BACKGROUND:Sarcopenia is an age-related condition characterized by the loss of skeletal muscle mass,strength,and/or physical function.Currently,effective treatments for sarcopenia remain limited.A new therapeutic approach to improve symptoms and prognosis of sarcopenia patients clinically was important.OBJECTIVE:To explore the effects of canine adipose-derived mesenchymal stem cells and their exosomes on a dexamethasone-induced sarcopenia in mice.METHODS:Mesenchymal stem cells were isolated and cultured from canine adipose tissue,and identified and functionally evaluated through flow cytometry and differentiation assays for osteogenesis,adipogenesis,and chondrogenesis.Subsequently,exosomes from adipose-derived mesenchymal stem cells were extracted and characterized using transmission electron microscopy,western blot assay,and nanocoulter tracking analysis.In vitro,the effects of canine adipose-derived mesenchymal stem cells and their exosomes on myotube growth and the expression of muscle atrophy-related genes were investigated using dexamethasone-induced C2C12 myotube atrophy and aging C2C12 models.In vivo,a dexamethasone-induced mouse sarcopenia model was established and received intraperitoneal or intravenous injection of canine adipose-derived mesenchymal stem cells.Therapeutic efficacy was assessed through mouse rotarod performance,histopathological analysis,and muscle atrophy-related genes testing.RESULTS AND CONCLUSION:(1)The isolated canine adipose-derived mesenchymal stem cells highly expressed CD73,CD90,and CD105,and lowly expressed MHC-Ⅱ,CD14,CD19,CD34,and CD45,and successfully differentiated into osteoblasts,adipocytes,and chondrocytes in vitro.(2)The adipose-derived mesenchymal stem cells-derived exosomes met the identification criteria in terms of particle size,electron microscopy morphology,and positive expression of specific markers.(3)Compared to the dexamethasone-induced C2C12 atrophy group,treatment with adipose-derived mesenchymal stem cells and their exosomes promoted the recovery and growth of myotubes,inhibited the expression of muscle atrophy-related genes MuRF1 and Atrogin-1.(4)Compared to the aging C2C12 group,adipose-derived mesenchymal stem cells and their exosomes significantly enhanced the recovery and growth of aged muscle tubes in aging cells.(5)Compared to the control group,the rotarod time in dexamethasone-induced sarcopenia model mice was significantly decreased(P＜0.01).After 7 days(P＜0.01,P＜0.01)and 10 days(P＜0.01,P＜0.05)of adipose-derived mesenchymal stem cells treatment via intraperitoneal and intravenous injection,rotarod time was significantly increased,respectively.After 14 days,all treatment groups showed longer rotarod times than the model group,although with no significant differences between them.(6)Compared to the control group,the cross-sectional area of anterior tibial muscle in the model group was significantly reduced(P＜0.01),and it was significantly increased after intraperitoneal and intravenous administration of adipose-derived mesenchymal stem cells(P＜0.05,P＜0.01).(7)Compared to the model group,intraperitoneal and intravenous administration of adipose-derived mesenchymal stem cells significantly inhibited the mRNA expression of MuRF1 and Atrogin-1 genes(P＜0.01,P＜0.01,P＜0.01,P＜0.01).The results indicated that adipose-derived mesenchymal stem cells and their exosomes promoted recovery and growth of atrophic myotube cells by inhibiting the expression of muscle atrophy-related genes,and both intraperitoneal and intravenous administration of adipose-derived mesenchymal stem cells provided good therapeutic effects on sarcopenia in mice.

