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.

Ductular reaction （DR） refers to the adaptive pathological changes that occur after hepatobiliary injury， and it is essentially a repair response involving the proliferation， fibrosis， and inflammation of biliary epithelial cell （BEC）. With the understanding of the biological function of BEC， the potential value of DR in disease prognosis and treatment has gradually become a research hotspot. This article systematically reviews the molecular mechanism of DR， its potential as a therapeutic target， and future development directions， as well as novel therapies suggested by targeting these molecular mechanisms， in order to provide a new direction for overcoming current bottlenecks in the treatment of bile duct diseases.

Education is a crucial element in the development of acupuncture as a discipline, providing essential talent support for its future advancement. A structured interview was conducted with renowned acupuncture expert Professor ZHAO Jiping, focusing on key topics such as the core of acupuncture education, the connotation and development of acupuncture textbooks, and acupuncture teaching models. Through in-depth discussion, the current problems in acupuncture education were analyzed, and possible solutions were explored, aiming to offer ideas for the innovative development of acupuncture education.
Acupuncture/trends* ; Humans ; Acupuncture Therapy ; China

Objective: To explore the potential application of PAK4-PROTAC targeted degradation drug (PpD) in renal cancer immunotherapy. Methods: TIMER 2.0 and TISIDB databases were used to analyze the relationship among PAK4 expression, tumor purity and abundance of immune cell infiltration in renal tumor microenvironment (TEM).Renal cancer cell lines OS-RC-2, 786-O and ACHN were treated with 0, 125 and 250 nmol/L PpD, and the effects of Jurkat cell co-culture on the results were investigated.The cell apoptosis was detected with flow cytometry, and the expression of programmed cell death 1 ligand 1 (PD-L1) in renal cancer cells was detected with immunoblotting. Results: The high expression of PAK4 was positively related to immune purity, and inhibited the abundance of immune killer cells in TEM, such as CD8 T cells, CD4 T cells, natural killer cells and dendritic cells.With 250 nmol/L PpD treatment, there were 21.02% apoptotic cells in OS-RC-2, 29.67% apoptotic cells in 786-O, and 15.39% apoptotic cells in ACHN, respectively.However, with the same concentration of 250 nmol/L PpD treatment, cell apoptotic rate was sharply increased to 70.13% in OS-RC-2/Jurkat, 70.68% in 780-O/Jurkat, and 60.27% in ACHN/Jurkat co-culture models, respectively. Conclusion: PpD can promote apoptosis of renal cancer cells by reducing the expression of PAK4 protein, and enhance the killing effects of immune cells on tumor cells.

Zoonosis prevention and control is a complex public health concern, which requires the collaboration of multiple regions, disciplines, and departments to enhance the effectiveness. The One Health concept aims to achieve the joint health security of humans, animals and environments through cross-disciplinary, cross-sector and cross-field collaborations. This review summarizes the development of One Health and the successful practices in the prevention and control of echinococcosis, rabies, COVID-19 and schistosomiasis, as well as explores the challenges faced in applying this concept to the prevention and control of zoonoses, so as to provide insights into formulation of the integrated zoonoses control strategy and implementation of zoonoses control interventions at the human-animal-environment interface.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

OBJECTIVE: To investigate the effects of acupuncture on the neurotransmitter levels and gut microbiota in a mouse model of Tourette syndrome (TS). METHODS: Thirty-six male C57/BL6 mice were randomly divided into 4 groups using a random number table method: 3,3'-iminodipropionitrile (IDPN) group, control group, acupuncture group, and tiapride group, with 9 mice in each group. In the IDPN group, acupuncture group, and tiapride group, mice received daily intraperitoneal injections of IDPN (300 mg/kg body weight) for 7 consecutive days to induce stereotyped behaviors. Subsequently, in the acupuncture intervention group, standardized acupuncture treatment was administered for 14 consecutive days to IDPN-induced TS model mice. The selected acupoints included Baihui (DU 20), Yintang (DU 29), Waiguan (SJ 5), and Zulinqi (GB 41). In the tiapride group, mice were administered tiapride (50 mg/kg body weight) via oral gavage daily for 14 consecutive days. The control group, IDPN group, and acupuncture group received the same volume of saline orally for 14 consecutive days. Stereotypic behaviors were quantified through behavioral assessments. Neurotransmitter levels, including dopamine (DA), glutamate (Glu), and aspartate (ASP) in striatal tissue were measured using enzyme-linked immunosorbent assay. Dopamine transporter (DAT) expression levels were additionally quantified through quantitative polymerase chain reaction (qPCR). Gut microbial composition was analyzed through 16S ribosomal RNA gene sequencing, while metabolic profiling was conducted using liquid chromatography-mass spectrometry (LC-MS). RESULTS: Acupuncture administration significantly attenuated stereotypic behaviors, concurrently reducing striatal levels of DA, Glu and ASP concentrations while upregulating DAT expression compared with untreated TS controls (P<0.05 or P<0.01). Comparative analysis identified significant differences in Muribaculaceae (P=0.001), Oscillospiraceae (P=0.049), Desulfovibrionaceae (P=0.001), and Marinifilaceae (P=0.014) following acupuncture intervention. Metabolomic profiling revealed alterations in 7 metabolites and 18 metabolic pathways when compared to the TS mice, which involved various amino acid metabolisms associated with DA, Glu, and ASP. CONCLUSIONS Acupuncture demonstrates significant modulatory effects on both central neurotransmitter systems and gut microbial ecology, thereby highlighting its dual therapeutic potential for TS management through gut-brain axis regulation.
Animals ; Tourette Syndrome/metabolism* ; Gastrointestinal Microbiome ; Neurotransmitter Agents/metabolism* ; Acupuncture Therapy ; Male ; Mice, Inbred C57BL ; Mice

