Background/Aims: Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment. Methods: A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets. Results: The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals. Conclusions Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.

OBJECTIVE To construct a comprehensive evaluation system for oral Chinese patent medicines in children that is compatible with pediatric physiological characteristics and the features of traditional Chinese medicine （TCM）， and provide a basis for the selection， pharmaceutical management， and medical insurance procurement of oral Chinese patent medicines in children.METHODS According to the Guidelines for the Management of Comprehensive Clinical Evaluation of Drugs （ 2021 Trial Edition ） and related policy documents and literatures， six first-level indicators were determined： safety， efficacy， suitability， economy， accessibility， and innovation. An initial indicator pool was constructed through literature retrieval， policy text analysis， and semi-structured expert interviews. A preliminary survey using a 5-point Likert scale was conducted to determine the primary indicator list. Two rounds of Delphi expert consultation were carried out. The analytic hierarchy process （AHP） was used to determine the weights and scores of indicators at all levels， and the methodological quality of the questionnaire and reliability were evaluated. Five oral Chinese patent medicines for pediatric respiratory diseases were selected for empirical evaluation. Two independent blinded reviewers scored the medicines， and the Kappa value was calculated to evaluate inter-rater consistency.RESULTS Both rounds of Delphi consulting had 21 experts， with a positive coefficient of 100% and an authoritative coefficient of 0.89. The Kendall’s W coefficients of concordance for the first and second rounds of Delphi expert consultation were 0.812 and 0.856， respectively （ P ＜0.01）. The consistency ratios of all AHP judgment matrices ranged from 0.032 to 0.087 （all ＜0.10）. The Cronbach’s α coefficient was 0.847. A comprehensive evaluation system for oral Chinese patent medicines in children was established， comprising 6 first-level indicators， 25 second-level indicators， and 78 third-level indicators. The weights of the first-level indicators were 0.32， 0.24， 0.16， 0.13， 0.10 and 0.05， respectively， for safety， effectiveness， suitability， economy， accessibility and innovation. The empirical evaluation showed that Xiao’er chiqiao qingre granules obtained the highest comprehensive score （90.8 points）， followed by Xiao’er feire kechuan oral liquid （86.3 points）， Ertong qingfei oral liquid （82.8 points）， Xiao’er xiaoji zhike oral liquid （82.0 points）， and Jinzhen oral liquid （81.5 points）. The inter-rater consistency Kappa value was 0.91.CONCLUSIONS The comprehensive evaluation system for oral Chinese patent medicines in children constructed in this study， includes 12 pediatric-specific third-level indicators and integrates key evaluation points of both traditional Chinese and Western medicine. It demonstrates good consistency and reliability， with good operability and reproducibility.

Objective To explore the impact of prolonged sitting on lumbar disc degeneration using MRI T1ρ and T2 mapping.Methods A total of 25 taxi drivers(prolonged sitting group)and 24 age-matched non-prolonged sitting volunteers(control group)underwent routine lumbar MRI,T1ρ,and T2 mapping.The differences of T1ρ and T2 values for different Pfirrmann grades of anterior annulus fibrosus(AAF),nucleus pulposus(NP),and posterior annulus fibrosus(PAF)were analyzed using Variance analysis,Spearman correlation test,and receiver operating characteristic(ROC)curve was drawn,with independent t-tests was used for between-group com-parisons.Results Statistically significant differences were observed in T1ρ and T2 values for all Pfirrmann Ⅰ-Ⅱ grades NP and Pfirrmann Ⅱ-Ⅳgrades AAF,NP,and PAF in both groups(P＜0.05).Both T1ρ and T2 values were negatively correlated with Pfirrmann grades.The area under the curve(AUC)of T1ρ values for NP at each Pfirrmann grade were 0.928,0.987,and 0.968,respectively,while the AUC of T2 values for NP were 0.777,0.966,and 0.975,respectively.The T1ρ and T2 values of L4/L5 NP and L5/S1 AAF,NP,and PAF were lower in the prolonged sitting group compared to the control group(P＜0.05).Conclusion T1ρ is superior to T2 mapping in detecting lumbar disc degeneration.Prolonged sitting is more likely to cause degeneration of L4/L5 and L5/S1 inter-vertebral discs.