BACKGROUND:Sarcopenia is an age-related condition characterized by the loss of skeletal muscle mass,strength,and/or physical function.Currently,effective treatments for sarcopenia remain limited.A new therapeutic approach to improve symptoms and prognosis of sarcopenia patients clinically was important.OBJECTIVE:To explore the effects of canine adipose-derived mesenchymal stem cells and their exosomes on a dexamethasone-induced sarcopenia in mice.METHODS:Mesenchymal stem cells were isolated and cultured from canine adipose tissue,and identified and functionally evaluated through flow cytometry and differentiation assays for osteogenesis,adipogenesis,and chondrogenesis.Subsequently,exosomes from adipose-derived mesenchymal stem cells were extracted and characterized using transmission electron microscopy,western blot assay,and nanocoulter tracking analysis.In vitro,the effects of canine adipose-derived mesenchymal stem cells and their exosomes on myotube growth and the expression of muscle atrophy-related genes were investigated using dexamethasone-induced C2C12 myotube atrophy and aging C2C12 models.In vivo,a dexamethasone-induced mouse sarcopenia model was established and received intraperitoneal or intravenous injection of canine adipose-derived mesenchymal stem cells.Therapeutic efficacy was assessed through mouse rotarod performance,histopathological analysis,and muscle atrophy-related genes testing.RESULTS AND CONCLUSION:(1)The isolated canine adipose-derived mesenchymal stem cells highly expressed CD73,CD90,and CD105,and lowly expressed MHC-Ⅱ,CD14,CD19,CD34,and CD45,and successfully differentiated into osteoblasts,adipocytes,and chondrocytes in vitro.(2)The adipose-derived mesenchymal stem cells-derived exosomes met the identification criteria in terms of particle size,electron microscopy morphology,and positive expression of specific markers.(3)Compared to the dexamethasone-induced C2C12 atrophy group,treatment with adipose-derived mesenchymal stem cells and their exosomes promoted the recovery and growth of myotubes,inhibited the expression of muscle atrophy-related genes MuRF1 and Atrogin-1.(4)Compared to the aging C2C12 group,adipose-derived mesenchymal stem cells and their exosomes significantly enhanced the recovery and growth of aged muscle tubes in aging cells.(5)Compared to the control group,the rotarod time in dexamethasone-induced sarcopenia model mice was significantly decreased(P＜0.01).After 7 days(P＜0.01,P＜0.01)and 10 days(P＜0.01,P＜0.05)of adipose-derived mesenchymal stem cells treatment via intraperitoneal and intravenous injection,rotarod time was significantly increased,respectively.After 14 days,all treatment groups showed longer rotarod times than the model group,although with no significant differences between them.(6)Compared to the control group,the cross-sectional area of anterior tibial muscle in the model group was significantly reduced(P＜0.01),and it was significantly increased after intraperitoneal and intravenous administration of adipose-derived mesenchymal stem cells(P＜0.05,P＜0.01).(7)Compared to the model group,intraperitoneal and intravenous administration of adipose-derived mesenchymal stem cells significantly inhibited the mRNA expression of MuRF1 and Atrogin-1 genes(P＜0.01,P＜0.01,P＜0.01,P＜0.01).The results indicated that adipose-derived mesenchymal stem cells and their exosomes promoted recovery and growth of atrophic myotube cells by inhibiting the expression of muscle atrophy-related genes,and both intraperitoneal and intravenous administration of adipose-derived mesenchymal stem cells provided good therapeutic effects on sarcopenia in mice.

Objective To investigate the relationship between serum trimethylamine oxide(TMAO),neurofilament light chain protein(NfL),peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α)expression levels and short-term prognosis in aneurysmal subarachnoid hemorrhage(aSAH)patients.Method A total of 125 aSAH patients(aSAH group)and 125 healthy volunteers in the same period(control group)who were admitted in heji hospital affiliated to Changzhi Medical College from March 2020 to June 2023 were selected.The serum expression levels of TMAO,NfL and PGC-1α were compared between control group and aSAH group.The aSAH patients were followed up for 6 months after discharge.Their prognosis were evaluated using Glasgow Outcome Scale(GOS)and they were further divided into good prognosis and poor prognosis groups according to the GOS results.The serum expression levels of TMAO,NfL and PGC-1α were compared between the two groups.The poor prognosis influencing factors were analyzed by multivariate Logistic regression analysis,the serum TMAO,NfL and PGC-1α value in predicting poor prognosis were analyzed by receiver operating characteristic(ROC)curve.Result The expression levels