Objective:To analyze the efficacy of combination of peginterferon α-2b（Peg-IFN α-2b）with nucleos（t）ide analogues（NAs）on antiviral therapy in children with chronic hepatitis B（CHB）and to provide an optimized clinical treatment strategies for CHB children.Methods:A retrospective analysis was conducted on 30 CHB children treated in The First Affiliated Hospital of the Army Medical University（Southwest Hospital）from January 2022 to January 2025 with treatment duration at least 48 weeks. The enrolled children were aged between 2 and 17 years and divided into the NAs combined with Peg-IFN α-2b（NPI）group（n=13）and NAs group（n=17）by their therapy regimens. The characteristics of baseline，week 12，week 24，week 48 and week 96 were compared between groups，as well as the differences in response to biochemical，immune and viral indicators at each observation point. Logistic regression analysis and receiver operating characteristic（ROC）curve analysis were performed to identify factors influencing the HBsAg seroclearance. Results:At baseline of treatment，the proportion of HBeAg positivity in the NPI group and the NAs group was high（76.9% vs 86.6%， χ2=0.679， P=0.628），and the alanine aminotransferase（ALT）and aspartate aminotransferase（AST）in the NPI group were significantly lower than those in the NAs group（ P<0.001）. At 24 weeks，the decrease in HBsAg in the NPI group was also significantly higher than that in the NAs group（ Z=-3.161， P=0.002）. Finally，the cumulative seroclearance rate of HBsAg at 96 weeks in the NPI group was significantly higher than that in the NAs group（46.15% vs 5.88%， χ2=0.679， P=0.025）. Mulitivariate Logistic regression analysis showed that treatment regimen and gender were risk factors affecting the outcome of HBsAg（ P<0.05）. ROC curve analysis showed that the increase in ALT at 12 weeks compared with baseline（AUC=0.857，Cutoff value=3.615 IU/L），the decrease in ALT at 24 weeks（AUC=0.870，Cutoff value=47.85 IU/L），and the decrease in HBsAg at 12 weeks and especially at 24 weeks（AUC=0.885，Cutoff value=0.97log IU/ml）were effective predictors of HBsAg prognosis at 96 weeks. Conclusion:In CHB children，antiviral regimen Peg-IFN α-2b combined with NAs was more effective than NAs alone in improving the HBsAg seroclearance rate of CHB，and the effects in female were better than in male. The decline of HBsAg and the fluctuation of ALT in the early treatment period are valid predictors of HBsAg clearance.

Objective:To analyze the efficacy of combination of peginterferon α-2b（Peg-IFN α-2b）with nucleos（t）ide analogues（NAs）on antiviral therapy in children with chronic hepatitis B（CHB）and to provide an optimized clinical treatment strategies for CHB children.Methods:A retrospective analysis was conducted on 30 CHB children treated in The First Affiliated Hospital of the Army Medical University（Southwest Hospital）from January 2022 to January 2025 with treatment duration at least 48 weeks. The enrolled children were aged between 2 and 17 years and divided into the NAs combined with Peg-IFN α-2b（NPI）group（n=13）and NAs group（n=17）by their therapy regimens. The characteristics of baseline，week 12，week 24，week 48 and week 96 were compared between groups，as well as the differences in response to biochemical，immune and viral indicators at each observation point. Logistic regression analysis and receiver operating characteristic（ROC）curve analysis were performed to identify factors influencing the HBsAg seroclearance. Results:At baseline of treatment，the proportion of HBeAg positivity in the NPI group and the NAs group was high（76.9% vs 86.6%， χ2=0.679， P=0.628），and the alanine aminotransferase（ALT）and aspartate aminotransferase（AST）in the NPI group were significantly lower than those in the NAs group（ P<0.001）. At 24 weeks，the decrease in HBsAg in the NPI group was also significantly higher than that in the NAs group（ Z=-3.161， P=0.002）. Finally，the cumulative seroclearance rate of HBsAg at 96 weeks in the NPI group was significantly higher than that in the NAs group（46.15% vs 5.88%， χ2=0.679， P=0.025）. Mulitivariate Logistic regression analysis showed that treatment regimen and gender were risk factors affecting the outcome of HBsAg（ P<0.05）. ROC curve analysis showed that the increase in ALT at 12 weeks compared with baseline（AUC=0.857，Cutoff value=3.615 IU/L），the decrease in ALT at 24 weeks（AUC=0.870，Cutoff value=47.85 IU/L），and the decrease in HBsAg at 12 weeks and especially at 24 weeks（AUC=0.885，Cutoff value=0.97log IU/ml）were effective predictors of HBsAg prognosis at 96 weeks. Conclusion:In CHB children，antiviral regimen Peg-IFN α-2b combined with NAs was more effective than NAs alone in improving the HBsAg seroclearance rate of CHB，and the effects in female were better than in male. The decline of HBsAg and the fluctuation of ALT in the early treatment period are valid predictors of HBsAg clearance.