Objective:To analyze the clinical characteristics of hospitalized premenopausal patients with hyperuricemia.Methods:The medical records of premenopausal women with hyperuricemia (serum uric acid ≥360 μmol/L during hospitalization) admitted in Peking Union Medical College Hospital from 2013 to 2018 were reviewed and the clinical data were analyzed.Results:A total of 2 099 patients were enrolled. Only 14.01% (294 cases) of the patients were concerned about hyperuricemia by physicians. Autoimmune diseases (32.11%, 674 cases), nephrotic disease (19.29%, 405 cases) and endocrine system diseases (9.72%, 204 cases) are the main reasons for hospitalization, while 6.34%(133 cases) of patients were in gestation. In terms of the etiology, renal diseases (49.35%, 1 035 cases), specific drug use (49.26%, 1 034 cases) were the main causes of secondary hyperuricemia in premenopausal women, followed by metabolic diseases (10.62%, 233 cases). There was no significant difference in serum uric acid level among premenopausal women of different ages ( H=4.47, P=0.107), but the etiology of hyperuricemia among patients of different ages had significant differences. The proportion of hyperuricemia in patients with cancer and metabolic syndrome,secondary to use of diuretics and anti-tuberculosis drugs had differences among different age groups ( χ2=90.96,52.89,19.26 and 6.41, P<0.05). Conclusion:Hyperuricemia is not uncommon in premenopausal women. There are many secondary factors leading to hyperuricemia in premenopausal women, among which drugs and renal lesions are the main causes. In addition, the secondary factors in women with hyperuricemia has differences among different age groups.

OBJECTIVE To stud y the chemical cons tituents of n-butanol part of Qubai tablet and its pharmacodynamic effect on the model of de melanocyte. METHODS The n-butanol part of Qubai tablet was prepared. The chemical constituents were analyzed by ultra-high performance liquid chromatography-mass spectrometry （UPLC-MS）. Taking mice B 16 melanoma cells as the research object ，the de melanocyte model was established and divided into model group ，positive control different concentration groups（8-methoxypsoralen 10，50，100，150，200 μmol/L），solvent group （diluted with DMSO ）and Qubai tablet n-butanol part different concentration groups （10，50，100，150，200 μmol/L）. The number of cells were observed by inverted microscope ，and the cell proliferation rate ，the rate of melanin production and promotion rate of tyrosinase activity were also detected. RESULTS In the positive and negative ion mode ，53 compounds in the n-butanol part of Qubai tablet were preliminarily determined （29 in the positive ion mode ，33 in the negative ion mode ，overlapping 9），of which coumarins accounted for the largest proportion ， followed by flavonoids. The n-butanol part of Qubai tablet could significantly increase the number of cells ，which was positively correlated with the action time and administration concentration. It could significantly increase the proliferation rate of cells ，the rate of melanin production and promotion rate of tyrosinase activity （P＜0.01）. CONCLUSIONS Coumarins and flavonoids may be the material basis for the anti-vitiligo effect of n-butanol part from Qubai tablet ；anti-vitiligo effect of n-butanol part of Qubai tablet may be realized by promoting tyrosinase activity.

Ovarian tissue cryopreservation and transplantation technology plays an important role in preserving female fertility. However, the ischemic injury after frozen-thawed ovarian tissue transplantation is a key issue for the survival of the transplanted ovarian tissue and the restoration of reproductive endocrine function. The use of appropriate ovarian tissue cryopreservation and transplantation techniques, or the addition of angiogenic factors, hormones, antioxidants, and Chinese medicine can effectively promote the angiogenesis of frozen-thawed ovarian tissue after transplantation, and improve the survival rate of follicles and the recovery of reproductive function. This article reviews the occurrence of ischemic injury after frozen-thawed ovarian tissue transplantation and how to promote angiogenesis.

