As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

Background/Aims: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a chronic liver disease characterized by hepatic steatosis. Ubiquitin-specific protease 29 (USP29) plays pivotal roles in hepatic ischemiareperfusion injury and hepatocellular carcinoma, but its role in MASLD remains unexplored. Therefore, the aim of this study was to reveal the effects and underlying mechanisms of USP29 in MASLD progression. Methods: USP29 expression was assessed in liver samples from MASLD patients and mice. The role and molecular mechanism of USP29 in MASLD were assessed in high-fat diet-fed and high-fat/high-cholesterol diet-fed mice and palmitic acid and oleic acid treated hepatocytes. Results: USP29 protein levels were significantly reduced in mice and humans with MASLD. Hepatic steatosis, inflammation and fibrosis were significantly exacerbated by USP29 deletion and relieved by USP29 overexpression. Mechanistically, USP29 significantly activated the expression of genes related to fatty acid β-oxidation (FAO) under metabolic stimulation, directly interacted with long-chain acyl-CoA synthase 5 (ACSL5) and repressed ACSL5 degradation by increasing ACSL5 K48-linked deubiquitination. Moreover, the effect of USP29 on hepatocyte lipid accumulation and MASLD was dependent on ACSL5. Conclusions USP29 functions as a novel negative regulator of MASLD by stabilizing ACSL5 to promote FAO. The activation of the USP29-ACSL5 axis may represent a potential therapeutic strategy for MASLD.

Objective To develop a home skin care guidance scheme for newborns,and initially implement it to reducing the risk of skin-related issues.Methods Searching both domestic and international databases,we identified relevant literature.Following a quality evaluation,evidence integration,and group discussions,we developed the con-tent of the home skin care guidance for newborns.Subsequently,we refined this content through 2 rounds of expert consultations to finalize the scheme.To initially implement the scheme,we conveniently selected 20 healthy new-borns born between August 1st and 15th,2024,at a tertiary-level comprehensive hospital in Fujian Province as an experimental group.Their parents received skin care guidance based on our scheme via a WeChat platform.In contrast,we selected another group of 20 healthy newborns delivered between July 1st and 15th,2024,at the same hospital as a control group;their parents were provided with conventional skin care guidance.We compared the in-cidence rates of diaper dermatitis and eczema between these 2 groups of newborns at a month of age.Results A total of 33 experts from 30 tertiary hospitals across 19 provinces(including autonomous regions and municipalities)were invited to participate in a questionnaire survey.The response rates for both rounds of expert questionnaires reached 100％.The authority coefficients for the experts were recorded at 0.78 and 0.83,while the Kendall concor-dance coefficients were found to be 0.188 and 0.142(all P＜0.001).The final newborn home skin care guidance scheme consists of 6 first-level items,41 second-level items,such as the selection of newborn care products,methods for neonatal bathing and prevention of neonatal diaper dermatitis,and so on.Preliminary application results indicated that the incidence of diaper dermatitis in the experimental group was significantly lower than that observed in the control group,with a statistically significant difference noted(P=0.047).There was no significant difference in the incidence of eczema between the 2 groups at the age of a month(P=0.201).Conclusion The Neonatal Home Skin Care Guidance Scheme for newborns has been demonstrated to be scientific,reliable and feasible.The implementa-tion of this scheme has proven beneficial in reducing the incidence of diaper dermatitis at a month of age.Howev-er,the sample size needs to be expanded to further verify its implementation effect.

