Objective: To investigate the incidence of occult hepatitis B virus infection (OBI) in spouses of asymptomatic hepatitis B virus (HBV) infected individuals in Shenzhen, China, and to analyze their serological and molecular characteristics and possible transmission routes, so as to propose refined strategies for blood safety. Methods: After rapid screening for HBsAg at the blood collection sites, samples from HBsAg-positive blood donors and their concurrently donating spouses were collected. All samples were tested for hepatitis B serological markers by electrochemiluminescence immunoassay (ECLI). Simultaneously, HBV nucleic acid extractiona, nested PCR amplification, gene sequencing of S and BCP/PC regions and qPCR were conducted. Results: A total of 112 samples were collected, including 56 from HBsAg positive donors and 56 from their spouses. All donors were confirmed as HBsAg+/DNA+/anti-HBc+, indicative of asymptomatic chronic hepatitis (CHB) infection. Among their 56 spouses, 11 (19.6%) were identified as HBV DNA+. The prevalence was higher in males (23.1%) than in females (16.7%). Six spouses (10.8%) had OBI, three of whom (5.4%) were negative in routine blood screening tests. The residual risk of HBV were estimated as 1∶127 (95%CI, 1∶356 to 1∶66). Among infected couples, immune escape mutation (E164D) and glycosylation mutations (I126T and T131N/M133T) were identified. Furthermore, sequence analysis suggested partner-to-partner transmission in eight cases. Conclusion: A substantial proportion (19.6%) of spouses of asymptomatic HBV infected donors were HBV-positve, with an OBI prevalence of 10.9%. Among these, 5.4% were negative in routine tests. To ensure blood safety, we recommend that spouses of HBV infected individuals be deferred from blood donation.

Objective:To analyze the relationship between cuprotosis-realted gene DLD expression in pan-cancer and progno-sis,tumor microenvironment and tumor immune infiltration by bioinformatics methods combined with multiple databases.Methods:TCGA,GTEx,TISDB,GEO,UCSC,TARGET,TIMER2.0,GEPIA2,SangerBox,PrognoScan and related R software packages were used to analyze the difference of DLD expression between human cancer and adjacent normal tissues,inestigate relationship between prognosis,explore expression of DLD in different immune subtypes and molecular subtypes of human cancer,analyze correlation between DLD expression and tumor immune infiltration and tumor microenvironment,detecet relationship between DLD expression and 60 immune checkpoint genes.Results:There were differences in expression of DLD in different tumor tissues;low DLD expression in 6 tumors and high DLD expression in 3 tumors were significantly associated with better prognosis;15 tumor immune subtypes,11 molecular subtypes of tumors were significantly correlated with DLD expression;DLD expression was significantly correlated with immune infiltration in 37 cancer types;DLD expression was significantly associated with immune infiltration in 23 tumor stroma scores,26 tumor immune scores and 25 tumor ESTIMATE scores;60 immune checkpoint genes in 39 tumors were significantly associated with DLD expression.Conclusion:Expression of DLD in pan-cancer is related to tumor prognosis and immune invasion,DLD may be a potential predictor of prognosis in tumors,and may be an immunomodulator of tumors.

[Objective] To investigate the factors associated with alanine aminotransferase (ALT) abnormalities in multi-ethnic blood donors across five Zang autonomous prefectures in the plateau regions of Qinghai Province, and to provide evidence for ensuring blood safety and formulating screening strategies. [Methods] A retrospective analysis was performed on the ALT abnormal test results of blood donors in the Zang autonomous prefectures of Qinghai from 2022 to 2024. The correlations between ALT levels and factors including gender, age, altitude, and infectious markers were investigated. [Results] The overall ALT unqualified rate among blood donors in this region was 9.01%. Significant differences in ALT levels were observed across genders and age groups (P<0.05). Variations in ALT abnormality rates were also noted among different plateau regions (P<0.05). Overall, ALT values exhibited an increasing trend with rising altitude. The average ALT unqualified rates were 11.19% in Zang donors, 7.96% in Han donors, and 4.79% in donors from other ethnic groups (P<0.05). No statistically significant association was observed between ALT abnormality and the presence of HBV/HCV infectious markers (P>0.05). [Conclusion] In the plateau areas of Qinghai, multi-ethnic blood donors have a relatively high ALT levels and ALT unqualified rates, showing distinct regional characteristics. ALT elevation in voluntary blood donors is related to non-pathological factors such as gender, age, and dietary habits, but not to infectious indicators.