The transcription factors (TFs) in the NAC family are involved in regulating multiple biological processes, playing an important role in plant growth, development, and stress adaptation. Our previous studies have demonstrated that TaNAC14, a member of the NAC family in wheat (Triticum aestivum L.), positively regulates root growth and development and enhances the drought tolerance of wheat seedlings. In this study, we analyzed the physicochemical properties and structure and verified the subcellular localization and transcriptional activation activity of TaNAC14. The prokaryotic expression vector pET21a-HMT-TaNAC14 was constructed and transformed into Escherichia coli BL21 CodonPlus (DE3)-RIPL. The conditions for inducing the expression of the recombinant protein HMT-TaNAC14 were optimized. The solubility of the recombinant protein was analyzed, and the protein was purified by affinity chromatography on a Ni-nitrilotriacetic acid column. The results indicated that TaNAC14 had a conserved domain of the NAM family. It was located in the nucleus and had transcriptional activation activity. The optimal conditions for expression of the recombinant protein in E. coli were induction with 0.2mmol/L IPTG for 4 h. The recombinant protein mainly existed in the soluble form, and the target protein was obtained after purification. This study lays a foundation for the identification of target genes regulated by TaNAC14.
Triticum/metabolism* ; Escherichia coli/metabolism* ; Plant Proteins/metabolism* ; Transcription Factors/metabolism* ; Recombinant Proteins/metabolism* ; Genetic Vectors/genetics*

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

【Objective】 To understand the structural characteristics of lapsed apheresis donors in our blood center and provide guidance for further improving recruitment and retention strategies by retrospectively analyzing the characteristics of lapsed apheresis donors in our center in recent years. 【Methods】 The apheresis donation and lapsed apheresis donors in Zhejiang Blood Center from 2016 to 2020 were statistically analyzed, and the general information of lapsed donors, including gender, blood type, age, education level and occupation composition, were compared and analyzed. The lapse of novel and long-term donors with different frequency were retrospectively analyzed. The SPSS 19.0 statistical software package was used for data analysis. 【Results】 In 2020, the total lapse of apheresis donors decreased by 16.6% as compared with 2016(P<0.05). The lapse rate of donors with blood groups A, B, O and AB was 1∶1∶1∶1, higher in female donors(59.0%) than males(50.0%), and dominated by age group of 18-35(66.3%). With the increase of age, the lapse rate decreased. Donors lapsed were mainly with college or above educational background(60.8%), with high proportion in students and the staff. In 2020, the lapse of novel apheresis donors decreased by 34.1% as compared with 2016, but the average lapse rate of novel apheresis donors was still as high as 70.5%. The average lapse rate of blood donors with different frequency was 52.5%, and the lapse rate decreased significantly with the increase of apheresis donation frequency. The average lapse rate of novel blood donors with whole blood donation experience was lower than those without (56.1% vs 82.9%). 【Conclusion】 Multiple measures for recruitment and retention have effectively reduced the lapse of apheresis donors. However, apheresis donors who are 18-35 years old, with college degree or above, students and staff were the main groups from lapsing. In addition, low-frequency and novel apheresis donors without whole blood donation experience were more likely to be lapsing. Targeted and personalized blood donation services should be further provided, and the management of " full cycle of blood donation" should be strengthened to reduce the lapsing, so as to retain more blood donors.

