Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

Autism spectrum disorder(ASD)is a neurodevelopmental disorder starting from early childhood.At present,the age of diagnosis for ASD in children is significantly delayed,typically occurring after two years of age,although behavioral signs or prodromal symptoms can emerge before the age of 12 months.These early indicators gradually evolve into the core symptoms of ASD.It has been well recognized that early screening and intervention can maximally improve its prognosis and promote optimal development of the affected children.Therefore,there has been increasing emphasis on preemptive screening and intervention for prodromal symptoms of ASD before the age of 12 months in clinical practice and research,so as to reduce the symptoms to a normal state to some extent.However,during the prodromal period of ASD,especially before the age of one,preemptive screening and intervention present many challenges.Preemptive screening faces obstacles such as significant individual differences in infant growth and development,incomplete presentation of ASD symptoms,and differing assessment content and criteria;preemptive intervention must overcome challenges like the diversity of screening tools and varying factors of parents.As a result,few research has been conducted in this field.This review mainly introduces preemptive screening tools and intervention techniques for children with ASD in the first year of life,including the intervention used in the British Autism Study of Infant Siblings-video interaction for promoting positive parenting(iBASIS-VIPP),the promoting first relationships,the environmental enrichment for infants,parenting with acceptance and commitment therapy(ENACT),and the adapted response teaching.The application of neuroimaging technology and artificial intelligence technology is also explained to provide reference for relevant research and clinical practice.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

Autism spectrum disorder(ASD)is a neurodevelopmental disorder starting from early childhood.At present,the age of diagnosis for ASD in children is significantly delayed,typically occurring after two years of age,although behavioral signs or prodromal symptoms can emerge before the age of 12 months.These early indicators gradually evolve into the core symptoms of ASD.It has been well recognized that early screening and intervention can maximally improve its prognosis and promote optimal development of the affected children.Therefore,there has been increasing emphasis on preemptive screening and intervention for prodromal symptoms of ASD before the age of 12 months in clinical practice and research,so as to reduce the symptoms to a normal state to some extent.However,during the prodromal period of ASD,especially before the age of one,preemptive screening and intervention present many challenges.Preemptive screening faces obstacles such as significant individual differences in infant growth and development,incomplete presentation of ASD symptoms,and differing assessment content and criteria;preemptive intervention must overcome challenges like the diversity of screening tools and varying factors of parents.As a result,few research has been conducted in this field.This review mainly introduces preemptive screening tools and intervention techniques for children with ASD in the first year of life,including the intervention used in the British Autism Study of Infant Siblings-video interaction for promoting positive parenting(iBASIS-VIPP),the promoting first relationships,the environmental enrichment for infants,parenting with acceptance and commitment therapy(ENACT),and the adapted response teaching.The application of neuroimaging technology and artificial intelligence technology is also explained to provide reference for relevant research and clinical practice.

ObjectiveTo analyze the detected results of CD4⁺T lymphocytes and viral load in newly identified human immunodeficiency virus (HIV) infected patients in Huangpu District of Shanghai in 2023, to explore the correlation between them, so as to provide a scientific basis for the development of targeted prevention and control measures and antiviral treatment programs. MethodsThe data of CD4 cell count, viral load and demographic characteristics of the newly infected patients living with HIV in Huangpu District, Shanghai in 2023 were collected and analyzed by using descriptive epidemiological method. ResultsThe mean CD4 cell count of the 67 newly identified HIV infected patients in Huangpu District was (301.22±235.19) cells·µL^-1, with a mean viral load of (5.15±1.28) ×10⁵ copies·mL^-1.There were statistically significant differences in CD4 cell count and viral load among different age groups (P<0.05), but there were no statistically significant differences by gender and marital status (both P>0.05). The CD4 cell count and CD4/CD8 ratio both were negatively correlated with the lg value of viral load (r=-0.290, -0.378; P=0.027, 0.002). ConclusionThe CD4 cell counts of the newly identified HIV infected patients in Huangpu District in 2023 were generally low, the proportion of patients with high viral load was high, but the risk for elderly infected with HIV was high. The elderly have gradually become the key population for AIDS prevention and control in Huangpu District. It is recommended to expand HIV screening in the elderly to reduce the risk of HIV transmission and increase the rate of early detection and treatment.

