Hepatitis B virus (HBV) infection represents a significant global health challenge. Current therapeutic options, such as interferon and nucleoside analogues (NAs), are limited by issues including long-term medication toxicity, the virus's propensity to develop drug resistance, and the inability to eradicate covalently closed circular DNA (cccDNA). Core protein allosteric modulators (CpAMs), as an emerging class of anti-HBV drugs, target HBcAg to interfere with capsid assembly. This not only blocks viral nucleocapsid formation and inhibits viral replication but also indirectly destabilizes the cccDNA pool, while exhibiting a relatively high genetic barrier to resistance. This article systematically evaluates HBV drug resistance to CpAMs and proposes anti-resistance strategies, including the combination of nucleoside analogues with CpAMs, enhancing protein-drug interactions, targeting HBcAg degradation, designing multi-target inhibitors, and employing combination therapy. Looking ahead, the integration of structural biology, computational chemistry, and immunotherapy will offer innovative approaches for developing novel, highly effective, and low-resistance inhibitors, thereby advancing the functional cure of hepatitis B.

Objective To investigate changes in gut microbiota during diabetic nephropathy(DN)pro-gression using 16S rDNA sequencing technology.Methods A total of 90 male SD rats were randomly divided into a normal control group(n=10,no modeling,regular feeding)and a model group(diabetes model).The diabetes model was established by a single intraperitoneal injection of streptozotocin(STZ)at 60 mg/kg,with regular feeding.According to the feeding time after modeling,the rats were divided into 2-week,4-week,8-week,and 12-week model groups(fed for 2,4,8,and 12 weeks after model establishment),with 20 rats in each group.Blood urea nitrogen(BUN)was measured using the urease method,serum creatinine(Scr)was deter-mined by the picric acid method,and ELISA was used to detect urinary kidney injury molecule-1(KIM-1)and neutrophil gelatinase-associated lipocalin(NGAL)levels.HE,PAS,and Masson staining were used to observe renal tissue pathological changes.Gut microbiota was collected from the rats,and 16S rDNA gene sequencing was used to analyze the gut microbiota to understand changes in the gut microbiota.Results Compared with the normal control group,the levels of KIM-1 and NGAL in urine of rats in all model groups were significantly increased(P<0.05).Pathological staining results showed that,compared with the normal control group,rats in all model groups exhibited diffuse thickening of the glomerular basement membrane and pathological chan-ges such as local necrosis and vacuolar degeneration in renal tubular epithelial cells.16S rDNA sequencing re-sults indicated that the abundance and structure of intestinal microbiota in rats of all model groups changed.Compared with the normal control group,in the 8-week and 12-week model groups,the relative abundance of Bacteroides and Akkermansia decreased,while the relative abundance of Roseburia,Alloprevotella,Prevotel-laceae-Ga6A1,and Ruminococcaceae UCG-005 increased.Compared with the normal control group,in the 12-week model group,the abundance of Akkermansia decreased and that of Prevotellaceae-NK3B31 increased.Conclusion The abundance and structure of gut microbial community in DN rats under conventional feeding at different time points change significantly,further confirming the"gut-kidney axis"theory.

