ObjectiveTo characterize the quality differences among different germplasm and introduced varieties of Bupleurum scorzonerifolium roots（BSR）， and explore the underlying molecular mechanisms， providing a basis for high-quality production and quality control. MethodsWild BSR from Yulin（YLW） served as the quality reference， we conducted comparative analysis among YLW， locally domesticated wild germplasm in Yulin（YLC3）， Daqing germplasm introduced and cultivated in Yulin（YLDQC3）， and locally cultivated germplasm in Daqing（DQC3）. A combination of traditional pharmacognostic methods and modern multi-omics analyses was employed， including macroscopic traits（appearance， odor）， microscopic features（proportions of cork， phloem， xylem）， cell wall component contents（hemicellulose， cellulose， lignin）， carbohydrate contents（starch， water-soluble polysaccharides）， marker compound contents（ethanol-soluble extracts， total saponins， liposoluble extracts， and saikosaponins A， B₂， C， D）， metabolomics， and transcriptomics， in order to systematically characterize quality differences and investigate molecular mechanisms among these samples. ResultsMacroscopically， Yulin-produced BSR（YLW， YLC3， YLDQC3） exhibited significantly greater weight， length， and upper and middle diameters than Daqing-produced BSR（DQC3）. Odor-wise， YLW and YLC3 had a a fragrance taste， YLDQC3 had a rancid oil odor， and DQC3 had a sweet and fragrant taste. Microscopically， Yulin germplasm（YLW， YLC3） and Daqing germplasm（YLDQC3， DQC3） shared similar structural features， respectively. However， Yulin germplasm showed significantly higher proportions of cork and phloem， as well as stronger xylem vessel staining intensity compared to Daqing germplasm. Regarding various component contents， Yulin germplasm contained significantly higher levels of ethanol-soluble extracts， total saponins， and saikosaponins A， B₂， C， D， while Daqing germplasm had significantly higher levels of hemicellulose， starch， and liposoluble extracts. After introduction to Yulin， the Daqing germplasm（YLDQC3） showed increased starch， water-soluble polysaccharides and liposoluble extracts contents， decreased cell wall component content， but no significant difference in other component contents. Metabolomics revealed that saponins and terpenes accumulated significantly in Yulin germplasm， while alcohols and aldehydes accumulated predominantly in Daqing germplasm. Transcriptomics indicated similar gene expression patterns within the same germplasm but specificity between different germplasms. Integrative metabolomic-transcriptomic analysis identified 145 potential key genes associated with the saikosaponin biosynthesis pathway， including one acetyl-coenzyme A（CoA） acetyltransferase gene（ACAT）， one 3-hydroxy-3-methylglutaryl-coenzyme A synthase gene（HMGS）， two hydroxymethylglutaryl-CoA（HMG-CoA） reductase genes（HMG）， one phosphomevalonate kinase gene（PMK）， one 1-deoxy-D-xylose-5-phosphate synthase gene（CLA）， one hydroxymethylbuten-1-aldol synthase gene（HDR）， two farnesyl pyrophosphate synthase genes（FPPS）， one squalene synthase gene（SQS）， one β-amyrin synthase gene（BAS）， 102 cytochrome P450（CYP450） gene family members， and 32 uridine diphosphate-glucuronosyltransferase（UGT） gene family members. ConclusionAmong the three cultivated types， YLC3 most closely resembles YLW in appearance， microscopic features， contents of major bioactive constituents， metabolomic and transcriptomic profiles. Yulin germplasm exhibits superior saponin synthesis capability compared to Daqing germplasm， and Yulin region is more suitable for the growth of B. scorzonerifolium. Based on these findings， it is recommended that artificial cultivation in northern Shaanxi and similar regions utilize the local Yulin germplasm source cultivated for at least three years.