Objective: To retrospectively analyze the prevalence of hepatitis C virus (HCV) infection among voluntary blood donors in Qinghai Province over a ten-year period and to provide evidence for refining blood safety screening strategies. Methods: Blood samples from 362 066 blood donors in Qinghai collected between January 2015 and April 2024 were simultaneously screened using enzyme-linked immunosorbent assay (ELISA) and nucleic acid testing (NAT). Follow-up was conducted for donors with reactive HCV RNA screening results, and alanine transaminase (ALT) was detected by rate method. Results: The HCV positive rate among blood donors in Qinghai was 0.22%. Gender, marital status, number of blood donations, and educational level were associated with HCV infection. Significant differences in HCV positive rates were observed among donors across regions and ethnic groups. The HCV positive rate among donors in Golog Tibetan Autonomous Prefecture (with an average altitude of 4 330 m) was significantly higher than that in Xining (0.52% vs 0.21%, P<0.001). Positivity rates were also significantly higher in Salar (0.84%), Hui (0.81%), Zang (0.60%), and Tu (0.45%) ethnic groups compared to the Han ethnic group (0.17%) (P<0.001). The abnormal rate of ALT in HCV-positive donors was higher than in non-HCV donors (6.13% vs 1.55%) (P<0.001). Conclusion: The relatively high HCV positivity rate among blood donors in Qinghai highlights the need for further investigation into viral sources, risk factors, and transmission routes. Optimized screening strategies are essential to ensure blood safety.

Objective:To analyze the assessment value of the quantitative parameters of coronary computed tomography angiography(CCTA)combined with QRS wave complex of electrocardiogram(ECG)for grading of cardiac function in patients with coronary heart disease(CHD).Methods:Eighty CHD patients admitted to Beijing Rehabilitation Hospital,Capital Medical University between January 2023 and December 2024 were selected.The grading of cardiac function of CHD patients were assessed according to the standard of New York Heart Association(NYHA).All patients underwent CCTA and ECG upon admission.CCTA quantitative parameters and QRS wave complex duration were recorded and compared among patients with different grades of cardiac function.The correlation between CCTA quantitative parameters[non-calcified plaque volume(NCPV),calcified plaque volume(CPV),total plaque volume(TPV),vessel volume,reconstruction index],QRS wave complex duration,and grading of cardiac function of CHD patient was analyzed.The area under curve(AUC)of receiver operating characteristic(ROC)curve was used to analyze the value of each parameter and QRS wave complex duration in assessing CHD patients whose cardiac function grade was≥III grade.Results:In the 80 CHD patients,NYHA grades were distributed as follows:11 cases were grade I,and 23 cases were grade II,and 27 cases were grade III,and 19 cases were grade IV.The NCPV,CPV,TPV,reconstruction index,and QRS wave complex duration of patients at grade III and grade IV were higher than those of patients at grade I-grade II,and the differences were significant(F=17.401,37.077,12.297,7.087,11.148,P<0.05).Furthermore,patients at grade IV showed higher values in all parameters than those of patients at grade III.The NCPV,CPV,TPV,reconstruction index(t=3.486,4.315,3.444,2.068,2.600,P<0.05),and QRS wave complex duration of CCTA parameters showed positive correlations with cardiac function grading in CHD patient(r=0.464,0.548,0.346,0.287,0.373,P<0.05).ROC curve analysis revealed that the AUC values of alone NCPV,CPV,TPV,reconstruction index,QRS wave complex duration of CCTA parameters,and the combination of these indicators were respectively 0.793,0.843,0.723,0.748,and 0.737 in assessing CHD patients whose cardiac function grade was≥III,which indicated that these indicators had a certain assessment value,and the combined detection can improve the AUC value and sensitivity.Conclusion:The combination of CCTA parameters(NCPV,CPV,TPV,reconstruction index)and QRS wave complex duration can improve the assessment value for CHD patients whose grade of cardiac function is≥grade III.

This study aims to investigate the polarized microscopic mineral phase characteristics, inorganic element content, and potential health risks associated with the intake of raw and calcined fossil mineral Chinese medicinal material Draconis Os. Microscopy was employed to observe the mineralogical characteristics of Draconis Os and compare the microscopic features and phase composition of raw and calcined Draconis Os under monochromatic and orthogonal polarized light. Inductively coupled plasma mass spectrometry(ICP-MS) was employed to determine the content of 30 inorganic elements. Health risk assessment was conducted by calculating the single pollution index(P_i), average daily intake of elements for adults(ADI), target hazard quotient(THQ), non-carcinogenic assessment method-hazard quotient(HQ), and the carcinogenic risk of elements(CR). The results indicated that under monochromatic polarized light, the Draconis Os powder sections exhibited light gray-brown to gray-brown irregular fragments, some with undulating textures that were slightly curved. Under crossed polarized light, they appeared dark gray, grayish-white, and yellowish-white. Clear apatite was visible in the ground sections of Draconis Os under crossed polarized light. P_i results indicated that Draconis Os samples were free from contamination and were of good quality. According to the maximum allowable limits of heavy metals stipulated in ISO Traditional Chinese Medicine: Determination of heavy metals in herbal medicines used in Traditional Chinese Medicine, ADI, THQ, HQ, and CR were taken as assessment indicators. Only the THQ value for As(arsenic) in raw Draconis Os was greater than 1, while the THQ values for other heavy metal elements in the Draconis Os samples were all less than 1. The study demonstrates that the primary mineral phase of raw and calcined Draconis Os is apatite, with some samples co-existing with calcite, which can serve as one of the means for quality control of Draconis Os. The elemental analysis results from ICP-MS provide scientific evidence for the safety assessment of Draconis Os, indicating that Draconis Os is safe in clinical application.
Drugs, Chinese Herbal/analysis* ; Risk Assessment ; Minerals/chemistry* ; Fossils ; Humans ; Drug Contamination ; Mass Spectrometry