Objective The reference range for perfusion index(PI)in healthy newborns was established,and the prognostic value of PI at multiple time points(6 h,18 h,24 h,48 h,and 72 h)in critically ill newborns was evaluated.Methods A total of 100 healthy neonates born at the Hainan Women and Children's Medical Center between July 2022 and September 2024,along with 142 critically ill neonates admitted to the neonatal intensive care unit,were enrolled as study participants.The healthy neonates constituted the control group,while the critically ill neonates were categorized into low-risk(n=44),medium-risk(n=61),and high-risk(n=37)groups according to disease severity.The clinical outcomes of the critically ill neonates were recorded and classified into poor prognosis(n=38)and good prognosis(n=104)groups.PI values were monitored in all neonates from 6 to 72 hours after birth.Spearman correlation analysis was performed to assess the association between illness severity and PI values during this period,while logistic regression analysis was employed to examine the relationship between PI values and prognosis in critically ill neonates.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of PI for poor prognosis,and the optimal cutoff threshold for prognosis prediction was determined.Results The PI values of healthy neonates between 6 and 72 hours after birth ranged from 2.61 to 3.31.Critically ill neonates exhibited consistently lower PI values than their healthy counterparts during the same period,with statistically significant differences observed across neonates of varying illness severity(P<0.05).PI values in all groups gradually increased within the first 72 hours post-birth(P<0.05).Neonatal illness severity was negatively correlated with PI values measured at 6,18,24,48,and 72 hours after birth(P<0.05).Furthermore,neonates in the poor prognosis group had significantly lower PI values between 6 and 72 hours compared to those in the good prognosis group(P<0.05).Reduced PI values were significantly associated with an increased risk of poor prognosis in critically ill neonates(P<0.05).The predictive performance of PI values for poor prognosis,as assessed by the area under the curve(AUC),yielded values of 0.760,0.779,0.768,0.797,and 0.808 at 6,18,24,48,and 72 hours,respectively,with corresponding cut-off values of 0.88,1.12,1.25,1.65,and 1.82.Conclusion The PI values measured between 6 and 72 hours after birth are closely associated with disease severity in neonates,with lower PI values indicating a poorer prognosis.These early postnatal PI measurements demonstrate auxiliary predictive value for the outcomes of critically ill neonates.

Neurogenic bladder(NB)is one of the most challenging urinary system disorders,with spinal cord injury(SCI)being an important etiological factor.Animal models provide crucial tools for investigating the pathogenesis,therapeutic strategies,and novel drug screening for NB subsequent to SCI.We reviewed and synthesized recent literature on NB animal models after SCI from both domestic and international sources.This review summarizes and analyzes research advancements using these models in terms of animal species,SCI segments,modeling techniques,and evaluation indicators,with the aim of offering insights and guidance for future experimental research based on animal models of NB following SCI.

Objective:To investigate the application value of dermoscopy and reflectance confocal microscopy (RCM) in identifying field cancerization in actinic keratosis (AK) in the elderly.Methods:A retrospective analysis was conducted on clinical, dermoscopic, and RCM features of elderly (> 60 years old) patients, who were confirmedly diagnosed with AK and had complete medical records at Shanghai Skin Disease Hospital from January 2022 to December 2023.Results:A total of 132 elderly patients with AK were included. Dermoscopy showed brownish-gray pseudonetwork pigment patterns, follicular horn plugs, irregular branched vessels, and rosette signs in AK lesions. Histopathological examination in 51 patients revealed that 47 (92.16%) were confirmedly diagnosed with AK. Field cancerization was observed in 106 patients (80.3%), among whom 66 (62.26%) had irregular branched vessels, 88 (83.02%) predominantly exhibited brownish-gray pseudonetwork pigment patterns, and 83 (78.30%) showed scattered brown pigment networks/fingerprint-like patterns. Post-treatment follow-up of 63 patients showed varying degrees of changes in vascular and pigment structures by dermoscopy, with significant reductions in follicular horn plugs and superficial yellow-white scales or keratin masses. RCM examinations in 41 AK patients all showed disordered arrangements of keratinocytes presenting as atypical honeycomb patterns, with atypical cells in the AK lesions; in the field cancerization areas of 20 patients, RCM revealed keratinocytes disorderedly arranged in an irregular honeycomb pattern, with some keratinocytes exhibiting mild atypia. Thirty-four AK patients underwent dynamic RCM monitoring before and after 1, 3 and 6 months of ALA-PDT treatment, which showed gradual regularization of arrangements of keratinocytes and reduction of atypical cells, as well as reappearance of atypical keratinocytes upon recurrence.Conclusions:The incidence of field cancerization was relatively high in elderly AK patients. Dermoscopy and RCM are helpful for the early identification of AK and field cancerization, especially in patients with multiple lesions and with difficulties in multi-site biopsy.