Background The Inner Mongolia Autonomous Region is a vast area with a wide array of ecological environments, resulting in considerable regional variations in air pollution characteristics. Current research is limited by a scarcity of systematic, region-wide studies and risk assessments. Objective To assess the health risks associated with inhalation exposure to nine heavy metal and metalloid elements in atmospheric fine particulate matter (PM_2.5) for the population of the Inner Mongolia Autonomous Region. Methods From the 10th to the 16th of each month throughout 2023, atmospheric PM_2.5 samples were collected at designated monitoring sites in 12 leagues (cities) across the Inner Mongolia Autonomous Region to analyze the characteristics and trends in concentration. The health risk assessment model developed by the United States Environmental Protection Agency was employed to evaluate both the non-carcinogenic and carcinogenic risks associated with the heavy metal elements beryllium (Be), cadmium (Cd), chromium (Cr), hydrargyrum (Hg), plumbum (Pb), manganese (Mn), and nickel (Ni) and the metalloid elements stibium (Sb) and arsenic (As). Results In 2023, a total of 1206 valid PM_2.5 samples were analyzed from the Inner Mongolia Autonomous Region. The annual average PM_2.5 concentrations in Inner Mongolia, as well as in the cities of Ordos, Wuhai, and the Alxa League, all exceeded the national limit of 35 μg·m⁻³. The PM_2.5 concentrations across the leagues (cities) exhibited a clear seasonal variation, peaking in winter, followed by spring, and reaching a minimum in summer and autumn. The median PM_2.5 concentration in Ordos throughout the year was higher than that in the other leagues (cities) of the region. Concerning health risks, the non-carcinogenic risks associated with the 9 elements detected in each league (city) were all below 1, indicating acceptable levels. However, the non-carcinogenic risk values for Mn, Cr, and As were relatively high; specifically, Ordos City displayed the highest non-carcinogenic risk values for Mn (7.74×10⁻¹) and Cr (2.97×10⁻²), while Chifeng City recorded the highest value for As (2.34×10⁻³). The carcinogenic risk values for As, Cd, Cr, and Ni fell within the range of 1×10⁻⁹ to 1×10⁻⁵, representing an acceptable level. The health risks varied with age, and the elderly residents faced the highest non-carcinogenic and carcinogenic health risks. Conclusion While the carcinogenic and non-carcinogenic risks from heavy metals and metalloids within atmospheric PM_2.5 in the Inner Mongolia Autonomous Region are generally within acceptable limits, the potential risks that Mn, As, and Cr pose to the health of elderly people warrants particular attention, and Ordos and Chifeng cities exhibit notably higher health risks among other areas. It is recommended that regular, long-term monitoring be conducted, taking into account the specific conditions at monitoring sites across each league (city), and that targeted air quality management strategies be implemented to protect public health.

Objective To explore the impact of suture configuration and fixation type on the biome-chanical strength of rotator cuff repair,using a factorial design study.Methods Sixteen fresh-frozen porcine shoulder samples were randomized into an anchorless double-row suture bridge transosseous su-tures(DS)group,an anchored double-row suture bridge transosseous-equivalent(DE)group,an an-chorless X-BOX construct transosseous sutures(XS)group,and an anchored X-BOX construct transos-seous-equivalent(XE)group,each of four,according to suture configuration(double-row suture bridge,traditional X-BOX construct)and fixation type(suture anchors,transosseous sutures).Then,their fatigue resistance(first-cycle excursion,gap length difference ratio,and the percentage of ex-posed footprints)and the failure strength(the maximum failure load and the re-tear type)were mea-sured using a biomechanical material testing machine.Results Different suture configurations affected failure strength(F=39.559,P<0.001),with the double-row suture bridge groups(693.07±58.35 N,746.76±138.57 N)showing significantly higher failure strength,compared to the traditional X-BOX groups(462.90±18.91 N,421.43±90.76 N).However,the fixation type did not significantly im-pact failure strength(F=1.161,P=0.302).Moreover,the suture configuration influenced the gap differ-ence ratio(F=7.781,P=0.016),but had no significant correlation with other fatigue resistance indica-tors(P>0.05).Meanwhile,failure strength and fatigue resistance were not correlated with fixation type,and the interaction between suture and fixation type(P>0.05).The incidence of failure types for the four suture configurations was as follows:Type I tendon tear:XS>XE>DS=DE;type II tendon tear:DS>XE>XS=DE;fixing material-related failure:DE>DS=XE=XS.Conclusion The failure strength and gap formation ratio in rotator cuff repair under fatigue loading are influenced by suture configuration,whereas no significant association has been observed with respect to fixation method,whether using transosseous sutures or suture anchors.