of serum TMAO and PGC-1 α in the aSAH group were(2.63±0.36)μmol/L and(0.51±0.13)ng/mL,respectively,which were lower than those in the control group(3.18±0.57)μmol/L and(0.81±0.16)ng/mL(P<0.05).The expression level of serum NfL was significantly higher in the aSAH group(64.48±14.35 pg/mL)than in the control group(28.36±8.82 pg/mL)(P<0.05).Compared with the good prognosis group whose serum levels of TMAO and PGC-1 α were(2.80±0.80)μmol/L and(0.58±0.16)ng/mL,respectively,the poor prognosis group had significantly lower serum TMAO[(2.29±0.63)μmol/L]and PGC-1 α[(0.36±0.12)ng/mL](P<0.05).In contrast,poor prognosis group had a significantly higher level of NfL(76.70±15.61)pg/mL compared to good prognosis group(58.52±10.52)pg/mL(P<0.05).The proportion of patients with hypertension,patients with diabetes,patients with large or giant aneurysms,patients with Hunt Hess grade Ⅲ-Ⅳ,patients with onset to hospital time>12 h,and the level of C-reactive protein(CRP)were higher in the poor prognosis group than in the good prognosis group(P<0.05).Hunt Hess grade Ⅲ-Ⅳ,elevated serum CRP and NfL were independent risk factors for poor prognosis in aSAH patients(P<0.05),while elevated TMAO and PGC-1 α were protective factors(P<0.05).The area under the curve(AUC)of serum TMAO,NfL,PGC-1 α,and their combined prediction of poor prognosis in aSAH patients were 0.726,0.830,0.862,and 0.956,respectively.The AUC of the combined detection was greater than that of each indicator detected separately.Conclusion Serum TMAO and PGC-1α are lowly expressed in aSAH patients,and serum NfL is highly expressed,which are related to the occurrence of short-term poor prognosis,the combined detection of the three indicators has a high predictive value for short-term poor prognosis in aSAH patients.

Objective:To study the relationship between the polarization state of hippocampal microglia and depression-like behavior in mice and the regulatory effect of Xiaoyaosan.Methods:Sixty female BALB/C mice were randomly divided into control group, model group, Xiaoyaosan group and fluoxetine group according to the random number method with 15 in each group. Except for control group, the mice in the other 3 groups received chronic restraint stress for 21 days to establish the depressive model. The mice in the Xiaoyaosan group and fluoxetine group were gavaged with Xiaoyaosan(28.06 g/kg) and fluoxetine(3.03 mg/kg) respectively, while the mice in control and model groups received the same volume of 0.9% NaCl solution. Mouse behaviors were evaluated by sucrose preference test and elevated plus maze test.ELISA was used to detect the contents of 5-hydroxytryptamine(5-HT), dopamine(DA) in serum and transforming growth factor-β1(TGF-β1), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the hippocampus. Immunohistochemistry was used to detect inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1) expression.Western blot was used to detect the protein levels of iNOS, Arg-1, CD86 and CD206. The mRNA expression of iNOS and Arg-1 in hippocampus was detected by qRT-PCR. The pathological changes of hippocampus were observed by HE staining.SPSS 27.0 software was used to analyze the data. One-way ANOVA was used for comparison among multiple groups, and LSD test was used for pairwise comparison.Results:(1) There were significant differences in sucrose preference among the 4 groups ( F=46.62, P<0.05).The sucrose preference of model group was lower than that of the control group ( P<0.05), while the sucrose preference of Xiaoyaosan group was higher than that of the model group ( P<0.05).There were significant differences in the number of open arm entries and residence time in the elevated plus maze test among the 4 groups ( F=24.63, 26.94, both P<0.05). The number of open arm entries and residence time in model group ((1.80±1.48)times, (6.19±1.67)s) were lower than those of the control group ((9.80±1.64)times, (56.81±2.75)s)) (both P<0.05). The number of open arm entries and residence time in Xiaoyaosan group ((6.80±0.84)times, (29.59±7.72)s) were significantly higher than model group(both P<0.05).(2) There were significant differences in serum 5-HT and DA levels among the 4 groups ( F=33.27, 76.03, both P<0.05). The serum 5-HT and DA levels in the model group were lower than those of the control group (both P<0.05).The serum 5-HT and DA levels in the Xiaoyaosan group were higher than those of model group (both P<0.05).(3)There were significant differences in the contents of TGF-β1, IL-10, TNF-α and IL-6 in the hippocampus of 4 groups ( F=31.93, 64.01, 25.74, 28.14, all P<0.05). The contents of TGF-β1 and IL-10 in the model group were lower than those of the control group, while the contents of TNF-α and IL-6 were higher (all P<0.05). Compared with the model group, the contents of TGF-β1 and IL-10 in Xiaoyaosan group ( TGF-β1: (30.40±1.56)pg/mL vs (23.77±2.24) pg/mL; IL-10: ((233.94±11.38)pg/mL) vs (130.46±15.34) pg/mL) were higher, and the contents of TNF-α ((73.35±1.51)ng/mL vs (85.89±4.52)pg/mL) and IL-6 (66.15±2.96)pg/mL vs (76.01±1.59)pg/mL) )were lower (all P<0.05).