As activated hepatic stellate cells (aHSCs) play a central role in fibrogenesis, they have become key target cells for anti-fibrotic treatment. Nevertheless, the therapeutic efficiency is constrained by the exosomes they secrete, which are linked to energy metabolism and continuously stimulate the activation of neighboring quiescent hepatic stellate cells (qHSCs). Herein, an intercellular communication interference strategy is designed utilizing paeoniflorin (PF) loaded and hyaluronic acid (HA) coated copper-doped ZIF-8 (PF@HA-Cu/ZIF-8, PF@HCZ) to reduce energy-related exosome secretion from aHSCs, thus preserving neighboring qHSCs in a quiescent state. Simultaneously, the released copper and zinc ions disrupt key enzymes involved in glycolysis to reduce bioenergy synthesis in aHSCs, thereby promoting the reversion of aHSCs to a quiescent state and further decreasing exosome secretion. Therefore, PF@HCZ can effectively sustain both aHSCs and qHSCs in a metabolically dormant state to ultimately alleviate liver fibrosis. The study provides an enlightening strategy for interrupting exosome-mediated intercellular communication and remodeling the energy metabolic status of HSCs with boosted antifibrogenic activity.

ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

Objective By establishing a model to screen out patients with potentially large positional deviations based on their abdominal circumference,personalized solutions can be taken to address setup errors in these patients and ensure treatment efficacy.Methods A total of 81 patients treated at Tianjin People's Hospital from May 2021 to June 2023 were selected as the study subjects.The correlations between setup errors in the lateral,longitudinal,and vertical directions and abdominal circumference were analyzed.Subsequently,linear regression was performed for the direction with a significant correlation to abdominal circumference to establish a linear regression model.Finally,the 81 patients were divided into a normal setup group and an abnormal setup group with 0.7 cm as the critical value.A receiver operating characteristic(ROC)curve was plotted,and the maximum Youden index was calculated to determine the optimal cutoff value for identifying patients prone to abnormal setup.Results The correlation analysis of abdominal circumference and setup errors in various directions showed that the correlation coefficient between abdominal circumference and longitudinal direction positioning error was 0.406 2,and the correlation was statistically significant and positively correlated.The correlation coefficients for abdominal circumference and the lateral as well as longitudinal directions were-0.117 5 and-0.067 47,respectively,with P values greater than 0.05,indicating no statistical significance.A linear regression model was established for abdominal circumference and longitudinal direction,and the results showed an R2of 0.165,with a regression coefficient B of 0.008(t=3.951,P<0.01),indicating that the model was well constructed.ROC curve analysis showed an area under the curve of 0.715,with a 95%confidence interval of 0.57-0.86 and a maximum Youden index of 0.478.The corresponding optimal cutoff value was determined to be at 87 cm,with sensitivity at 0.875 and specificity at 0.603.Conclusion The abdominal circumference is significant to diagnose whether the longitudinal setup error is abnormal.Patients with an abdominal circumference greater than 87 cm are more likely to experience abnormal positioning during radiotherapy,which is reflected in the longitudinal setup errors being the largest.It is recommended to provide individualized target area margins for patients with an abdominal circumference greater than 87 cm,or perform daily cone-beam computed tomography to correct setup errors,thereby ensuring target coverage and treatment efficacy.

