1.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
2.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
3.Analyzing the influencing factors of work-related musculoskeletal disorders in passenger drivers
Xinyang YU ; Yingfei XIANG ; Yonglin LUO ; Meifang XU ; Xiao YIN ; Min YANG ; Huiqing CHEN ; Shijie HU
China Occupational Medicine 2025;52(2):155-159
Objective To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in passenger drivers and its influencing factors. Methods A total of 951 passenger drivers in Guangdong Province were selected as the research subjects using the judgmental sampling method. A Musculoskeletal Injury Questionnaire was employed to assess the prevalence of WMSDs in the past year. Results The prevalence of WMSDs in passenger drivers was 41.11%. The result of multivariable logistic regression analysis showed that married drivers had a higher risk of WMSDs than single drivers (P<0.05). The lower the frequency of physical exercise, the longer the driving time per week, the longer the continuous driving time, the more restricted the driving working space, the poorer the foot comfort during driving, and the more affected the normal meal, the higher the risk of WMSDs (all P<0.05). The risk of WMSDs in drivers with sleep time ≤ 8.0 h/d was higher than that in drivers with sleep time > 8.0 h/d (P<0.01), and the risk of WMSDs in drivers with the same posture for a long time on the shoulder was higher than that in drivers without this poor working posture (P<0.01). Conclusion WMSDs were prevalent among passenger drivers, which was associated with demographic and adverse ergonomic factors. Intervention on lifestyle and adverse ergonomic factors could further reduce the risk of WMSDs of passenger drivers.
4.Survey on the awareness and clinical application of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians
Yuanyuan KONG ; Yujie GUO ; Yujuan GUAN ; Xuan LIANG ; Zhongjie HU ; Xiaobo LU ; Mingqin LU ; Yongfeng YANG ; Meifang HAN ; Hong YOU ; Zhiyun YANG ; Jidong JIA
Journal of Clinical Hepatology 2025;41(6):1068-1074
ObjectiveTo investigate the awareness and clinical practice of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians. MethodsFrom July 19 to December 31, 2024, a self-designed electronic questionnaire was distributed via the WeChat mini program to collect related data from 1 588 clinicians nationwide, including their awareness and practice based on 18 questions regarding testing and referral, diagnosis and treatment, and follow-up. ResultsAmong all respondents, only 350 clinicians correctly understood all the updated key points of antiviral indications and treatment for special populations in the 2022 edition of guidelines for the prevention and treatment of chronic hepatitis B, with an overall awareness rate of 22.0%. Only 20% — 40% of the patients with positive HBV DNA and an age of >30 years receive antiviral therapy, while 80% — 100% of the patients with positive HBV DNA and a family history of hepatitis B cirrhosis or hepatocellular carcinoma receive antiviral therapy. The median follow-up rates at 1 year, 3 years, and 5 years were 67.5% 57.5% and 47.5%,respectively, showing a trend of gradual reduction, which might be associated with the influencing factors such as insufficient time for follow-up management by clinicians, insufficient awareness of the disease among patients, and poor adherence to follow-up. ConclusionThere is a gap between the awareness and practice of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians. It is recommended to further strengthen training and focus on the whole process of “detection, diagnosis, treatment, and management” for patients with chronic hepatitis B in healthcare institutions, in order to promote the implementation of the guidelines.
5.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
6.Safety and efficacy of mitoxantrone liposome combined chemotherapy in the treatment of mixed phenotype acute leukemia
Huiwen JIANG ; Cong LU ; Jing HE ; Qiuzhe WEI ; Meifang SU ; Yaohui WU ; Junbin HU
Chinese Journal of Hematology 2025;46(1):64-69
Objective:To evaluate the safety and efficacy of mitoxantrone liposome (MIT-LIP) combined chemotherapy in treating mixed phenotype acute leukemia (MPAL) .Methods:December 2021 to November 2024, MPAL patients who underwent the MAED (MIT-LIP + cytarabine + etoposide + dexamethasone) regimen were retrospectively analyzed. Data on clinical characteristics, adverse reactions, therapeutic outcomes, and long-term prognoses were collected.Results:A total of 7 MPAL patients who received MAED regimen were admitted. Among them, two patients were initially diagnosed with T-ALL or B-ALL, respectively, and transformed into AML after treatment. Three patients were initially diagnosed as MPAL (B/myeloid), one as MPAL (T/myeloid), and one with MPAL (myeloid/plasmacytoid dendritic cell). Among the 7 patients, there were 3 males and 4 females, 1 chromosome abnormalities and 6 gene abnormalities, including 1 case with BCR∷ABL fusion gene. The median age was 38 years (range: 16–58 years). There was no clear related drug allergy and organ toxicity during MAED regimen, and the main adverse effect was hematological toxicity. After induced chemotherapy, all patients achieved complete remission (CR), 2 maintained MRD-negative CR and 1 maintained MRD-positive CR. The other 4 patients underwent allogeneic hematopoietic stem cell transplantation, 2 maintained MRD-negative CR, and 2 relapsed. The current median follow-up time was 12 months, the overall survival (OS) rate was 100%, the relapse-free survival (RFS) rate was 60%, and the median OS time and median RFS time were not reached.Conclusion:The MAED regimen demonstrates high safety and a favorable CR rate in MPAL treatment.