(4)The results of qRT-PCR, immunohistochemistry and Western blot all showed that there were significant differences in mRNA and protein levels of iNOS ( F=41.92, 20.78, 9.27, all P<0.05) and Arg-1 ( F=27.24, 24.23, 6.49, all P<0.05) in the hippocampus among the 4 groups of mice. The mRNA and protein levels of iNOS of the model group were higher than those in the control group (both P<0.05), while the mRNA and protein levels of Arg-1 were lower than those in the control group(both P<0.05).The mRNA and protein levels of iNOS in the Xiaoyaosan group were lower than those in the model group (both P<0.05), while the mRNA and protein levels of Arg-1 were higher than model group(both P<0.05).(5) The expressions of CD206 and CD86 in hippocampus of the 4 groups were significantly different ( F=86.14, 24.02, both P<0.05). Compared with the control group, the model group had a higher expression of CD86 in the hippocampus and a lower expression of CD206 (both P<0.05).Compared with the model group, the CD86 of Xiaoyaosan group was lower, while CD206 was higher (both P<0.05). (6) The HE staining results showed that the cells in the hippocampal CA1 region of the model group mice exhibited disordered arrangement, fewer cells, larger intercellular space, unclear boundary and other changes.The morphology of the cells in the Xiaoyaosan group was improved compared to the model group. Conclusion:Xiaoyaosan can inhibit M1 activation of microglia and neuronal damage in the hippocampus of mice caused by chronic restraint stress, exerting neuroprotective effects and improving depressive behavior in mice.

Objective To investigate the relationship between serum trimethylamine oxide(TMAO),neurofilament light chain protein(NfL),peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α)expression levels and short-term prognosis in aneurysmal subarachnoid hemorrhage(aSAH)patients.Method A total of 125 aSAH patients(aSAH group)and 125 healthy volunteers in the same period(control group)who were admitted in heji hospital affiliated to Changzhi Medical College from March 2020 to June 2023 were selected.The serum expression levels of TMAO,NfL and PGC-1α were compared between control group and aSAH group.The aSAH patients were followed up for 6 months after discharge.Their prognosis were evaluated using Glasgow Outcome Scale(GOS)and they were further divided into good prognosis and poor prognosis groups according to the GOS results.The serum expression levels of TMAO,NfL and PGC-1α were compared between the two groups.The poor prognosis influencing factors were analyzed by multivariate Logistic regression analysis,the serum TMAO,NfL and PGC-1α value in predicting poor prognosis were analyzed by receiver operating characteristic(ROC)curve.Result The expression levels of serum TMAO and PGC-1 α in the aSAH group were(2.63±0.36)μmol/L and(0.51±0.13)ng/mL,respectively,which were lower than those in the control group(3.18±0.57)μmol/L and(0.81±0.16)ng/mL(P<0.05).The expression level of serum NfL was significantly higher in the aSAH group(64.48±14.35 pg/mL)than in the control group(28.36±8.82 pg/mL)(P<0.05).Compared with the good prognosis group whose serum levels of TMAO and PGC-1 α were(2.80±0.80)μmol/L and(0.58±0.16)ng/mL,respectively,the poor prognosis group had significantly lower serum TMAO[(2.29±0.63)μmol/L]and PGC-1 α[(0.36±0.12)ng/mL](P<0.05).In contrast,poor prognosis group had a significantly higher level of NfL(76.70±15.61)pg/mL compared to good prognosis group(58.52±10.52)pg/mL(P<0.05).The proportion of patients with hypertension,patients with diabetes,patients with large or giant aneurysms,patients with Hunt Hess grade Ⅲ-Ⅳ,patients with onset to hospital time>12 h,and the level of C-reactive protein(CRP)were higher in the poor prognosis group than in the good prognosis group(P<0.05).Hunt Hess grade Ⅲ-Ⅳ,elevated serum CRP and NfL were independent risk factors for poor prognosis in aSAH patients(P<0.05),while elevated TMAO and PGC-1 α were protective factors(P<0.05).The area under the curve(AUC)of serum TMAO,NfL,PGC-1 α,and their combined prediction of poor prognosis in aSAH patients were 0.726,0.830,0.862,and 0.956,respectively.The AUC of the combined detection was greater than that of each indicator detected separately.Conclusion Serum TMAO and PGC-1α are lowly expressed in aSAH patients,and serum NfL is highly expressed,which are related to the occurrence of short-term poor prognosis,the combined detection of the three indicators has a high predictive value for short-term poor prognosis in aSAH patients.

