Objective: To systematically analyze the confirmatory positivity of different combinations of HBsAg screening results in blood testing, providing data to support the optimization of blood donor eligibility management. Methods: A retrospective analysis was conducted on blood screening data from 174 266 voluntary blood donor samples at the Chongqing Blood Center between October 2021 and September 2022. Samples with inconsistent results between the two HBsAg enzymelinked immunosorbent assays (ELISA) and individual donor nucleic acid testing (NAT) were confirmed using an electrochemiluminescence immunoassay (ECLIA) and a neutralization test. The detection efficacy of four different HBsAg ELISA reagents was compared using the HBsAg-confirmed positive samples. Results: A total of 767(0.44%) HBV-reactive (HB-sAg and/or HBV DNA reactive) samples were detected. Among them, 344 samples with discordant serological and NAT results were collected, of which 64(18.6%) were confirmed positive by neutralization test. Additionally, 5 samples that were neutralization-negative but double-reactive for HBsAg and HBV DNA were confirmed as positive according to FDA guidance, resulting in a total of 69(20.1%) confirmed HBsAg-positive samples. There were significant differences in the neutralization test confirmation rates among different screening result categories (P<0.05): The group with dual HBsAg reagent reactivity (double reactive) & NAT-negative had the highest confirmation rate (96.9%, 31/32); the group reactive to only reagent 2 (single reactive) had a rate of 25.7% (29/113); while the confirmation rates for samples reactive to only reagent 1 and samples with isolated HBV DNA positivity were extremely low [0(0/34) and 2.4%(4/165), respectively]. The four commercial reagents showed significant differences in their ability to detect confirmed positive samples that were initially single reactive (P<0.05). Conclusion: Given the performance variations among HBsAg screening reagents, thorough performance verification is essential before implementation. When NAT is negative, dual HBsAg reactivity in screening can serve as a basis for confirming infection and directly deferring blood donors. However, confirming infection in donors with single HBsAg reactivity is more challenging, necessitating supplementary tests to rule out infection risk.

Background: Adrenocortical hormones, particularly 11-oxygenated androgens, are pivotal in female reproductive health and fertility. Standardized detection kits and population-specific reference intervals are lacking in China, hindering related clinical applications. Methods: A HPLC-tandem mass spectrometry (HPLC-MS/MS) pipeline was developed, rigorously validated, and applied to simultaneously quantify corticosterone, cortisone, cortisol, 18-OH cortisol, androstenedione (A4), 11β-hydroxyandrostenedione (11-OH A4), dehydroepiandrosterone, and dehydroepiandrosterone sulfate in serum samples from 455 reproductive-aged women (18–45 yrs) in Guangxi, China. Age-dependent concentration trends were analyzed, and reference intervals stratified by age (2.5th to 97.5th percentiles) were established. Correlations with body-composition metrics, ethnicity, and the menstrual cycle were investigated. Results: The HPLC-MS/MS method demonstrated high precision (intra- and inter-assay CVs < 15%), accuracy, and sensitivity. All eight hormones exhibited significant age-related declines (P < 0.001 for seven hormones; P = 0.001 for 11-OH A4). Notably, 11-OH A4 levels were significantly lower in the 35–45-yr (3.05 nmol/L) and 25–34-yr (3.09 nmol/L) age groups than in the 18–24-yr (3.57 nmol/L) age group, whereas no significant difference was observed between the 35–45-yr and 25–34-yr age groups. Weak negative correlations were observed between the body mass index and corticosterone and cortisone levels, whereas ethnicity and the menstrual cycle showed no significant associations with hormone levels. Conclusions We developed an HPLC-MS/MS-based method for simultaneously quantifying eight adrenocortical hormones, including 11-OH A4, and defined age-specific reference intervals for reproductive-aged Chinese women. These findings advance the clinical utility of adrenocortical hormones in diagnosing and managing reproductive disorders.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective To evaluate the efficacy and safety of intense pulsed light(IPL)combined with micro-crosslinked hyaluronic acid injected by Shuiguang needle in skin photoaging.Methods Patients with skin photoaging who were treated in Hangzhou Plastic Surgery Hospital from January 2021 to February 2023 were selected.According to the different treatment methods,they were divided into 3 groups:one group was treated with micro-crosslinked hyaluronic acid injected by Shuiguang needle(Shuiguang treatment group),one group was treated with IPL alone[broad band light(BBL)treatment group],and one group was treated with IPL combined with micro-crosslinked hyaluronic acid injected by Shuiguang needle(combined treatment group).The patients were followed up 3 months after treatment.Global scores for photoaging(GSP)were used to evaluate the photoaging degree on the whole face.Global aesthetic improvement scale(GAIS)was used to evaluate the improvement of the overall appearance after treatment.The data of facial wrinkles,texture,pores,brown spots and red areas of patients was collect by using VISIA complexion analysis system.The visual analog scale(VAS)wasused for pain assessment,and adverse effects were recorded.Results GSP score of combined treatment group was lower than that of Shuiguang treatment group and BBL treatment group(P＜0.05).GAIS improvement scores for wrinkles and texture in combined treatment group were higher than those of Shuiguang treatment group and BBL treatment group(P＜0.05),and the GAIS improvement score for pores in combined treatment group was higher than that in BBL treatment group(P＜0.05).The analysis results of VISIA skin test showed that the values of wrinkles and brown spots in combined treatment group after the operation were lower than those in Shuiguang treatment group and BBL treatment group(P＜0.05),and the value of the red area in combined treatment group was lower than that in Shuiguang treatment group(P＜0.05).The effective rates of wrinkle,texture and pore in combined treatment group was 88.2％,94.1％and 94.1％,respectively,higher than those in other two groups.The complications were immediate erythema,acupuncture reaction,and papule,which could be relieved within a few hours.Conclusion IPL combined with micro-crosslinked hyaluronic acid injection in skin photoaging appears to be effective,durable and safety for skin photoaging.