Objective:To analyze the incidence and spatiotemporal clustering of hepatitis B in China from 2006 to 2020 and provide reference for hepatitis B prevention and control.Methods:The incidence data of hepatitis B in 31 provinces (autonomous regions and municipalities) from 2006 to 2020 were collected from National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. The incidence trend analysis was conducted by using software Joinpoint 5.0.2, and the spatiotemporal scan analysis was performed by using software SaTScan 10.1.2.Results:From 2006 to 2020, a total of 1 049 546 cases of acute hepatitis B were reported in China. The average annual reported incidence rate was 5.17/100 000. The reported incidence rate showed a decreasing trend during this period. The incidence decreased from 3.00/100 000 to 0.41/100 000 in age group 0-14 years, from 14.15/100 000 to 3.44/100 000 in age group 15-34 years, and from 6.87/100 000 to 3.72/100 000 in age group ≥35 years, the differences were all significant (all P<0.001). From 2006 to 2020, a total of 10 732 017 cases of chronic hepatitis B were reported in China. The average annual reported incidence rate was 52.85/100 000. The reported incidence of chronic hepatitis B varied in different age groups, which decreased from 11.38/100 000 to 2.18/100 000 in age group 0-14 years, and from 73.17/100 000 to 61.40/100 000 in age group 15-34 years, while increased from 48.07/100 000 to 90.75/100 000 in age group ≥35 years, the differences were all significant (all P<0.05). Spatiotemporal scan analysis indicated that the age of reported acute hepatitis B cases became older over time, and the regions with high-incidence gradually shifted from western China to southwestern China. The overall reported incidence of chronic hepatitis B in those aged ≥35 years showed an upward trend, and the regions with high-incidence were mainly found in coastal area in southeastern China and in southwestern China. Conclusions:From 2006 to 2020, the overall reported incidence of acute hepatitis B in China showed a continuous downward trend, while the reported incidence of chronic hepatitis B in those aged ≥35 years showed an upward trend. It indicated that the need to improve the diagnosis and treatment of chronic hepatitis B in adults in coastal area in southeastern China and southwestern China.

Objective:To analyze the incidence and spatiotemporal clustering of hepatitis B in China from 2006 to 2020 and provide reference for hepatitis B prevention and control.Methods:The incidence data of hepatitis B in 31 provinces (autonomous regions and municipalities) from 2006 to 2020 were collected from National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. The incidence trend analysis was conducted by using software Joinpoint 5.0.2, and the spatiotemporal scan analysis was performed by using software SaTScan 10.1.2.Results:From 2006 to 2020, a total of 1 049 546 cases of acute hepatitis B were reported in China. The average annual reported incidence rate was 5.17/100 000. The reported incidence rate showed a decreasing trend during this period. The incidence decreased from 3.00/100 000 to 0.41/100 000 in age group 0-14 years, from 14.15/100 000 to 3.44/100 000 in age group 15-34 years, and from 6.87/100 000 to 3.72/100 000 in age group ≥35 years, the differences were all significant (all P<0.001). From 2006 to 2020, a total of 10 732 017 cases of chronic hepatitis B were reported in China. The average annual reported incidence rate was 52.85/100 000. The reported incidence of chronic hepatitis B varied in different age groups, which decreased from 11.38/100 000 to 2.18/100 000 in age group 0-14 years, and from 73.17/100 000 to 61.40/100 000 in age group 15-34 years, while increased from 48.07/100 000 to 90.75/100 000 in age group ≥35 years, the differences were all significant (all P<0.05). Spatiotemporal scan analysis indicated that the age of reported acute hepatitis B cases became older over time, and the regions with high-incidence gradually shifted from western China to southwestern China. The overall reported incidence of chronic hepatitis B in those aged ≥35 years showed an upward trend, and the regions with high-incidence were mainly found in coastal area in southeastern China and in southwestern China. Conclusions:From 2006 to 2020, the overall reported incidence of acute hepatitis B in China showed a continuous downward trend, while the reported incidence of chronic hepatitis B in those aged ≥35 years showed an upward trend. It indicated that the need to improve the diagnosis and treatment of chronic hepatitis B in adults in coastal area in southeastern China and southwestern China.

