 were extracted from the National Management Information System for the Prevention of mother-to-child transmission of HIV, syphilis and Hepatitis B. The logistic regression model was used to analyze related factors of negative conversion of syphilis-specific antibody.Results:In 2021, a total of 34 201 children was delivered by syphilis-infected pregnant women, and 23 592 (68.98%) children were included in this study. Negative conversion of syphilis-specific antibody occurred in 21 076 (89.34%) children, but not in 2 516 (10.66%) children. Multivariate logistic regression analysis identified several factors associated with a higher probability of the negative conversion of syphilis-specific antibody: prophylactic benzathine penicillin injection at birth (a OR=1.35,95% CI:1.10-1.65), mother's age 26-30 years (a OR=1.22,95% CI:1.01-1.46), 36-40 years (a OR=1.34, 95% CI:1.09-1.64), other ethnic groups (a OR=1.19,95% CI:1.04-1.36), non-syphilis-specific antibody titers less than 1∶8 during pregnancy (a OR=1.56,95% CI:1.37-1.78), penicillin treatment (a OR=1.56,95% CI:1.23-1.98) and standardized treatment (a OR=1.21,95% CI:1.11-1.32). Conclusions:In 2021,the level of syphilitic-specific antibody negative conversion in follow-up in children born to pregnant women with syphilis was high in China. According to the factors associated with syphilis-specific antibody negative conversion, it is necessary to develop the follow-up strategies for the children born to pregnant women.

Objective:To construct a nanoparticle vaccine displaying the prefusion F (preF) protein of respiratory syncytial virus (RSV) using the I53-50 protein nanoparticle platform, and to systematically evaluate its immunogenicity and protective efficacy.Methods:The RSV preF trimer antigen was genetically fused to I53-50A and assembled in vitro with I53-50B to form preF-I53-50 nanoparticles, theoretically displaying 20 preF antigens per particle. The structure and purity were characterized by size-exclusion chromatography, SDS-PAGE, and negative-stain electron microscopy. BALB/c mice were intramuscularly immunized with varying doses (1 μg or 5 μg) of preF antigen or an equimolar amount of preF-I53-50 nanoparticles. Humoral immunity, B-cell responses, and protective efficacy were assessed following intranasal viral challenge.Results:The preF-I53-50 nanoparticles self-assembled into spherical structures (50-60 nm in diameter) with uniformly arrayed antigens. The nanoparticle vaccine enhanced RSV-specific IgG1 and IgG2a antibody responses, promoting a Th1-biased immune profile. At equimolar preF doses, the neutralizing antibody titers induced by 1 μg and 5 μg nanoparticle formulations were 2.8-fold and 2.3-fold higher, respectively, than those elicited by preF alone ( P<0.05). Notably, even the low-dose nanoparticle group outperformed the high-dose preF group (1.6-fold increase). Viral challenge experiments demonstrated that preF-I53-50 effectively suppressed pulmonary viral replication, mitigated pathological damage, and induced stronger germinal center and memory B-cell responses, suggesting enhanced B-cell affinity maturation and long-term immune memory. Conclusion:The preF-I53-50 vaccine improves the immunogenicity and protective efficacy of RSV preF through multivalent antigen display.

OBJECTIVE To investigate the current status of quality management of cold chain medicines in direct-to-patient(DTP)pharmacies and propose measures for pre-emptive risk management,providing references for the quality risk management of cold chain medicines.METHODS Based on the requirements of national regulations,a survey was conducted on the quality management of cold chain medicines in DTP pharmacies of J Province from November 2023 to February 2024,focusing on the receipt,storage,distribution,and delivery processes,using questionnaires,telephone interviews,and on-site visits.Common quality management issues in the operation of cold chain medicines were identified,and the causes of these issues were analyzed to propose feasible pre-emptive risk management measures.RESULTS&CONCLUSIONS A total of 122 DTP pharmacies participated in the questionnaire survey,and personnel from 30 DTP pharmacies participated in on-site and telephone interviews.Typical problems were identified in some DTP pharmacies,including insufficient personnel allocation or training,incomplete or inadequate implementation of quality system documentation,inadequate provision or management of cold chain facilities and equipment,and non-compliant storage and distribution of cold chain medicines.These issues posed certain risks to the quality management of cold chain medicines.It is recommended that DTP pharmacies strengthen personnel allocation and training,improve quality system documentation,enhance the provision and management of facilities and equipment,standardize storage and transportation operations,and strengthen supervision and assessment as pre-emptive measures.In addition,all sectors of society should also collaborate in governance from the perspective of ensuring the safety of cold chain drug storage and transportation,in order to mitigate the risk of quality and safety issues during the distribution of cold chain drugs and guarantee the safe and effective use of medications for patients.