7.Multicenter survey on the current status of pediatric life support training
Xin QIAN ; Xiaodi CAI ; Quan WANG ; Meifang LIN ; Qian WANG ; Tingting XUE ; Biru LI ; Quelan HUANG ; Yi WANG ; Yunxia HONG ; Zhixu CHEN ; Guoping LU ; Ye CHENG ; Hongyang HU
Chinese Pediatric Emergency Medicine 2025;32(11):827-831
Objective:To investigate the current status and challenges of pediatric life support training in China and provide references for improving training quality.Methods:A cross-sectional study was conducted to collect data from pediatric life support training centers across the country,covering basic institutional information,training capacity and training faculty,training program funding,as well as existing challenges and issues.The domestic registry of training centers in 2023 was obtained through the American Heart Association's online platform.After contacting and verifying each center,an online questionnaire was distributed,and the aggregated data were statistically analyzed.Results:A total of 42 institutions participated in the survey,including 19 children's hospitals,14 general hospitals,6 maternal and child health hospitals,2 women and children’s hospitals,and 1 training institution.The distribution of training centers showed a concentration in coastal areas,with the top three provinces/municipalities being Guangdong(7/42,16.7%),Zhejiang(6/42,14.3%),and Shanghai(4/42,9.5%).As of December 31 2023,the 42 institutions had an annual basic life support(BLS)training volume of 8 587 individuals,the median was 120 (100,200),and an annual pediatric advanced life support(PALS)training volume of 2 448 individuals,the median was 30 (20,50).Among the 42 institutions,there were 598 BLS instructors and 306 PALS instructors.Among the surveyed institutions,24(24/42,57.1%)reported BLS instructor teams comprising fewer than 10 members,and 33(33/42,78.6%)reported PALS instructor teams comprising fewer than 10.Only 7 centers(7/42,16.7%)reported having dedicated funding support.The top three challenges were:training sessions occupying instructors’personal time(27/42,64.3%),low instructor compensation(16/42,38.1%),and issues with the data submission system(16/42,38.1%).Conclusion:Pediatric life support training centers in China are primarily children’s hospitals,with a geographical concentration in coastal areas,which is also reflected in the distribution of training scale and instructor resources.Most centers have relatively small training scales and limited instructor capacity,with many instructors conducting training during their personal time.These issues may hinder the implementation and effectiveness of training programs.
8.Multicenter survey on the current status of pediatric life support training
Xin QIAN ; Xiaodi CAI ; Quan WANG ; Meifang LIN ; Qian WANG ; Tingting XUE ; Biru LI ; Quelan HUANG ; Yi WANG ; Yunxia HONG ; Zhixu CHEN ; Guoping LU ; Ye CHENG ; Hongyang HU
Chinese Pediatric Emergency Medicine 2025;32(11):827-831
Objective:To investigate the current status and challenges of pediatric life support training in China and provide references for improving training quality.Methods:A cross-sectional study was conducted to collect data from pediatric life support training centers across the country,covering basic institutional information,training capacity and training faculty,training program funding,as well as existing challenges and issues.The domestic registry of training centers in 2023 was obtained through the American Heart Association's online platform.After contacting and verifying each center,an online questionnaire was distributed,and the aggregated data were statistically analyzed.Results:A total of 42 institutions participated in the survey,including 19 children's hospitals,14 general hospitals,6 maternal and child health hospitals,2 women and children’s hospitals,and 1 training institution.The distribution of training centers showed a concentration in coastal areas,with the top three provinces/municipalities being Guangdong(7/42,16.7%),Zhejiang(6/42,14.3%),and Shanghai(4/42,9.5%).As of December 31 2023,the 42 institutions had an annual basic life support(BLS)training volume of 8 587 individuals,the median was 120 (100,200),and an annual pediatric advanced life support(PALS)training volume of 2 448 individuals,the median was 30 (20,50).Among the 42 institutions,there were 598 BLS instructors and 306 PALS instructors.Among the surveyed institutions,24(24/42,57.1%)reported BLS instructor teams comprising fewer than 10 members,and 33(33/42,78.6%)reported PALS instructor teams comprising fewer than 10.Only 7 centers(7/42,16.7%)reported having dedicated funding support.The top three challenges were:training sessions occupying instructors’personal time(27/42,64.3%),low instructor compensation(16/42,38.1%),and issues with the data submission system(16/42,38.1%).Conclusion:Pediatric life support training centers in China are primarily children’s hospitals,with a geographical concentration in coastal areas,which is also reflected in the distribution of training scale and instructor resources.Most centers have relatively small training scales and limited instructor capacity,with many instructors conducting training during their personal time.These issues may hinder the implementation and effectiveness of training programs.