Objective By establishing a model to screen out patients with potentially large positional deviations based on their abdominal circumference,personalized solutions can be taken to address setup errors in these patients and ensure treatment efficacy.Methods A total of 81 patients treated at Tianjin People's Hospital from May 2021 to June 2023 were selected as the study subjects.The correlations between setup errors in the lateral,longitudinal,and vertical directions and abdominal circumference were analyzed.Subsequently,linear regression was performed for the direction with a significant correlation to abdominal circumference to establish a linear regression model.Finally,the 81 patients were divided into a normal setup group and an abnormal setup group with 0.7 cm as the critical value.A receiver operating characteristic(ROC)curve was plotted,and the maximum Youden index was calculated to determine the optimal cutoff value for identifying patients prone to abnormal setup.Results The correlation analysis of abdominal circumference and setup errors in various directions showed that the correlation coefficient between abdominal circumference and longitudinal direction positioning error was 0.406 2,and the correlation was statistically significant and positively correlated.The correlation coefficients for abdominal circumference and the lateral as well as longitudinal directions were-0.117 5 and-0.067 47,respectively,with P values greater than 0.05,indicating no statistical significance.A linear regression model was established for abdominal circumference and longitudinal direction,and the results showed an R2of 0.165,with a regression coefficient B of 0.008(t=3.951,P<0.01),indicating that the model was well constructed.ROC curve analysis showed an area under the curve of 0.715,with a 95%confidence interval of 0.57-0.86 and a maximum Youden index of 0.478.The corresponding optimal cutoff value was determined to be at 87 cm,with sensitivity at 0.875 and specificity at 0.603.Conclusion The abdominal circumference is significant to diagnose whether the longitudinal setup error is abnormal.Patients with an abdominal circumference greater than 87 cm are more likely to experience abnormal positioning during radiotherapy,which is reflected in the longitudinal setup errors being the largest.It is recommended to provide individualized target area margins for patients with an abdominal circumference greater than 87 cm,or perform daily cone-beam computed tomography to correct setup errors,thereby ensuring target coverage and treatment efficacy.

This study summarizes the application of automatic recognition technologies for patient-ventilator asynchrony(PVA)during mechanical ventilation.In the early stages,the method of setting rules and thresholds relied on manual interpretation of ventilator parameters and waveforms.While these methods were intuitive and easy to operate,they were relatively sensitive in threshold setting and rule selection and could not adapt well to minor changes in patient status.Subsequently,machine learning and deep learning technologies began to emerge and develop.These technologies automatically extract and learn data characteristics through algorithms,making PVA detection more robust and universal.Among them,logistic regression,support vector machines,random forest,hidden Markov models,convolutional autoencoders,long short-term memory networks,one-dimensional convolutional neural networks,etc.,have all been successfully used for PVA recognition.Despite the significant advancements in feature extraction through deep learning methods,their demand for labelled data is high,potentially consuming significant medical resources.Therefore,the combination of reinforcement learning and self-supervised learning may be a viable solution.In addition,most algorithm validations are based on a single dataset,so the need for cross-dataset validation in the future will be an important and challenging direction for development.

Abnormal activation of phosphoinositide 3-kinase (PI3K) pathway is one of the pathogenesis of malignant lymphoma. PI3K inhibitors are new targets for lymphoma treatment in recent years. At present, a variety of different types of PI3K inhibitors have been developed, some of which have been approved for clinical use, and some are still in clinical trials. PI3K inhibitors have multiple side effects. Improving safety and efficacy is an important direction for the future development of PI3K inhibitors.

Background: MicroRNA (miRNA) plays a crucial role in neuropathic pain (NP) by targeting mRNAs. This study aims to analyze the regulatory function and mechanism of miR-382-5p/dual specificity phosphatase-1 (DUSP1) axis in NP. Methods: We utilized rats with chronic constriction injury (CCI) of the sciatic nerve as the NP model. The levels of miR-382-5p and DUSP1 were reduced by intrathecal injection of lentiviral interference vectors targeting miR-382-5p and DUSP1. The mRNA levels of miR-382-5p and DUSP1 in the dorsal root ganglions (DRGs) were measured by RT-qPCR assay. The pain behavior was evaluated by mechanical nociceptive sensitivity and thermal nociceptive sensitivity. The expression levels of interleukin-6 (IL)-6, IL-1β, and tumor necrosis factor-α in the DRGs were analyzed by ELISA assay. The targeting relationship between miR-382-5p and DUSP1 was verified by DLR assay and RIP assay. Results: Compared to the Sham group, the CCI rats exhibited higher levels of miR-382-5p and lower levels of DUSP1. Overexpression of miR-382-5p significantly decreased DUSP1 levels. Reducing miR-382-5p levels can lower the mechanical nociceptive sensitivity and thermal nociceptive sensitivity of CCI rats and inhibit the over-activation of pro-inflammatory factors. Reduced miR-382-5p levels decreased NP in CCI rats. DUSP1 is the target of miR-382-5p, and down-regulation of DUSP1 reverses the inhibitory effect of reduced miR-382-5p levels on NP. Conclusions Down-regulation of miR-382-5p inhibits the over-activation of pro-inflammatory factors by targeting and regulating the expression of DUPS1, thereby alleviating NP.