Objective:To evaluate the effect of arctigenin (ARG) on cognitive dysfunction induced by sevoflurane anesthesia in aged rats and the role of autophagy-mediated pyroptosis.Methods:Fifty SPF male Sprague-Dawley rats, aged 18-20 months, weighing 550-600 g, were divided into 5 groups ( n=10 each) using a random number table method: control group (C group), sevoflurane anesthesia group (Sev group), sevoflurane anesthesia+ ARG group (Sev+ ARG group), sevoflurane anesthesia+ autophagy inducer rapamycin group (Sev+ RAPA group), and sevoflurane anesthesia+ ARG+ autophagy inhibitor 3-methyladenine (3-MA) group (Sev+ ARG+ 3-MA group). Except for group C, the rats in the other groups inhaled 6% sevoflurane for 3 h to establish the cognitive impairment model. At 30 min before anesthesia, ARG 20 mg/kg was intraperitoneally injected in Sev+ ARG group, rapamycin 7.5 mg/kg was intraperitoneally injected in Sev+ RAPA group, and ARG 20 mg/kg (dissolved in dimethyl sulfoxide) was intraperitoneally injected, followed by immediate intraperitoneal injection of 3-MA 1.5 mg/kg in Sev+ ARG+ 3-MA group. The equal volume of dimethyl sulfoxide was intraperitoneally injected in C group and Sev group. The Morris water maze test was conducted to assess the cognitive function at 48 h after the end of administration. After completion of the Morris water maze test, the hippocampal tissue was taken under deep anesthesia for observation of the pathological changes (after HE staining) which were scored and for determination of neuronal pyroptosis (after propidium iodide staining) and expression of neuronal autophagy-related proteins (microtubule-associated protein 1 light chain 3 [LC3], Beclin-1, p62), pyroptosis-related proteins (NOD-like receptor protein 3 [NLRP3], apoptosis-associated speck-like protein containing a CARD [ASC], pro-cysteine aspartate-specific protease 1 [pro-caspase-1], cleaved-caspase-1, gasdermin D [GSDMD], and N-terminal fragment of gasdermin D [GSDMD-N], interleukin-1β [IL-1β] and IL-18). Results:Compared with C group, the escape latency was significantly prolonged, the time of staying at the original platform quadrant was shortened, the number of crossing the original platform was reduced, the hippocampal injury score and neuronal pyroptosis rate were increased, LC3Ⅱ/LC3Ⅰ ratio was decreased, the expression of Beclin-1 was down-regulated, the expression of p62, NLRP3, ASC, IL-1β and IL-18 was up-regulated, and the cleaved-caspase-1/pro-caspase-1 ratio and GSDMD-N/GSDMD ratio were increased in Sev group ( P<0.05). Compared with Sev group, the escape latency was significantly shortened, the time of staying at the original platform quadrant was prolonged, the number of crossing the original platform was increased, the hippocampal injury score and neuronal pyroptosis rate were decreased, LC3Ⅱ/LC3Ⅰ ratio was increased, the expression of Beclin-1 was up-regulated, the expression of p62, NLRP3, ASC, IL-1β and IL-18 was down-regulated, and the cleaved-caspase-1/pro-caspase-1 ratio and GSDMD-N/GSDMD ratio were decreased in Sev+ ARG group and Sev+ RAPA group ( P<0.05). Compared with Sev+ ARG group, the escape latency was significantly prolonged, the time of staying at the original platform quadrant was shortened, the number of crossing the original platform was reduced, the hippocampal injury score and neuronal pyroptosis rate were increased, LC3Ⅱ/LC3Ⅰ ratio was decreased, the expression of Beclin-1 was down-regulated, the expression of p62, NLRP3, ASC, IL-1β and IL-18 was up-regulated, and the cleaved-caspase-1/pro-caspase-1 ratio and GSDMD-N/GSDMD ratio were increased in Sev+ ARG+ 3-MA group ( P<0.05). Conclusions:AGR can alleviate sevoflurane anesthesia-induced cognitive dysfunction in aged rats, and the mechanism is related to reduction of autophagy-mediated cell pyroptosis.