Objective:To explore the association between A Body Shape Index (ABSI) and sarcopenia in Chinese older adults.Methods:Totally 1 728 participants in waves 1 and 3 of the China Health and Retirement Longitudinal Survey (CHARLS) were enrolled in this cohort-based cross-sectional analysis. ABSI was calculated by using anthropometric measurements from CHARLS. According to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus update on sarcopenia, low muscle strength and low muscle mass were used as the diagnostic criteria for sarcopenia. Logistic regression and restricted cubic spline (RCS) were used to assess the relationship between ABSI and sarcopenia, and subgroup and interaction analyses were conducted to evaluate the influence of other factors on this association.Results:High ABSI showed a significant association with the risk of sarcopenia among older adults in China, and RCS analysis demonstrated a positive linear correlation between ABSI and sarcopenia. Additionally, the relationship of ABSI with sarcopenia was significantly modified by educational level and depressive status.Conclusion:ABSI, a novel anthropometric measure, serves as an effective threshold for assessing sarcopenia risk in the Chinese older population, providing a basis for developing clinical interventions and public health strategies for the prevention and early identification of sarcopenia.

Objective:To analyze the current status, influencing factors and action pathways of quality of life in patients with cardiovascular disease.Methods:From July 2023 to June 2024, a convenience sampling method was used to obtain 2 702 patients with cardiovascular disease from 9 hospitals in Guangxi Zhuang Autonomous Region.The general information questionnaires, item short form health survey, self-rating depression scale, self-rating anxiety scale, type D personality scale-14, and type A behavior pattern scale were used for investigation.SPSS 26.0 and AMOS 24.0 softwares were used for data statistical analysis.The current status of quality of life were analyzed through descriptive statistics, the influencing factors of quality of life were analyzed using multiple linear regression analysis models, and the relationship between statistical variables was analyzed through paths.Results:The overall quality of life score of patients with cardiovascular disease was (59.29±17.59).Compared with the domestic normal population norm, the 8 factors had statistically significant differences ( t=16.50-44.16, all P<0.001).The results of multiple regression analysis showed that age, marital status, low per capita monthly income, lack of exercise, irregular daily life, poor appetite, unhealthy diet, poor sleep quality, hypertension, coronary heart disease, chronic heart failure, heart valve disease, multiple types of medication taken daily, anxiety level, depression level, type D personality, and type A personality all had negative predictive effects on quality of life ( B=-0.862--0.205, all P<0.05).Demographic and life factors affected the quality of life through 4 paths, and their direct effect and indirect effect were -0.183, 0.224 respectively (there was a masking effect).Disease-related factors affected life through 2 paths, and its direct effect and indirect effect were -0.341, 0.255 respectively (there was a masking effect).Psychological factors directly and negatively affected the quality of life through one path, and its effect value was -0.651. Conclusion:The quality of life of patients with cardiovascular disease is generally at a moderate to low level.The factors that affect the quality of life of patients with cardiovascular disease produce effects through multiple pathways in a multi-combined state.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To explore the association between A Body Shape Index (ABSI) and sarcopenia in Chinese older adults.Methods:Totally 1 728 participants in waves 1 and 3 of the China Health and Retirement Longitudinal Survey (CHARLS) were enrolled in this cohort-based cross-sectional analysis. ABSI was calculated by using anthropometric measurements from CHARLS. According to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus update on sarcopenia, low muscle strength and low muscle mass were used as the diagnostic criteria for sarcopenia. Logistic regression and restricted cubic spline (RCS) were used to assess the relationship between ABSI and sarcopenia, and subgroup and interaction analyses were conducted to evaluate the influence of other factors on this association.Results:High ABSI showed a significant association with the risk of sarcopenia among older adults in China, and RCS analysis demonstrated a positive linear correlation between ABSI and sarcopenia. Additionally, the relationship of ABSI with sarcopenia was significantly modified by educational level and depressive status.Conclusion:ABSI, a novel anthropometric measure, serves as an effective threshold for assessing sarcopenia risk in the Chinese older population, providing a basis for developing clinical interventions and public health strategies for the prevention and early identification of sarcopenia.