To examine the evolution of surgical techniques and trends in overall inpatient burden for pediatric adenoidectomy in Beijing tertiary hospitals from 2013 to 2022. A retrospective observational study was conducted using the regional health information platform of Beijing. Data from children aged ≤14 years who underwent adenoidectomy between 2013 and 2022 were extracted, including total hospitalization cost, length of stay(LOS), surgical material cost, surgical fee, operative technique, perioperative antimicrobial drugs cost, coagulation factor cost, and blood transfusion cost. The Mann-Kendall trend test was used to assess temporal changes in total hospitalization expenses and the structure of cost components. The results showed that over the 10-year period from 2013 to 2022, a total of 25 989 children underwent adenoidectomy in tertiary hospitals. The proportion of children aged ≤6 years increased from 59.83% to 76.11%, showing a significant upward trend ( Z=2.15, P=0.032). Only one case required surgical hemostasis due to postoperative bleeding. During the ten-year period, the median hospitalization cost for adenoidectomy in tertiary hospitals was ￥12 425.82 (￥11 307.43, ￥14 955.42).Overall hospitalization cost demonstrated a fluctuating downward pattern, decreasing from ￥15 229.73 in 2013 to ￥13 927.52 in 2022, this declining trend was not statistically significant( Z=-0.54, P=0.592). In contrast, the surgical costs showed an upward trend over the decade increasing from ￥1 856.22 in 2013 to ￥3 726.45 in 2022, which was statistically significant ( Z=3.22, P=0.001), while the cost of surgical materials showed no significant increase ( Z=1.79, P=0.074).Concurrently, the average LOS decreased remarkably from 10.56 days in 2013 to 3.26 days in 2022 ( Z=-3.94, P<0.001). The cost of perioperative antimicrobial drugs decreased ( Z=-3.94, P<0.001), while the cost of coagulation factors and blood transfusion remained unchanged ( Z=0.54, P=0.592; Z=0.56, P=0.578). Comparison between 2013-2017 and 2018-2022 showed a significant increase in the use of coblation from 28.9% to 42.5% ( χ2=638.7, P<0.001).Furthermore, in the coblation group, total hospitalization cost decreased by 27.73%, surgical cost increased by 94.98%, surgical material cost decreased by 10.33%, LOS shortened by 56.24%, and antimicrobial drug cost increased by 43.03%. In contrast, the non-coblation group showed a 23.94% increase in total hospitalization cost, a 57.08% increase in surgical procedure cost, a 33.88% increase in material cost, and a 30.14% reduction in LOS and a 26.0% decrease in antimicrobial drugs cost. In conclusion,from 2013 to 2022, total hospitalization cost for pediatric adenoidectomy in Beijing tertiary hospitals remained stable. Compared to non-coblation techniques, coblation was associated with a shorter LOS, lower total costs, a higher proportion of surgical fees, and a decreased proportion of material costs, without a significant increase in overall healthcare costs.

This study aims to compare the vaccination rates and incidence of adverse reaction rates following administration of two domestically produced human papillomavirus (HPV) vaccines in individuals aged 9-30 years,investigate the impact of distinct manufacturing processes and vaccination schedules on adverse reaction rates. From November 2023 to June 2024, the Immunization Planning Department of Liuzhou Center for Disease Control and Prevention conducted a single-center, randomized, open-label, parallel-group trial using community-based recruitment of eligible participants aged 9 to 30 years. Participants were randomly assigned to receive either of two domestically produced HPV vaccines (Walrinvax or Cecolin). As specified in the vaccine package inserts, subjects were stratified into a two-dose regimen group (aged 9-14 years) and a three-dose regimen group (aged 15-30 years). Vaccination rates were recorded, and adverse reactions within 0-30 days post-vaccination were monitored. The results showed that a total of 400 participants were enrolled. Both the full vaccination rate and the timely completion rate were significantly higher in the two-dose regimen group compared to the three-dose regimen group (Fisher′s exact test, P<0.01; χ2=7.06, P<0.01). A total of 985 doses were administered. The overall adverse reaction rate was 18.78% (185/985), with local and systemic reactions occurring at 8.02% (79/985) and 10.76% (106/985), respectively. The most frequent adverse reactions were injection site pain (4.97%, 49/985) and fever (4.47%, 44/985). No grade 4 or special-interest adverse events were reported.The incidence of adverse reactions for the two domestic HPV vaccines with different production processes (at 0/6 months) was 13.96% (55/394) and 17.46% (69/395) respectively, with no statistically significant difference (χ2=1.83, P>0.05).The adverse reaction rate was significantly lower in the 9-14 years group (9.77%) compared the 15-30 years group (24.91%)(χ 2=35.67, P<0.01). In conclusion, both domestic HPV vaccines demonstrated a favorable safety profile in the 9-30 years age group, with mostly mild adverse reactions. Compared to the three-dose schedule (15-30 years group), the two-dose HPV vaccination schedule (9-14 years group) significantly reduced the incidence of adverse reactions and improved vaccination compliance.