Objective: To analyze characteristics of hepatitis B infection in HBsAg-/HBV DNA+ blood donors in Taiyuan, so as to provide evidence for adjusting blood screening strategies. Methods: Blood samples of HBsAg-/HBV DNA+ donors were tested using enzyme-linked immunosorbent assay (ELISA), chemiluminescence assay, nucleic acid qualitative test, and nucleic acid quantitative test. Data on HBsAg-/HBV DNA+ donors in Taiyuan region from January 1, 2016 to December 31, 2024 were statistically analyzed to evaluate the detection rate, demographic characteristics, influencing factors of detection rate, nucleic acid quantitative results, and serological patterns of HBsAg-/HBV DNA+ donors. Results: From January 1, 2016 to December 31, 2024, 991 565 donor samples underwent nucleic acid testing in Taiyuan. A total of 309 HBsAg-/HBV DNA+ samples were detected, resulting in an HBsAg-/HBV DNA+ detection rate of 3.12 per 10 000. The detection rate varied significantly across different years (P<0.05). Males had a significantly higher HBsAg-/HBV DNA+ detection rate than females, first-time donors had a higher rate than repeat donors, and whole blood donors had a higher rate than apheresis donors (P<0.05). The detection rate also differed significantly among age groups (P<0.05). Logistic regression analysis showed that gender, age, donation frequency, and donation type were all influencing factors for HBsAg-/HBV DNA+ detection (all P<0.05). The predominant serological patterns among HBsAg-/HBV DNA+ donors were HBsAb+/HBcAb+ (43.69%, 135/309) or HBcAb+ alone (24.27%, 75/309). Viral load was detectable in 53.40% (165/309) of the HBsAg-/HBV DNA+ donors. Among these, 61.21% (101/165) donors had a viral load<20 IU/mL, and 94.55% (156/165) had a viral load<200 IU/mL. Donors with viral load<200 IU/mL primarily exhibited HBsAb+/HBcAb+ (41.67%, 65/156) or HBcAb+alone (36.54%, 57/156) serological patterns. Conclusion: The prevalence of HBsAg-/HBV DNA+ is low among blood donors in Taiyuan. Higher detection rates were observed in the 46-55 years age group, males, first-time donors, and whole blood donors. HBsAg-/HBV DNA+ donors exhibit specific serological patterns and generally have low viral loads, indicating a potential residual transfusion risk. It is recommended to add HBcAb testing, together with high-sensitivity nucleic acid testing technologies and donor follow-up, to ensure blood safety and guide donor reentry.

ObjectiveTo investigate the epidemiological and clinical characteristics of human bocavirus (HBoV) in hospitalized children with acute lower respiratory tract infection (ALRTI) at a single-center children’s hospital in Shanghai, thereby providing evidence for the diagnosis, treatment, and prevention of HBoV infection. MethodsA retrospective study was conducted on 19 537 hospitalized children with ALRTI at Shanghai Children’s Hospital from January 2021 to December 2023. Multiplex polymerase chain reaction (PCR) combined with capillary electrophoresis was used to detect HBoV and 12 other common respiratory viruses /atypical pathogens. The positive detection rate, demographic characteristics (sex, age), temporal distribution (year, season) of HBoV, as well as the clinical characteristics of severe and non-severe pneumonia were analyzed. ResultsThe overall HBoV-positive rate was 2.57% (503/19 537), with 59.44% (299/503) being single infections and 40.56% (204/503) being co-infections. The positive detection rate was significantly higher in boys than that in girls (2.78% vs 2.33%, χ²=3.88, P=0.049). The highest infection rate was observed in toddlers, followed by infants (χ²=379.57, P<0.001). The positive rate peaked in 2021 and reached its lowest point in 2023 (χ²=45.49, P<0.001), with epidemics mainly prevalent in summer and autumn. The main clinical symptoms were cough (90.06%, 453/503), fever (75.94%, 382/503), and wheezing (39.96%, 201/503). Children with severe pneumonia showed a higher incidence of wheezing compared with the non-severe group (P<0.001), while underlying diseases and co-infections had no significant association with disease severity (P>0.05). ConclusionHBoV was an important pathogen of ALRTI in children, predominantly affecting infants and toddlers, with higher susceptibility in boys and seasonal peaks in autumn and summer. The main clinical manifestations included cough, fever, and wheezing, with wheezing being more prevalent in children with severe pneumonia.

Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

Objective To systematically reconstruct the evolution of schistosomiasis prevalence in China from 1950 to 2024, so as to fill the gap of national data on schistosomiasis prevalence in China before 1986. Methods Schistosomiasis control data were collected from schistosomiasis-endemic areas of China before 1986, which mainly included statistical data on schistosomiasis, compilations of control records, annual work reports, and academic papers. Data pertaining to the prevalence of schistosomiasis from each province (autonomous region, municipality) were collected and summarized annually, and integrated into national annual work reports for schistosomiasis control in China from 1986 to 2024 to build a national schistosomiasis epidemic database covering schistosomiasis patients, cattle with schistosomiasis, and Oncomelania hupensis snails. The provincial-level epidemic data of schistosomiasis were summarized annually from 1986 to 2024 with pivot tables, and then the national epidemic data of schis tosomiasis were summarized. The temporal trends in key epidemic indicators of schistosomiasis were analyzed in China from 1950 to 2024. Results A complete time-series dataset of schistosomiasis was established in China from 1950 to 2024 through systematic reconstruction of multi-source historical documents and materials. A total of 1.97 million newly detected schistosomiasis cases were recorded in China from 1950 to 2024, and the actual number of schistosomiasis patients was all more than 1 million each year from 1955 to 1978. There were only more than 20 000 advanced schistosomiasis patients in China by the end of 2024, and the prevalence of Schistosoma japonicum human infections reduced from 34.6% in 1950 to below 1.0% after 1996. A total of 2.47 million cattle were tested positive for schistosomiasis, and the prevalence of S. japonicum infections reduced from 21.4% in bovines since 1950. The area of emerging O. hupensis snail habitats was concentrated during the period between 1956 and 1958, accounting for 49.8% of total areas, while the area of emerging O. hupensis snail habitats significantly decreased since 1992, indicating a stable distribution pattern of O. hupensis snails. Data validation results showed that the cumulative variation in areas of O. hupensis snail habitats was 1.6%, and the cumulative variation in the number of schistosomiasis cases was 1.4%. Join-point regression analysis revealed four turning points in the prevalence of S. japonicum infections in humans and seven turning points in the prevalence of S. japonicum infections in livestock across China from 1955 to 2024. Conclusions Through the joint efforts of the Communist Party of China and government leadership, interdepartmental collaboration, professional teams, scientific and technological innovation, and public participation, the schistosomiasis epidemic has been effectively controlled in China following active control for more than 70 years. This study builds, for the first time, a complete time-series dataset on schistosomiasis in China, which provides insights into assessment of the effectiveness of schistosomiasis control programmes and refinement of the experience from schistosomiasis control programmes in China.

ObjectiveTo systematically compare the effects of diverse electromagnetic stimulation protocols on hand function and activities of daily living (ADL) in stroke patients using network meta-analysis (NMA), and screen the optimal stimulation strategy for post-stroke hand dysfunction rehabilitation. MethodsNMA was performed in accordance with the PRISMA-NMA statement. Databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science and Embase were searched from database inception to April, 2026 for eligible randomized controlled trials (RCTs) comparing different electromagnetic stimulation protocols for post-stroke hand impairment. The Cochrane Risk of Bias tool and PEDro scale were used to assess methodological quality of included studies, while the GRADE system was adopted to grade evidence quality of primary outcomes of Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI). After literature screening, data extraction and bias evaluation, RevMan 5.4 and Stata 17.0 were used for meta-analysis and NMA. ResultsA total of 22 RCT involving 17 electromagnetic stimulation protocols were finally included. The PEDro scores ranged from six to ten. The top five protocols for improving FMA-UE score were repetitive peripheral magnetic stimulation (rPMS) + repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS) + rPMS, iTBS + transcranial direct current stimulation (tDCS), transcutaneous electrical acupoint stimulation (TEAS) and contralaterally controlled functional electrical stimulation (CCFES). tDCS was the most effective on MBI, followed by TEAS and iTBS+rPMS. Evidence quality for FMA-UE and MBI was moderate. Funnel plots suggested low risk of publication bias, and consistency tests verified good coherence between direct and indirect comparisons in network models. ConclusionElectromagnetic stimulation significantly facilitates upper limb and hand functional recovery, and improves ADL in stroke patients. The combined central-peripheral magnetic stimulation protocol may be the most effective on motor rehabilitation, whereas tDCS on ADL.