Objective:To analyze the current status, influencing factors and action pathways of quality of life in patients with cardiovascular disease.Methods:From July 2023 to June 2024, a convenience sampling method was used to obtain 2 702 patients with cardiovascular disease from 9 hospitals in Guangxi Zhuang Autonomous Region.The general information questionnaires, item short form health survey, self-rating depression scale, self-rating anxiety scale, type D personality scale-14, and type A behavior pattern scale were used for investigation.SPSS 26.0 and AMOS 24.0 softwares were used for data statistical analysis.The current status of quality of life were analyzed through descriptive statistics, the influencing factors of quality of life were analyzed using multiple linear regression analysis models, and the relationship between statistical variables was analyzed through paths.Results:The overall quality of life score of patients with cardiovascular disease was (59.29±17.59).Compared with the domestic normal population norm, the 8 factors had statistically significant differences ( t=16.50-44.16, all P<0.001).The results of multiple regression analysis showed that age, marital status, low per capita monthly income, lack of exercise, irregular daily life, poor appetite, unhealthy diet, poor sleep quality, hypertension, coronary heart disease, chronic heart failure, heart valve disease, multiple types of medication taken daily, anxiety level, depression level, type D personality, and type A personality all had negative predictive effects on quality of life ( B=-0.862--0.205, all P<0.05).Demographic and life factors affected the quality of life through 4 paths, and their direct effect and indirect effect were -0.183, 0.224 respectively (there was a masking effect).Disease-related factors affected life through 2 paths, and its direct effect and indirect effect were -0.341, 0.255 respectively (there was a masking effect).Psychological factors directly and negatively affected the quality of life through one path, and its effect value was -0.651. Conclusion:The quality of life of patients with cardiovascular disease is generally at a moderate to low level.The factors that affect the quality of life of patients with cardiovascular disease produce effects through multiple pathways in a multi-combined state.

Objective To explore the impact of suture configuration and fixation type on the biome-chanical strength of rotator cuff repair,using a factorial design study.Methods Sixteen fresh-frozen porcine shoulder samples were randomized into an anchorless double-row suture bridge transosseous su-tures(DS)group,an anchored double-row suture bridge transosseous-equivalent(DE)group,an an-chorless X-BOX construct transosseous sutures(XS)group,and an anchored X-BOX construct transos-seous-equivalent(XE)group,each of four,according to suture configuration(double-row suture bridge,traditional X-BOX construct)and fixation type(suture anchors,transosseous sutures).Then,their fatigue resistance(first-cycle excursion,gap length difference ratio,and the percentage of ex-posed footprints)and the failure strength(the maximum failure load and the re-tear type)were mea-sured using a biomechanical material testing machine.Results Different suture configurations affected failure strength(F=39.559,P<0.001),with the double-row suture bridge groups(693.07±58.35 N,746.76±138.57 N)showing significantly higher failure strength,compared to the traditional X-BOX groups(462.90±18.91 N,421.43±90.76 N).However,the fixation type did not significantly im-pact failure strength(F=1.161,P=0.302).Moreover,the suture configuration influenced the gap differ-ence ratio(F=7.781,P=0.016),but had no significant correlation with other fatigue resistance indica-tors(P>0.05).Meanwhile,failure strength and fatigue resistance were not correlated with fixation type,and the interaction between suture and fixation type(P>0.05).The incidence of failure types for the four suture configurations was as follows:Type I tendon tear:XS>XE>DS=DE;type II tendon tear:DS>XE>XS=DE;fixing material-related failure:DE>DS=XE=XS.Conclusion The failure strength and gap formation ratio in rotator cuff repair under fatigue loading are influenced by suture configuration,whereas no significant association has been observed with respect to fixation method,whether using transosseous sutures or suture anchors.