OBJECTIVE To explore the mechanism of Shenqi guben formula （SQGB） in improving cancer-related fatigue （CRF） based on network pharmacology and cellular experiments. METHODS Active components of SQGB and CRF-related targets were identified on the basis of databases such as the Traditional Chinese Medicine Systems Pharmacology platform. An in vitro CRF cell model was established by inducing A549 cells with interleukin-17 （IL-17）. Cells were treated with low （1.0 mg/mL） or high （1.5 mg/mL） concentrations of SQGB. The effects on cell viability， migration， apoptosis， inflammatory factors， mRNA expression， apoptosis-related proteins and key proteins 011） of IL-17 signaling pathway were evaluated using scratch assay， flow cytometry， ELISA， real-time fluorescent quantitative PCR and Western blot analysis. RESULTS SQGB contained 84 active components acting on 209 potential CRF targets. Among E-these， quercetin， kaempferol， and luteolin were identified as the core components of the compound. Core targets included tumor protein p53， AKT serine/threonine kinase 1， IL-6， and tumor necrosis factor （TNF）. IL-17， TNF and phosphatidylinositol-3- kinase-serine/threonine protein kinase （PI3K/Akt） signaling pathways were identified as crucial pathways. Compared with IL-17 intervention group， the cell migration rate， B-cell lymphoma 2 （Bcl-2） protein expression， the levels of IL-6 and TNF-α in the supernatant， mRNA expression of IL-17 receptor A （IL-17RA）， TNF-α， and IL-6， as well as the protein expression of IL-17RA and nuclear factor kappa-B p65 subunit （p65）， and phosphorylated （p）-p65/p65 ratio in IL-17+SQGB low- and high- quality concentration groups were all significantly decreased or down-regulation （P＜0.05）； the apoptosis rate， expression levels of Bcl-2 associated X protein （Bax） and cleaved caspase-3 protein， the ratio of Bax/Bcl-2， the expression level of p-p38 protein， and the p- p38/p38 ratio were all significantly increased or up-regulated （P＜0.05）. Moreover， the improvement effects of these indicators were mostly better in the high-quality concentration groups compared to the low-quality concentration groups （P＜0.05）. CONCLUSIONS SQGB ameliorates CRF by regulating the IL-17 signaling pathway， inhibiting the expression of inflammatory factors， and activating p38 MAPK-dependent apoptosis pathway.

Objective:To analyze the relationship between cuprotosis-realted gene DLD expression in pan-cancer and progno-sis,tumor microenvironment and tumor immune infiltration by bioinformatics methods combined with multiple databases.Methods:TCGA,GTEx,TISDB,GEO,UCSC,TARGET,TIMER2.0,GEPIA2,SangerBox,PrognoScan and related R software packages were used to analyze the difference of DLD expression between human cancer and adjacent normal tissues,inestigate relationship between prognosis,explore expression of DLD in different immune subtypes and molecular subtypes of human cancer,analyze correlation between DLD expression and tumor immune infiltration and tumor microenvironment,detecet relationship between DLD expression and 60 immune checkpoint genes.Results:There were differences in expression of DLD in different tumor tissues;low DLD expression in 6 tumors and high DLD expression in 3 tumors were significantly associated with better prognosis;15 tumor immune subtypes,11 molecular subtypes of tumors were significantly correlated with DLD expression;DLD expression was significantly correlated with immune infiltration in 37 cancer types;DLD expression was significantly associated with immune infiltration in 23 tumor stroma scores,26 tumor immune scores and 25 tumor ESTIMATE scores;60 immune checkpoint genes in 39 tumors were significantly associated with DLD expression.Conclusion:Expression of DLD in pan-cancer is related to tumor prognosis and immune invasion,DLD may be a potential predictor of prognosis in tumors,and may be an immunomodulator of tumors.