Objective:To investigate the dynamic changes of cellular miRNA expression profiles in EBV latently infected Raji cells upon reactivation with Phorbol ester (TPA).Methods:Total RNA was extracted using TRIzol reagent from Raji cells treated with TPA at different time points (0 h, 24 h, 48 h). Small RNA libraries were constructed and sequenced on an Illumina SE50 platform. Differentially expressed miRNAs were identified, and their target genes were predicted and functionally annotated. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were carried out through online tools. Additionally, miRanda and RNAhybrid software were used to predict cellular miRNAs targeting the EBV genome. Real-time RT-qPCR was employed to validate the expression levels of differentially expressed novel miRNAs.Results:High-throughput sequencing identified 1 301 celluar miRNAs, comprising 1 189 known and 112 novel miRNAs. A total of 264 known differentially expressed cellular miRNAs and 13 novel miRNAs were identified through high-throughput miRNA sequencing. Secondary structure prediction revealed that the novel miRNAs exhibited typical pre-miRNA hairpin structures. Stem-loop quantitative real-time PCR (RT-qPCR) validation of Novel_miR_183 and Novel_miR_242 did not exhibit a statistically significant difference ( F=1.407, P=0.370 7 for Novel_miR_183; F=1.277, P=0.397 0 for Novel_miR_242) between the TPA-stimulated and untreated groups. Target gene prediction analysis revealed that the differentially expressed cellular miRNAs were involved in various important biological processes and signaling pathways. Furthermore, 1 189 known cellular miRNAs and 108 novel miRNAs were predicted to target the EBV genome. Conclusions:Treatment of Raji cells with TPA stimulation successfully reactivated Raji cells and significantly altered their miRNA expression patterns. Differentially expressed miRNAs were identified, suggesting that these miRNAs probably play crucial roles in regulating EBV infection and replication by directly targeting the EBV genome.

Objective:To investigate the effect of nuclear factor erythroid-2 related factor (Nrf2) overexpression on high-risk human papillomavirus type 16 (HPV16) E6 protein.Methods:The pRK5-FLAG-NFE2L2 plasmid was constructed, and pRK5-FLAG-NFE2L2 and pRK5-HA-HPV16E6 plasmids were co-transfected in HEK293T cells, and the expression of the two proteins was detected by Western blotting (WB). Next, pRK5-HA-HPV16E6 and pRK5-FLAG-Nrf2 plasmids were expressed using an in vitro transcription system to observe the expression of both. Finally, pEGFP-HPV16E6 and pLVX-mCherry-Nrf2 plasmids were co-transfected in HEK293T cells, and the cellular localization of the E6 protein and the Nrf2 protein was observed using fluorescence microscopy.Results:Nrf2 protein was successfully overexpressed in HEK293T cells, and the WB result showed that Nrf2 inhibited HPV16 E6 protein expression in a significant dose-dependent manner. The expression of HPV16 E6 protein in the TNT Quick Coupled Transcription/Translation Systems was affected by Nrf2, while the expression of HPV16 E6 in TnT SP6 High-Yield Wheat Germ Protein Expression System was no longer inhibited by Nrf2. Fluorescence imaging further showed no intracellular co-localization of Nrf2 and HPV16 E6.Conclusions:Overexpression of the nuclear transcription factor Nrf2 reduces HPV16 E6 protein expression, but there is no intracellular co-localization of them.

Objective To explore the relationship between systemic immune-inflammation index(SII),red blood cell distribution width(RDW),25-hydroxy-vitamin-D[25(OH)D]levels and frailty index in elderly pa-tients with type 2 diabetes mellitus(T2DM).Methods A total of 197 elderly patients with T2DM admitted to the hospital from March 2023 to March 2024 were collected as the research subjects.The patients were divided into the frailty group(106 cases)and the non-frailty group(91 cases)according to the scores of the clinical frailty scale.The clinical data and the levels of SII,RDW and 25(OH)D of the two groups were compared.Pearson correlation analysis was used to analyze the correlations between the levels of SII,RDW and 25(OH)D and the frailty index of elderly patients with T2DM.Logistic regression was used to analyze the influencing factors of frailty in elderly patients with T2DM.Results Compared with the non-frailty group,the proportion of women,the history of falls within 1 year,and the age of the frailty group increased,while the body mass in-dex and the proportion of men decreased,and the differences were statistically significant(P＜0.05).The SII and RDW levels in the non-frailty group were lower than those in the frailty group,and the 25(OH)D level was higher than that in the frailty group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that SII and RDW levels were positively correlated with frailty index,and 25(OH)D level was negatively correlated with frailty index in elderly T2DM patients(P＜0.05).Logistic regression analysis showed that female,age ≥ 74.25 years old,SII≥ 938.36,RDW≥ 15.19％,and 25(OH)D≥48.42 nmol/L were independent risk factors for frailty in elderly T2DM patients(P＜0.05).Conclusion The levels of SII,RDW and 25(OH)D in elderly patients with T2DM are related to the frailty index.