Objective:To investigate the distribution and epidemiological patterns of hepatitis B virus（HBV）serological markers among pediatric surgical inpatients in Beijing.Methods:A retrospective cross-sectional study was conducted using data from all surgical inpatients（0?18 years of age）at a tertiary children’s hospital in Beijing between January 2019 and December 2024. Five HBV serological markers（HBsAg，anti-HBs，anti-HBc，HBeAg，anti-HBe）were analyzed and compared across sex，age，and ethnicity.Results:Of 15 339 children included，56.50% were male and 43.50% female；the 6?12-year age group predominated（37.41%），and Han ethnicity accounted for 91.61%. The overall positive rates were 0.78% for HBsAg，75.32% for anti-HBs，7.42% for anti-HBc，0.02% for HBeAg，and 3.05% for anti-HBe. The prevalences of “big three-positive”（HBsAg+/HBeAg+/anti-HBc+）and “small three-positive”（HBsAg+/anti-HBe+/anti-HBc+）patterns were only 0.02% and 0.04%，respectively. Boys had significantly higher anti-HBs（76.02% vs 74.40%）and anti-HBc（8.01% vs 6.69%）positivity than girls. HBsAg peaked in the 1?3-year group（1.75%）and was lowest in the 6?12-year group（0.19%）. Anti-HBs reached its highest level in the 3?6-year group（81.25%）and declined to 56.07% in adolescents（12?18 years）. No ethnic differences were observed.Conclusion:Universal HBV vaccination has achieved remarkable success among surgical inpatients in Beijing，as evidenced by high anti-HBs levels and very low rates of active or chronic infection. However，antibody titers wane with age，underscoring the need for targeted booster strategies for school-aged children.

Objective:By analyzing the disease spectrum and composition of inpatients in general surgery department of a children′s hospital in Beijing from January 2018 to June 2024, to understand the impact of the COVID-19 on the number of inpatients in children′s hospitals and the composition of disease types, and to provide scientific evidence for hospital capacity building and medical response after the outbreak of the epidemic.Methods:The hospitalization medical records of children in the general surgery ward of the children′s hospital from January 1, 2018 to June 30, 2024 were collected. SPSS 22.0 software and EXCEL tools were used to analyze the ranking and composition of general surgery diseases in the hospital from three dimensions: different years, different genders, and different age groups. At the same time, the source of children in the hospital was counted by province.Results:Overall, the total number of hospitalized children has shown a significant decrease since 2020, and has since slowly rebounded; Acute appendicitis, inguinal hernia, and common bile duct cyst rank among the top three diseases annually; From a gender perspective, inguinal hernia and acute appendicitis are the most common in male children, while acute appendicitis and common bile duct cysts are the most common in female children; In terms of age, the 1-year-old group has the highest number of patients with inguinal hernia, while the 5-year-old and 10-18-year-old groups have the highest number of patients with acute appendicitis; Compared with 2018-2019, the number of hospitalized children with inguinal hernia decreased sharply in the first half of 2020-2024, and the first priority disease changed from inguinal hernia to acute appendicitis.Conclusions:This study analyzed the disease spectrum and composition of the children′s hospital before and after the COVID-19 epidemic, which has important reference value for the capacity building, resource allocation and epidemic response of the children′s hospital.