Objective To assess the status of rodent infestation in commercial kitchens using data from the‘Bright Kitchen, Clean Stove' initiative. The potential use of artificial-intelligence(AI)-based surveillance systems to monitor rodent density was explored, thereby providing a scientific basis for rodent control strategies. Methods As a component of the ‘Bright Kitchen, Clean Stove' initiative, the Minhang District Market Supervision Administration in Shanghai has installed cameras in 297 kitchens. These systems incorporate an AIpowered rodent image recognition method that automatically captures and stores the first image captured in each kitchen each day when a rodent is detected. In 2023, the system collected and stored 736 screenshots of rodents. Following manual verification,720 of the images were confirmed to contain rodents. The images were analyzed by noting the time, location, and kitchen area, and the species were manually identified to assess the population density. Results Rodent activity was detected in 34 of the 297 monitored kitchens, with an overall infestation rate of 11.45%. Of the 720 confirmed images of rodents, Rattus norvegicus(brown rat)was the predominant species, present in 409(56.81 %)images. Rodents were primarily concentrated in hot food preparation spaces. The density fluctuation curve had a multimodal pattern peaking in spring and autumn. The peak of daily activity was between 22: 00 and 2: 00. There was a significant difference in the rodent detection frequency between weekends and weekdays during peak hours and during non-peak hours(χ2=7.18, P＜ 0.01). Conclusions The ‘Bright Kitchen, Clear Stove' smart monitoring system has been proven to be applicable to rodent density monitoring. To control rodents in commercial kitchens, greater efforts are required to address and identify the specific infesting conditions and the key points in the control process.

At present,there are policies for hepatitis B testing in 89.8%of countries and regions around the world.In 2022,the global hepatitis B vaccine birth dose coverage reached 45%,while the third-dose coverage reached 85%.Approximately 3%of pregnant women with high viral loads have received antiviral therapy,and the prevalence rate of HBsAg is about 0.7%among children aged≤5 years.While significant progress has been made in various countries towards eliminating mother-to-child transmission of hepatitis B virus(HBV),there are still large gaps across countries and numerous challenges.There are differences in the prevalence of hepatitis B,vaccination,and access to antiviral drugs across the globe,and in addition,the factors such as insufficient laboratory testing capacity and difficulties in ensuring sustained access to treatment among pregnant and parturient women with HBV infection pose obstacles to eliminating the mother-to-child transmission of HBV.

Objective:To comprehend the main characteristics and historical evolution of health finan-cing transition in China.Methods:Data were collected from various sources,including the Global Health Expenditure Database(GHED),China Health Statistics Yearbook,National Health Finance Annual Report,China's Total Health Expenditure Research Report,et al.Descriptive statistics and liter-ature study was conducted.Results:Since the beginning of the 21st century,most countries in the world had witnessed a transition of health financing,characterized by the expansion of health financing scale and the strengthening of public financing responsibility.Notably,China's health financing transition exhibited distinctive features.Firstly,there had been a more rapid expansion in health financing scale compared with global averages.Between 2000 and 2019,total health expenditure per capita experienced a remarkable increase of 816.6％at comparable prices,significantly surpassing average growth rates observed among other countries worldwide(102.1％).Secondly,greater efforts had been made to strengthen the responsibilities of public financing.From 2000 to 2019,there was a substantial decrease of 30.6 percentage points in the proportion of out-of-pocket health expenditure as a share of total health expenditure.This decline was significantly larger than the average reduction observed among other coun-tries worldwide(5.6 percentage points).Thirdly,there had been a significant shift in government health expenditure allocation patterns,with an increased emphasis on"demand-side subsidies"surpassing"supply-side subsidies".Within the realm of"supply-side subsidies",funding directed towards hospitals had notably increased and surpassed that allocated to primary healthcare institutions and public health institutions.Based on these distinctive characteristics,this paper expanded China's health financing tran-sition into three dimensions:Scale dimension,structure dimension and flow dimension.Using a compre-hensive analytical framework,the history of China's health financing transition was roughly divided into four stages:The planned economy stage,the economic transition stage,the post-SARS stage and the new health system reform stage.The main features and evolutionary logic associated with each stage were ana-lyzed.Conclusion:Above all,the health financing system should be enhanced in terms of vertical"em-beddedness"and horizontal"complementarity".Moreover,the significance of health financing transition in preserving hidden value and mitigating public risk should be emphasized,and there is a need for an improved two-way trade-off mechanism that balances value and risk.Additionally,the ethical principles associated with health financing transition should be considered comprehensively,while optimizing budget decision-making within the government's actual governance model.Lastly,it is crucial to recognize the overall and profound impact of modern medicine development and explore long-term strategies and path-ways for health financing transition in China.

Objective:To establish a Plaque-reduction Neutralization Test (PRNT) for the detection of neutralizing antibody titers of Human Respiratory Syncytial Virus (HRSV) and optimize the conditions for preliminary application.Methods:The CHO expression system was used to produce palivizumab monoclonal antibody (palivizumab) and the influencing factors such as cell type, cell culture duration, fixation and permeabilization protocols, and blocking agents. The reproducibility of the method was verified and its correlation was verified with conventional PRNT. Finally, the optimized PRNT assay was further used to determine neutralizing antibody titers against HRSV subtypes A and B in BALB/c mouse serum (immunized by intramuscular injection of HRSV fusion proteins).Results:Palivizumab was expressed at approximately 50 mg/L. The optimal working conditions for PRNT were as follows: culturing HEp-2 cells for 2 days, fixing with 4% (V/V) paraformaldehyde at room temperature for 15 min followed by 0.2% (V/V) Triton X-100 permeabilization for 15 minutes as the optimal fixation-permeabilization and removing the blocking step. The overall coefficient of variation (CV) for the reproducibility validation of this method was <15%, showing a good linear relationship with the conventional PRNT. The Spearman correlation coefficient r s was 0.983. This method was used to detect neutralizing antibody titers in mouse sera against HRSV subtype A strain long and subtype B strain 9320, and the fusion proteins combined with AlOH and CpG adjuvant induced the highest neutralizing antibody titers in mice. Conclusion:The HRSV neutralizing antibody assay established in this study is rapid, reproducible, high-throughput, and can be used to detect neutralizing antibodies to HRSV subtypes A and B.