Objective:To investigate the evaluation of disease perception, treatment compliance and community follow-up services of community schizophrenia patients, family members and personnel in Shantou City, and to provide a reference basis for improving the quality of management treatment.Methods:With the method of stratified sampling qualitative research, a community sample of 17 198 patients with schizophrenia in seven districts or county in Shantou City were sampled from February to August 2019, with 2 towns being drawn from each district or county, and 10 patients, 10 family members and 3 personnel were selected in each town. The evaluation of disease perception, treatment compliance and community follow-up services were investigated and analyzed. Respondents were eventually included in 137 patients, 138 family members and 41 personnel.The interviewees were conducted with semi-structured interviews, the data were collected according to traditional methods, and the descriptive statistical analysis was carried out with SPSS 12.0.Results:(1)34.3% of patients and 32.6% of the family members were not fully aware of the disease.22.6% of the patients and 23.2% of the family members had a sense of ill shame. (2)26.3% of patients did not comply with treatment, 29.9% of patients had not insight, 53.3% of patients and 24.6% of family members on the side effects of drugs and addiction understood improperly, and, 35.0% of patients and 13.0% of the family had a misunderstanding of illness and using drugs. (3)29.2% of patients and 31.2% of their families were tired of taking long-term medication, 24.8% of patients and 21.0% of their families felt socially isolated, and, 17.5% felt unsupported and 18.8% of their families admitted that they did not care enough about patients. (4)31.4% of patients did not actively receive follow-up services, 37.2% of patients and 20.3% of family members did not cooperate with follow-up doctors, and, 21.2% of patients and 10.1% of family members were not satisfied with follow-up services. (5)The personnel of psychiatric care could basically grasp the conditions of patients in the jurisdiction and carried out follow-up services on a regular basis (90.2%), master emergency disposal methods (92.7%), and have carried out training (97.6%). However, the psychiatric practice of the personnel were lower than (58.5%) and most lying part-time (78.0%), the average length of service was 5.7±1.4 years. The personnel satisfaction with the community follow-up service was higher (95.1%), but most of them thought that the psychiatric care was more difficult (36.6%), and were dissatisfied with the multi-functional staff to undertake a number of public services (31.7%).Conclusion:The management treatment project of mental disorders services in Shantou City show initial results.The patients were satisfied with the community follow-up service, but the patients and their families still have low level of cognition, poor compliance, obvious negative emotions, and have concerns about drug treatment.It is necessary to strengthen the professionalization of personnel, to carry out early mental health education and rational emotional behavior training for patients and their families.

Objective:To evaluate the effect of sedation management based on visual analysis of electroencephalography (EEG) on postoperative delirium in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods:Eighty patients, aged ≥ 18 yr, of American Society of Anesthesiologists physical status Ⅲ or Ⅳ, with New York Heart Association Ⅱ-Ⅳ, scheduled for elective cardiac valve replacement with CPB, were randomly divided into visual analysis of EEG-guided sedation management group (group A, n=40) and BIS-guided sedation management group (group B, n=40). The target plasma concentration of propofol was adjusted to maintain the depth of anaesthesia at grade C or grade D in group A and BIS value at 40-60 in group B. Propofol consumption during CPB and total consumption of propofol during surgery, requirement for vasoactive agents during surgery, and parameters of intraoperative arterial blood gas analysis were recorded.Postoperative delirium was evaluated using Confusion Assessment Method for the Intensive Care Unit (ICU) at 1-7 days after surgery.Extubation time, length of ICU stay, length of postoperative hospital stay and intraoperative awareness were also recorded. Results:Compared with group B, the length of postoperative hospital stay was significantly shortened, the incidence of postoperative delirium was decreased, and no significant change was found in the parameters of arterial blood gas analysis, propofol consumption, requirement for vasoactive agents, extubation time, or length of postoperative ICU stay in group A ( P<0.05). No intraoperative awareness occurred in both groups. Conclusion:Sedation management based on visual analysis of EEG is helpful in decreasing the development of postoperative delirium in the patients undergoing cardiac valve replacement with CPB.

Objective To determine the risk factors for the anxiety status of the patients undergoing breast surgery in the waiting area. Methods A total of 214 female patients scheduled for elective breast surgery, underwent biopsy under local anesthesia, were selected. When the patients were waiting for the pathological results in the waiting area, they filled in the questionnaire independently, read and understood the questionnaire of this study, showed cooperation and voluntarily received investigation including State-Trait Anxiety Inventory (STAI), self-evaluation questionnaire, etc. Anxiety was assessed and scored by the patients themselves. The patients were divided into state anxiety group and non-state anxiety group ac-cording to State-Anxiety scale. The variables were compared, and the variables of which P values less than 0. 05 would enter the logistic regression analysis to stratify the risk factors for the anxiety status of the pa-tients undergoing breast surgery in the waiting area. Results The incidence of state anxiety in the wait-ing area was 62. 6％. Compared with non-state anxiety group, significant change was found in the larger possibility of malignant breast lesions in preoperative conversation, preoperative anxiety, self anxiety score, STAI score and no understanding of disease prognosis in state anxiety group (P<0. 05). Logistic regression analysis showed that the larger possibility of malignant breast lesions in preoperative conversation, preoperative anxiety, self anxiety score and STAI score were all independent risk factors for the anxiety status of the patients undergoing breast surgery in the waiting area. Among all the patients involved in the investigation, 144 patients felt anxiety before surgery, 100％ patients expected help from the doctor in charge, and 60. 4％ patients expected the company of family in the waiting area. Conclusion Larger possibility of ma-lignant breast lesions in preoperative conversation, preoperative anxiety, self anxiety score and STAI score are independent risk factors for the anxiety status of the patients undergoing breast surgery while waiting for the pathological results in the waiting area after biopsy under local anesthesia.