Objective:To analyze the assessment value of the quantitative parameters of coronary computed tomography angiography(CCTA)combined with QRS wave complex of electrocardiogram(ECG)for grading of cardiac function in patients with coronary heart disease(CHD).Methods:Eighty CHD patients admitted to Beijing Rehabilitation Hospital,Capital Medical University between January 2023 and December 2024 were selected.The grading of cardiac function of CHD patients were assessed according to the standard of New York Heart Association(NYHA).All patients underwent CCTA and ECG upon admission.CCTA quantitative parameters and QRS wave complex duration were recorded and compared among patients with different grades of cardiac function.The correlation between CCTA quantitative parameters[non-calcified plaque volume(NCPV),calcified plaque volume(CPV),total plaque volume(TPV),vessel volume,reconstruction index],QRS wave complex duration,and grading of cardiac function of CHD patient was analyzed.The area under curve(AUC)of receiver operating characteristic(ROC)curve was used to analyze the value of each parameter and QRS wave complex duration in assessing CHD patients whose cardiac function grade was≥III grade.Results:In the 80 CHD patients,NYHA grades were distributed as follows:11 cases were grade I,and 23 cases were grade II,and 27 cases were grade III,and 19 cases were grade IV.The NCPV,CPV,TPV,reconstruction index,and QRS wave complex duration of patients at grade III and grade IV were higher than those of patients at grade I-grade II,and the differences were significant(F=17.401,37.077,12.297,7.087,11.148,P<0.05).Furthermore,patients at grade IV showed higher values in all parameters than those of patients at grade III.The NCPV,CPV,TPV,reconstruction index(t=3.486,4.315,3.444,2.068,2.600,P<0.05),and QRS wave complex duration of CCTA parameters showed positive correlations with cardiac function grading in CHD patient(r=0.464,0.548,0.346,0.287,0.373,P<0.05).ROC curve analysis revealed that the AUC values of alone NCPV,CPV,TPV,reconstruction index,QRS wave complex duration of CCTA parameters,and the combination of these indicators were respectively 0.793,0.843,0.723,0.748,and 0.737 in assessing CHD patients whose cardiac function grade was≥III,which indicated that these indicators had a certain assessment value,and the combined detection can improve the AUC value and sensitivity.Conclusion:The combination of CCTA parameters(NCPV,CPV,TPV,reconstruction index)and QRS wave complex duration can improve the assessment value for CHD patients whose grade of cardiac function is≥grade III.

Objective:To analyze the safety and therapeutic efficacy of laparoscopic pancreaticoduodenectomy (LPD) and laparoscopic total pancreatectomy (LTP) in the treatment of pancreatic cancer.Methods:Clinical data of 87 patients with pancreatic head and neck cancer who underwent LPD or LTP in the Department of General Surgery at Peking Union Medical College Hospital from December 2018 to August 2023 were retrospectively analyzed. The surgical approach, operative time, intraoperative blood loss volume, conversion rate to open surgery, perioperative mortality, re-operative rate, rate of major postoperative complications, postoperative hospital stay, number of lymph nodes harvested, tumor pathological stage, R 0 resection rate, initiation of postoperative chemotherapy and survival outcomes were recorded. The follow-up period extended until September 2023. Results:Among the 87 patients, 78(89.7%) underwent LPD and 9(10.3%) underwent LTP. PV-SMV vascular resection and reconstruction was performed in 16 cases (18.4%), and 11 cases totally underwent laparoscopy. Five cases (5.7%) required conversion to open surgery. The mean operative time was 279.8±74.0 minutes, and the mean intraoperative blood loss volume was 520.1±743.2 ml. The overall length of hospital stay was 15.9±6.3 days, with a mean postoperative hospital stay of 11.5±6.0 days. The rate of major postoperative complications was 19.5%, including 4 cases (4.6%) of postoperative bile leakage, 6 cases (6.9%) of postoperative gastric emptying disorders, and 3 cases (3.4%) of postoperative bleeding. There was one case (1.1%) with secondary surgery and one case (1.1%) with perioperative death. Among LPD patients, 5 cases (6.4%) had postoperative grade B or higher pancreatic fistula. Advanced age (≥70 years) did not increase the incidence of perioperative complications. All patients achieved R 0 resection. The mean number of lymph nodes harvested was 25.9±11.4. The median time to initiation of postoperative chemotherapy was 2.13±1.43 months. The median overall survival was 16 months. Conclusions:In a high-volume center for pancreatic diseases, LPD and LTP are safe and feasible for the treatment of pancreatic cancer, which could achieve satisfactory anti-tumor efficacy and improve patients' prognosis.