Objective:To investigate the correlation between postoperative spinal sagittal parameters and reinforced vertebral recompression fractures in patients with osteoporotic vertebral compression fractures (OVCFs) who have undergone percutaneous kyphoplasty (PKP).Methods:Data on patients with OVCFs treated with PKP at the Department of Orthopaedics, Second Affiliated Hospital of Soochow University, from August 2020 to August 2024, were collected. Among these, 31 patients who underwent single-segment PKP experienced postoperative reinforced vertebral recompression fractures (recompression fracture group), comprising 8 males and 23 females, with a mean age of 73.74±8.76 years, a body mass index (BMI) of 23.83±1.87 kg/m 2, and a bone mineral density T-value of -2.29±0.55. The remission rate of the visual analogue scale (VAS) after surgery was 80.14%±4.86%, with a mean volume of bone cement used at 5.37±0.69 ml. The surgical segments involved included T 5 (1 case), T 8 (1 case), T 10 (1 case), T 11 (4 cases), T 12 (9 cases), L 1 (7 cases), L 2 (4 cases), L 3 (2 cases), and L 4 (2 cases). Following a 1∶1 matching principle, 31 patients whose vertebrae did not experience reinforced recompression fractures during the same period (non-recompression fracture group) were included. This group also comprised 8 males and 23 females, with a mean age of 74.88±8.31 years, a BMI of 23.15±2.04 kg/m 2, a bone mineral density T-value of -2.76±0.64, and a VAS remission rate of 79.75%±5.01%. The mean volume of bone cement used in this group was 5.41±0.72 ml. The surgical segments involved included T 8 (1 case), T 10 (1 case), T 11 (4 cases), T 12 (8 cases), L 1 (7 cases), L 2 (5 cases), L 3 (2 cases), L 4 (2 cases), and L 5 (1 case). There were no statistically significant differences in the aforementioned indicators between the two patient groups ( P>0.05). A comparison of the postoperative spinal sagittal parameters between the two groups was conducted, focusing on the local kyphosis angle (LKA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and the lumbar-pelvic matching value (PI-LL). Indicators that exhibited statistically significant differences were included in the binary logistic regression analysis to evaluate the impact of spinal sagittal parameters following PKP on the recompression of the reinforced vertebral. Results:The time to reinforced vertebral recompression fractures after PKP ranged from 35 to 184 d, with a median of 69 d. The TK in the recompression fracture group (46.56°±7.02°) was significantly greater than that in the non-recompression fracture group (41.95°±5.76°). Additionally, the LKA, PI and SS were all smaller in the recompression fracture group (9.84°±2.13°, 41.36°±4.27°, 22.69°±5.53°, respectively) compared to the non-recompression fracture group (12.37°±2.64°, 48.09°±6.33°, 28.41°±7.64°), with all differences being statistically significant ( P<0.05). However, no significant differences were observed between the LL, PT, and PI-LL values ( P>0.05). TK, LKA, PI, and SS were included in the binary logistic regression analysis, which indicated that TK [ OR=1.533, 95% CI(1.47, 1.59)] after PKP was positively correlated with the occurrence of reinforced vertebral recompression fractures. Conversely, LKA [ OR=0.882, 95% CI(0.80, 0.96)], PI [ OR=0.815, 95% CI(0.71, 0.91)], and SS [ OR=0.833, 95% CI(0.73, 0.93)] were negatively correlated. Conclusions:The incidence of reinforced vertebral recompression fractures following PKP is associated with spinal sagittal parameters, including TK, LKA, PI, and SS. Specifically, a larger TK and smaller values of LKA, PI, and SS are correlated with an elevated risk of reinforced vertebral recompression fractures.

Objective To investigae microbial community structure of lower respiratory tract in severe hospital-acquired pneumonia(SHAP)patients in intensive care unit(ICU)using metagenomic next-generation sequencing(mNGS).Methods mNGS was performed on bronchoalveolar lavage fluid(BALF)of 84 patients with SHAP.Patients were grouped based on age,smoking status,underlying diseases and duration of artificial airway.The differences in α diversity,β diversity,microbial composition and community structure of airway microbiota were compared between different groups.The differential airway microbiota associated with artificial airway were screened,and microbial co-occurrence networks was constructed to observe the interaction in microorganisms.Results Results of α diversity analysis revealed that diversity and evenness of the microbial community were higher in young adults compared to those of middle-aged patients,while microbial diversity and evenness were significantly reduced in patients with comorbid stroke.In the group of artificial airway treatment,the diversity and uniformity of microorganisms decreased as the duration of artificial airway treatment increased.The diversity was the lowest when the artificial airway treatment lasted for more than 3 days.β diversity analysis confirmed that there were significant differences in the distinct microbial community structures between the>3 days support group and the non-intubated and≤3 days support cohorts.Acinetobacter baumannii was dominant in all groups.The bacterial diversity was significantly higher in the middle-aged group,the non-smoking group,the group without artificial airway therapy,the group without diabetes mellitus,the group with artificial airway therapy≥3 days and the group with chronic lung disease than those of other groups.In particular,pseudomonas aeruginosa,corynebacterium striatum and veillonella parvula were enriched in these groups.Difference analysis showed that there were significant differences in pseudomonas aeruginosa and corynebacterium striatum between the group with artificial airway treatment>3 days,the group without artificial airway therapy and the group with artificial airway treatment≤3 days.Network co-occurrence showed that there may be synergistic or antagonistic relationships between some microorganisms.Conclusion The microbial diversity of the lower respiratory tract in patients with SHAP significantly decreases in the elderly,those with concurrent stroke and those receiving artificial airway treatment.For these groups,rational use of antibiotics should be adopted to guide precise anti-infection treatment.