Objective: To evaluate the predictive value of GRACE discharge score on the long-term out-of-hospital coronary thrombotic events (CTE) after percutaneous coronary intervention (PCI) with drug-eluting stents. Methods: Present study was a prospective, observational, single center study. 10 724 consecutive patients underwent PCI in Fuwai Hospital between January and December 2013 were included, stents were implanted with conventional method. After PCI, patients were prescribed aspirin 100 mg once daily indefinitely, and either clopidogrel 75 mg once daily or ticagrelor 90 mg twice daily for at least 1 year. A total of 9 782 patients were included in the final analysis after excluding patients who did not undergo successful stent implantation, who were not discharged on dual anti-platelet therapy (DAPT), who only underwent bare-metal stents, who experienced in-hospital major bleeding, stent thrombosis, myocardial infarction (MI) or death,and who lost follow up. Clinical data were collected from all patients. 9 543 patients with complete baseline data were further analyzed for risk stratification and predictive value of GRACE discharge score. CTE was defined as stent thrombosis or spontaneous myocardial infarction. All patients were followed through Fuwai Hospital Follow-up Center, and evaluated either by phone, letter, or clinic visits or at 1, 6, 12 and 24 months after PCI. Risk stratification was performed according to the GRACE discharge score, and the predictive value of the GRACE discharge score was assessed using the receiver operating characteristic (ROC) curve. Results: After 2 years follow-up, there were 95 CTE among the 9 782 patients. The patients were divided into 2 groups according to the presence or absence of CTE: CTE group (95 cases) and no CTE group (9 687 cases). GRACE discharge score was significantly higher in CTE group than no CTE group (82.98±27.58 vs. 75.51±22.46, t=-2.57, P=0.012). According to risk stratification of GRACE discharge score, the patients were divided into low-risk (≤88) group (n=6 902), moderate-risk (89-118) (n=2 988) and high-risk (>118) (n=343) groups. As compared to the low-risk group, CTE risk in moderate- and high-risk groups was 1.59 times (HR 1.59, 95%CI 1.01-2.52, P=0.046) and 3.89 times higher (HR 3.89, 95%CI 1.98-7.65, P<0.001), respectively. Further analysis showed that the GRACE score had predictive value in the total cohort for CTE (area under the receiver operating characteristic (AUROC) 0.576, 95%CI 0.512-0.640, P=0.012) and in the acute coronary syndromes(ACS) subgroup for CTE: (AUROC 0.594, 95%CI 0.509-0.680, P=0.019), but not in the non-ACS subgroup: (AUROC 0.561, 95%CI 0.466-0.657, P=0.187). Conclusion GRACE discharge score can predict the long-term out-of-hospital CTE in patients undergoing PCI with drug-eluting stents and treated with DAPT, and patients can be stratified into the low-, moderate- and high-risk groups of CTE by the GRACE discharge score.

AIM:To investigate the effect of Shenci capsule combined with cisplatin ( DDP) in reversing DDP resistance by PI3K/AKT/mTOR signaling pathway in nude mice bearing A 549/DDP tumor.METHODS:The patient-de-rived lung adenocarcinoma A 549/DDP cell xenograft model was established .The tumor-bearing nude mice were randomly divided into control group , Shenci capsule group , DDP group and Shenci capsule combined with DDP group .The mice in control group was treated with normal saline , while the mice in other groups were treated with different drugs for 21 d.After treatment, the mice were killed and lung cancer tissues were collected .Flow cytometry was used to analyze the cell cycle and apoptosis.FQ-PCR was used to determined the mRNA levels of PTEN , P-glycoprotein, PI3K, AKT and mTOR in A549/DDP lung tumor .RESULTS:Compared with control group , the cell proliferation in all the drug treatment groups was inhibited .Compared with other drug treatment groups , Shenci capsule combined with DDP blocked the cell cycle of A 549/DDP cells at G2/M phase, promoted the apoptosis rate , increased the mRNA expression of PTEN and inhibited the mRNA expression of P-glycoprotein, PI3K, AKT and mTOR.CONCLUSION:Shenci capsule increases the sensitivity of A 549/DDP resistant cells in nude mice to DDP by blocking PI 3K/AKT/mTOR signaling pathway , increasing the expression of PTEN or inhibiting P-glycoprotein-mediated resistance pathway .