Ovarian tissue cryopreservation and transplantation technology plays an important role in preserving female fertility. However, the ischemic injury after frozen-thawed ovarian tissue transplantation is a key issue for the survival of the transplanted ovarian tissue and the restoration of reproductive endocrine function. The use of appropriate ovarian tissue cryopreservation and transplantation techniques, or the addition of angiogenic factors, hormones, antioxidants, and Chinese medicine can effectively promote the angiogenesis of frozen-thawed ovarian tissue after transplantation, and improve the survival rate of follicles and the recovery of reproductive function. This article reviews the occurrence of ischemic injury after frozen-thawed ovarian tissue transplantation and how to promote angiogenesis.

The level of anti-Müllerian hormone (AMH) in the serum of patients with polycystic ovary syndrome (PCOS) was higher than that of normal women. In recent years, more and more studies have suggested that the interaction between AMH and androgen causes follicular developmental disorder in PCOS patients, and AMH can be used as a biochemical indicator for the diagnosis of PCOS, especially in PCOS patients with hyperandrogenism. This paper reviews the prospects and challenges of AMH in the diagnosis of PCOS.

The level of anti-Müllerian hormone (AMH) in the serum of patients with polycystic ovary syndrome (PCOS) was higher than that of normal women. In recent years, more and more studies have suggested that the interaction between AMH and androgen causes follicular developmental disorder in PCOS patients, and AMH can be used as a biochemical indicator for the diagnosis of PCOS, especially in PCOS patients with hyperandrogenism. This paper reviews the prospects and challenges of AMH in the diagnosis of PCOS.

Objective To investigate the effect of occipitocervical fusion in patients with craniovertebral junction deformity combined with atlantoaxial instability. Methods The clinical data of 59 patients with craniovertebral junction deformity combined with atlantoaxial instability from March 2013 to June 2017 were retrospectively analyzed. The patients were treated with occipitocervical fusion. The atlantoaxial distance (ADI), distance between the odontoid and Chamberlain line and cervicomedullary angle (CMA) were used to evaluate atlantoaxial dislocation, vertical displacement and spinal cord compression, and the Japan Orthopedic Association (JOA) score was used to evaluate the effect before operation and 7 days after operation. Results The operation time was 109 to 214 (148.5 ± 20.1) min, the transoperative bleeding was 55 to 210 (122.0 ± 16.7) ml, and no injury of spinal cord nerve and vertebral artery occurred during operation. The CMA and JOA score 7 d after operation were significantly higher than that before operation: (153.8 ± 5.4)° vs. (131.2 ± 7.1) ° and (12.7 ± 1.8) scores vs. (10.6 ± 1.4) scores, and the ADI and distance between the odontoid and Chamberlain line 7 d after operation were significantly lower than that before operation: (2.9 ± 0.7) mm vs. (8.3 ± 2.7) mm and (3.2 ± 1.4) mm vs. (8.2 ± 2.3) mm, and there were statistical difference (P＜0.05). One case (1.7%, 1/59) died of massive brainstem infarction 1 d after operation; 2 patients (3.4%, 2/59) had undergone a revision operation due to fusion failure 3 months after operation; other 56 patients in reduction, internal fixation and bone graft fusion. The patients were followed up for 6 to 38 (15.9 ± 7.2) months, and the symptom relief was in 56 cases. The rate of symptom relief was 94.9% (56/59). The JOA score at last follow-up was significantly higher than that before operation: (13.3 ± 1.8) scores vs. (10.6 ± 1.4) scores, and there was statistical difference (P＜0.05). Conclusions The occipitocervical fusion can effectively relieve spinal cord compression and atlantoaxial instability in patients with craniovertebral junction deformity combined with atlantoaxial instability.