Objective To explore the risk factors for postoperative pneumonia (POP) following esophagectomy for esophageal cancer, and to identify potential clinical indicators for predicting POP. Methods A retrospective analysis was conducted on the clinical data of patients with esophageal cancer who underwent esophagectomy at the Department of Thoracic Surgery, West China Hospital of Sichuan University from 2017 to 2021. Perioperative clinical indicators were collected to analyze the risk factors for the occurrence of POP. Patients were divided into a POP group and a non-POP group according to whether POP occurred. Results A total of 613 patients with esophageal cancer were included, comprising 472 males and 141 females, with a median age of 62.0 (53.0, 67.0) years. Among them, 51 patients were in the POP group, and 562 patients were in the non-POP group. Multivariate logistic regression analysis showed that the forced expiratory volume in 1 second percentage of predicted (FEV1%) [OR=0.958, 95%CI (0.943, 0.973), P<0.001], systemic immune-inflammation index (SII) [OR=1.001, 95%CI (1.000, 1.002), P=0.007], and prognostic nutritional index (PNI) [OR=0.869, 95% CI (0.813, 0.928), P<0.001] were independent risk factors for POP. Receiver operating characteristic (ROC) curve analysis combining FEV1%, SII, and PNI demonstrated that the area under the curve (AUC) for predicting POP was 0.826 [95%CI (0.793, 0.855), cut-off value: 0.08, sensitivity: 80.3%, specificity: 72.4%, Youden index: 0.528, P<0.001]. Cross-validation confirmed that the combined indicators had the highest predictive efficacy, which was significantly superior to that of any single indicator alone. Conclusion Preoperative levels of FEV1%, SII, and PNI are closely associated with the occurrence of POP following surgery for esophageal cancer. The combined application of FEV1%, SII, and PNI demonstrates good predictive efficacy for the occurrence of POP.

Objective To investigate the epidemiological characteristics, influencing factors, and community dietary network drivers of clonorchiasis in Longjiang Village, Congjiang County, Guizhou Province using social network analysis from a One Health perspective, so as to provide insights into implementation of precision control measures. Methods Longjiang Village, Congjiang County, Guizhou Province was selected as a survey point. A total of 128 permanent residents at ages of over 6 years were sampled using a random sampling method, and subjects’ stool samples were collected. In addition, at least 10 fecal samples were collected from domestic cats and dogs, reservoir hosts of Clonorchis sinensis, and at least 80 freshwater snails and at least 200 freshwater fish, intermediate hosts of C. sinensis, were sampled in Longjiang Village. C. sinensis eggs were detected in human, domestic cat and domestic dog fecal samples using a modified Kato-Katz thick smear method (two slides for one stool sample) . The C. sinensis metacercariae were detected in freshwater fish with a compression method and the C. sinensis cercariae were detected in freshwater snails with a cercarial shedding method, respectively. Participants’ demographic characteristics, dietary and drinking hygiene behaviors and food-sharing relationships were collected with structured questionnaires and semi-structured in-depth interviews, and factors affecting C. sinensis infection were identified using regression analysis. Based on the north-south orientation delineated by the village river, participants were divided into groups a and b. Subjects’ food-sharing network was analyzed using social network analysis, and the Louvain algorithm was employed to investigate the community structure and key nodes of the network. Results The overall prevalence of C. sinensis infection was 33.59% (43/128) among participants in Longjiang Village, Congjiang County, Guizhou Province. The detection of C. sinensis metacercariae was 7.63% (22/288) in freshwater fish, and no C. sinensis cercariae were detected in freshwater snails. The prevalence of C. sinensis infection was 7.69% (1/13) in domestic cats, and no infection was detected in domestic dogs. Regression analysis identified age groups of 25 to 45 years [adjusted odds ratio (AOR) = 23.17, 95% confidence interval (CI): (1.85, 490.29)], Dong ethnicity [AOR = 26.80, 95% CI: (1.54, 1 105.09)], frequent consumption of raw water [AOR = 9.39, 95% CI: (1.58, 99.79)], and consumption of raw fish [AOR = 3.49, 95% CI: (1.52, 34.69)] as independent risk factors for C. sinensis infection among villagers in Longjiang Village (all P values < 0.05). Social network analysis showed a significantly higher global clustering coefficient (0.52 vs. 0.16; t = 2.41, P = 0.02) and average local clustering coefficient (0.52 vs. 0.16; t = 2.41, P = 0.02) in Group b than in Group a, and a significantly higher degree centrality was found among C. sinensis-infected individuals than among uninfected individuals in Group b (17.54 vs. 4.26; t = 2.33, P = 0.02). There was a high-risk community S11 with a 45.83% prevalence rate of C. sinensis infection in Group b, and C. sinensis-infected individuals with high betweenness centrality in Group b might serve as critical “bridges” in the food-sharing network, which facilitated the aggregation and diffusion of the risk of C. sinensis infection in the community. Conclusions Individual dietary behaviors, such as drinking raw water and consuming raw or undercooked fish, and sociocultural factors of household-neighborhood food-sharing networks, may contribute to the clustering transmission of clonorchiasis in Longjiang Village. The clonorchiasis control strategy is recommended to shift from individual-centered health education towards integrated interventions under a One Health framework in this region, which focus on key individuals within social networks, strengthen coordinated water and environmental management, and enhance community participation to improve the acceptability and sustainability of interventions.