Neurogenic bladder(NB)is one of the most challenging urinary system disorders,with spinal cord injury(SCI)being an important etiological factor.Animal models provide crucial tools for investigating the pathogenesis,therapeutic strategies,and novel drug screening for NB subsequent to SCI.We reviewed and synthesized recent literature on NB animal models after SCI from both domestic and international sources.This review summarizes and analyzes research advancements using these models in terms of animal species,SCI segments,modeling techniques,and evaluation indicators,with the aim of offering insights and guidance for future experimental research based on animal models of NB following SCI.

Objective The reference range for perfusion index(PI)in healthy newborns was established,and the prognostic value of PI at multiple time points(6 h,18 h,24 h,48 h,and 72 h)in critically ill newborns was evaluated.Methods A total of 100 healthy neonates born at the Hainan Women and Children's Medical Center between July 2022 and September 2024,along with 142 critically ill neonates admitted to the neonatal intensive care unit,were enrolled as study participants.The healthy neonates constituted the control group,while the critically ill neonates were categorized into low-risk(n=44),medium-risk(n=61),and high-risk(n=37)groups according to disease severity.The clinical outcomes of the critically ill neonates were recorded and classified into poor prognosis(n=38)and good prognosis(n=104)groups.PI values were monitored in all neonates from 6 to 72 hours after birth.Spearman correlation analysis was performed to assess the association between illness severity and PI values during this period,while logistic regression analysis was employed to examine the relationship between PI values and prognosis in critically ill neonates.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of PI for poor prognosis,and the optimal cutoff threshold for prognosis prediction was determined.Results The PI values of healthy neonates between 6 and 72 hours after birth ranged from 2.61 to 3.31.Critically ill neonates exhibited consistently lower PI values than their healthy counterparts during the same period,with statistically significant differences observed across neonates of varying illness severity(P<0.05).PI values in all groups gradually increased within the first 72 hours post-birth(P<0.05).Neonatal illness severity was negatively correlated with PI values measured at 6,18,24,48,and 72 hours after birth(P<0.05).Furthermore,neonates in the poor prognosis group had significantly lower PI values between 6 and 72 hours compared to those in the good prognosis group(P<0.05).Reduced PI values were significantly associated with an increased risk of poor prognosis in critically ill neonates(P<0.05).The predictive performance of PI values for poor prognosis,as assessed by the area under the curve(AUC),yielded values of 0.760,0.779,0.768,0.797,and 0.808 at 6,18,24,48,and 72 hours,respectively,with corresponding cut-off values of 0.88,1.12,1.25,1.65,and 1.82.Conclusion The PI values measured between 6 and 72 hours after birth are closely associated with disease severity in neonates,with lower PI values indicating a poorer prognosis.These early postnatal PI measurements demonstrate auxiliary predictive value for the outcomes of critically ill neonates.

Vitiligo is a depigmentation skin disease caused by the progressive destruction of autologous epidermal melano-cytes.However,the mechanism of melanocyte dysfunction and death is unclear.It is worth noting that most melanocyte deaths in patients with vitiligo are directly caused by autoimmune response.There are many immune related cell molecules in the body,such as CD8+T cells,IFN-γ and inflammatory cytokines all play a role in the pathogenesis of vitiligo.To clarify the effects of body immunity,cytokines and autoantibodies on the normal function of melanocyte and their role in the condition of vitiligo can provide a basis for finding the treatment of vitiligo.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.