9.Safety and efficacy of mitoxantrone liposome combined chemotherapy in the treatment of mixed phenotype acute leukemia
Huiwen JIANG ; Cong LU ; Jing HE ; Qiuzhe WEI ; Meifang SU ; Yaohui WU ; Junbin HU
Chinese Journal of Hematology 2025;46(1):64-69
Objective:To evaluate the safety and efficacy of mitoxantrone liposome (MIT-LIP) combined chemotherapy in treating mixed phenotype acute leukemia (MPAL) .Methods:December 2021 to November 2024, MPAL patients who underwent the MAED (MIT-LIP + cytarabine + etoposide + dexamethasone) regimen were retrospectively analyzed. Data on clinical characteristics, adverse reactions, therapeutic outcomes, and long-term prognoses were collected.Results:A total of 7 MPAL patients who received MAED regimen were admitted. Among them, two patients were initially diagnosed with T-ALL or B-ALL, respectively, and transformed into AML after treatment. Three patients were initially diagnosed as MPAL (B/myeloid), one as MPAL (T/myeloid), and one with MPAL (myeloid/plasmacytoid dendritic cell). Among the 7 patients, there were 3 males and 4 females, 1 chromosome abnormalities and 6 gene abnormalities, including 1 case with BCR∷ABL fusion gene. The median age was 38 years (range: 16–58 years). There was no clear related drug allergy and organ toxicity during MAED regimen, and the main adverse effect was hematological toxicity. After induced chemotherapy, all patients achieved complete remission (CR), 2 maintained MRD-negative CR and 1 maintained MRD-positive CR. The other 4 patients underwent allogeneic hematopoietic stem cell transplantation, 2 maintained MRD-negative CR, and 2 relapsed. The current median follow-up time was 12 months, the overall survival (OS) rate was 100%, the relapse-free survival (RFS) rate was 60%, and the median OS time and median RFS time were not reached.Conclusion:The MAED regimen demonstrates high safety and a favorable CR rate in MPAL treatment.
10.A multicenter study on the effects of congenital cytomegalovirus infection on hearing loss
Bofei HU ; Xinxin LIU ; Canyang ZHAN ; Tianming YUAN ; Lihua CHEN ; Jianfeng LIANG ; Jing SUN ; Meifang LIN ; Man HE ; Suling WEI ; Jiening ZHANG ; Jiajun ZHU ; Yinghu CHEN
Chinese Journal of Pediatrics 2024;62(8):721-726
Objective:To assess the clinical features and effectiveness of antiviral therapy in newborns with sensorineural hearing loss (SNHL) caused by congenital congenital cytomegalovirus (cCMV) infection, and to speculate the risk factors for poor hearing outcomes.Methods:A multicenter prospective cohort study wasconducted, enrolling 176 newborns diagnosed with cCMV at four research centers in Zhejiang Province from March 1, 2021, to April 30, 2024. Clinical characteristics at birth were recorded and hearing was followed up. The children were divided into groups based on their condition at birth, specifically into asymptomatic, mild symptom, and moderate to severe symptom groups. Additionally, they were divided into SNHL and normal hearing groups based on the results of air conduction brainstem audiometry at birth. And they were also divided into treatment and untreated groups according to antiviral treatment. Mann Whitney U test, and chi square test were used for inter group comparison to analyze the differences in clinical features between different disease groups, and to analyze the effects of clinical features, antiviral therapy, and other factors on hearing improvement. Logistic regression analysis was employed to identify the risk factors influencing hearing outcomes. Results:Among the cohort of 176 children diagnosed infection with cCMV, 90 cases were male and 86 cases were female. Of these, 79 cases were asymptomatic, 12 cases classified as mild cCMV and 85 cases as moderate to severe cCMV. Fifty cases belonged to SNHL group, with different degrees of severity, including 30 cases of mild, 9 cases of moderate, 5 cases of severe, and 6 cases of extremely severe SNHL. Among the 121 cases in the normal hearing group, 2 cases (1.7%) exhibited late-onset hearing loss despite having normal hearing at birth. Among 81 cases (46.0%) who completed the hearing follow-up, 71 cases (87.7%) had good hearing outcomes and 10 cases (12.3%) had poor hearing outcomes. Among the 81 children, 29 cases (35.8%) had SNHL at birth. During follow-up, the hearing threshold improved in 19 cases (65.5%), remained stable in 7 cases (24.1%) and progressed in 3 cases (10.3%). A total of 26 cases in the treatment group and 55 cases in the untreated group completed the hearing follow-up assessment. The rate of hearing improvement in the treatment group was found to be higher compared to the untreated group (13 cases (50.0%) vs. 6 cases (10.9%), χ2=15.00, P<0.01), with individuals in the treatment group having a 4.58 times greater likelihood of experiencing hearing improvement ( RR=4.58,95% CI 1.96-10.70, P<0.05). However, no statistically significant difference was observed in hearing outcomes between the antiviral treatment group and the untreated group ( RR=0.90, 95% CI 0.57-1.41, P=0.517). Multivariate analysis further confirmed SNHL ( OR=11.58, 95% CI 2.10-63.93, P=0.005) and preterm birth ( OR=4.98, 95% CI 1.06-23.41, P=0.042) as independent risk factors for poor hearing outcomes. Conclusions:SNHL resulting from cCMV infection presents symptoms at birth and can be improved by antiviral therapy. Poor hearing outcomes are associated with SNHL and prematurity.

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