ObjectiveTo evaluate the comparative clinical outcomes of zero-profile interbody fusion （Zero-P） and traditional anterior cervical discectomy and fusion with titanium plate （ACDF-plate） for three-level cervical spondylosis， providing a reference to optimize surgical strategies for three-level cervical spondylosis. MethodsIn this retrospective comparative study， 113 patients were included and assigned to either the Zero-P group （n=51） or the ACDF-plate group （n=62） according to their surgical approaches. Clinical outcomes were evaluated and compared between the two groups using operative time， intraoperative blood loss， length of hospital stay， visual analog scale （VAS） scores， cervical range of motion （ROM）， neck disability index （NDI）， Cervical Disability Index （CDI）， Japanese orthopaedic association （JOA） scores， and postoperative complication rates. ResultsCompared with the ACDF-plate group， the Zero-P group had a shorter operative time and less intraoperative blood loss （P<0.05）； the neck pain VAS score was lower on the 1st day and 1st week after surgery （P<0.05）； the cervical flexion range of motion was higher at 1 month after surgery （P<0.05）； the JOA score was higher at 3 months after surgery， while the NDI and CDI scores were lower （P<0.05）； the total incidence of complications （11.76%） was significantly lower than that in the plate fixation group （35.48%）， and the incidence of neck foreign body sensation/stiffness was lower （P<0.05）. ConclusionZero-P not only demonstrates safety and efficacy comparable to the ACDF-plate， but also highlights the significant value of the minimally invasive concept in facilitating early recovery. Both procedures have their respective emphasis on biomechanical maintenance and minimally invasive benefits， providing a clear evidence-based reference for individualized and precise surgical decision-making in three-level cervical spondylosis.

Objective: To evaluate the effect of repeated testing combined with cross-validation using different principles of NAT systems on improving the detection rate of occult HBV infection (OBI) in HBsAg-negative/NDR samples. Methods: A total of 89 NDR samples from the Taiyuan Blood Center between August 2024 and May 2025 were enrolled. All samples were tested for HBsAg by ELISA and subjected to NAT screening using the Roche system (PCR method). For all HBsAgnegative, MPNAT+/IDNAT (NDR) samples, further crossvalidation was performed using repeat IDNAT with the Roche system and the Grifols system (TMAbased) dHBV discriminatory assay; in addition, HBV serological markers were detected, and the results were confirmed by realtime quantitative PCR and nested PCR with sequencing genotyping. The NAT yield/window period ratio model was used to estimate the residual risk of HBV transfusion for the Roche single system in actual use, and the theoretical residual risk was calculated by assuming that the Grifols system was applied to individual screening of all blood donors. Results: The detection rate of HBsAg-negative/NDR was 0.99‰ (89/90 115), consistent with the national average. Among the 89 NDR samples, 4 were confirmed as HBV DNA-positive by nested PCR (viral load 15 - 20 IU/mL), including 3 of genotype C1 and 1 of genotype B2. Serological analysis showed that the anti-HBc positivity rate in NDR samples was 24.7% (22/89); all 4 OBI samples were antiHBcpositive (18.2%) and none were antiHB-spositive. In the single-NAT system, the residual risk for first-time donors (RR_FD) was 48.98/10 person-years for the Roche system and 21.01/10 person-years for the Grifols system, both higher than the corresponding residual risk for repeat donors (RR_RD: 15.23/10 and 9.80/10 person-years, respectively), but the differences showed no statistical significance (P>0.05). Conclusion: Implementing repeated testing combined with cross-validation using different principles of NAT systems can effectively increase the detection rate of low-viral-load OBI and reduce the risk of missed detection.