Objective:To investigate the distribution and epidemiological patterns of hepatitis B virus（HBV）serological markers among pediatric surgical inpatients in Beijing.Methods:A retrospective cross-sectional study was conducted using data from all surgical inpatients（0?18 years of age）at a tertiary children’s hospital in Beijing between January 2019 and December 2024. Five HBV serological markers（HBsAg，anti-HBs，anti-HBc，HBeAg，anti-HBe）were analyzed and compared across sex，age，and ethnicity.Results:Of 15 339 children included，56.50% were male and 43.50% female；the 6?12-year age group predominated（37.41%），and Han ethnicity accounted for 91.61%. The overall positive rates were 0.78% for HBsAg，75.32% for anti-HBs，7.42% for anti-HBc，0.02% for HBeAg，and 3.05% for anti-HBe. The prevalences of “big three-positive”（HBsAg+/HBeAg+/anti-HBc+）and “small three-positive”（HBsAg+/anti-HBe+/anti-HBc+）patterns were only 0.02% and 0.04%，respectively. Boys had significantly higher anti-HBs（76.02% vs 74.40%）and anti-HBc（8.01% vs 6.69%）positivity than girls. HBsAg peaked in the 1?3-year group（1.75%）and was lowest in the 6?12-year group（0.19%）. Anti-HBs reached its highest level in the 3?6-year group（81.25%）and declined to 56.07% in adolescents（12?18 years）. No ethnic differences were observed.Conclusion:Universal HBV vaccination has achieved remarkable success among surgical inpatients in Beijing，as evidenced by high anti-HBs levels and very low rates of active or chronic infection. However，antibody titers wane with age，underscoring the need for targeted booster strategies for school-aged children.

Purpose To explore the correlation between spectral CT-derived quantitative parameters and different programmed death-ligand 1(PD-L1)expression status in gastric adenocarcinoma,in order to provide additional imaging-based references for immunotherapy regimen selection in patients with this disease.Materials and Methods A total of 45 patients with gastric adenocarcinoma,pathologically confirmed by biopsy,who underwent PD-L1 testing prior to treatment were retrospectively enrolled from Lanzhou University Second Hospital between January 2021 and September 2023.All patients underwent baseline spectral CT scans.Based on PD-L1 expression status,patients were categorized into the higher combined positive score(CPS)group(CPS≥5)and the lower CPS group(CPS<5).From the single-energy images of arterial and venous phases,the CT values(CT40 keV,CT70 keV),effective atomic number,and iodine concentration of the lesions were measured.The standardized iodine concentration and slope of the spectral curve were calculated.Differences in spectral CT parameters between the two groups were compared.Receiver operating characteristic curves were plotted for parameters with statistically significant differences,and the area under the curve was calculated to evaluate the efficacy of each single parameter and combined parameters in distinguishing PD-L1 expression status.Results In the arterial phase,the CT40 keV,CT70 keV,iodine concentration,standardized iodine concentration,effective atomic number,and slope of the spectral curve of lesions in the higher expression group were all significantly higher than those of lesions in the lower expression group(t/Z=-3.115 to-2.725,all P<0.05),whereas no significant differences were observed in all parameters in the venous phase(all P>0.05).For the standardized iodine concentration in the enhanced arterial phase,the area under the curve for distinguishing PD-L1 expression status was 0.755(95%CI 0.612 to 0.898),with a sensitivity of 81.8%and a specificity of 65.2%.No significant differences were found between it and other single spectral CT parameters in the arterial phase(all P>0.05),and its diagnostic efficacy was similar to that of the combined parameters[the area under the curve was 0.755(95%CI 0.613 to 0.897),sensitivity was 90.9%,specificity was 52.2%].Conclusion Quantitative parameters of spectral CT in the arterial phase can predict the PD-L1 expression of gastric adenocarcinoma,which may provide a reference for the screening and immunotherapy evaluation of patients with gastric adenocarcinoma.