Objective To observe the clinical efficacy of Zishen Shujing decoction in the treatment of kidney deficiency and liver depression type premature ovarian failure(POF).Methods A total of 70 female POF patients who visited the Fourth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine from July 2023 to April 2024 were selected as the research subjects,they were divided into traditional Chinese medicine(TCM)treatment group(n=35)and Western medicine treatment group(n=35)by using a random number table method.Western medicine treatment group was treated with femostone,and TCM treatment group was treated with Zishen Shujing decoction.Differences of TCM syndrome scores and clinical efficacy were compared between two groups before and after treatment,and changes of peripheral blood follicle-simulating hormone(FSH),anti-Müllerian hormone(AMH),anal follicle count(AFC)and interleukin(IL)-4,IL-6 before and after treatment were compared.Results The effective rate of TCM treatment group was higher than that of Western medicine treatment group,the difference was statistically significant(P<0.05).The TCM syndrome scores after treatment were lower than before treatment,and TCM treatment group was lower than Western medicine treatment group,the difference was statistically significant(P<0.05).After treatment,FSH levels in two groups were lower than before treatment,AMH and AFC levels were higher than before treatment,and improvement of hormone levels,AMH and AFC in TCM treatment group was better than that in Western medicine treatment group,with statistical significance(P<0.05).After treatment,the anti-inflammatory factors IL-4 were increased,and the pro-inflammatory factors IL-6 were decreased,and the increase effect of anti-inflammatory factors and the decrease effect of pro-inflammatory factors in TCM treatment group were better than those in Western medicine treatment group with statistical significance(P<0.05).Conclusion Zishen Shujing decoction can improve the clinical symptoms,serum hormone levels of POF patients with kidney deficiency and liver depression,improve ovarian function,reduce immune inflammation,reduce oxidative stress,and effectively improve the quality of life of patients.

Objective:To explore effect of Astragalus polysaccharides(APS)through TLR4/NF-κB signal pathway on intesti-nal immune inflammation of rats with dampness stagnancy due to spleen deficiency syndrome based on fecal microbiota transplantation.Methods:Rats with dampness stagnancy due to spleen deficiency syndrome were fed with high-fat and low-protein diet and subjected to exhaustive swimming,transplant flora microbiota after intervention of APS.General condition,changes in weight gain,time of weight exhaustion swimming,spleen index and thymus index were tested.Pathological manifestations of duodenal tissue inflammation were observed by HE staining.Serum IL-1β,IL-6 and TNF-α concentrations of rats were determined by ELISA.Protein levels of TLR4,NF-κB p65 and IκBα in colon were determined by Western blot.Results:Compared with model group,general condition rating,changes in weight gain and time of weight exhaustion swimming in APS-FTG group were increased significantly(P<0.01);spleen index and thymus index were increased;pathological manifestations of duodenal inflammation were significantly relieved;serum IL-1β,IL-6 and TNF-α concentrations were decreased significantly(P<0.01),TLR4 and NF-κB p65 levels in colon were decreased significantly(P<0.05 and P<0.01),IκBα level was in colon increased significantly(P<0.01).Conclusion:APS improves intestinal microbiota of rats with dampness stagnancy due to spleen deficiency syndrome and inhibits TLR4/NF-κB pathway activation through intestinal flora,thus improving intestinal immune inflammation status in rats with dampness stagnancy due to spleen deficiency syndrome.

Objective:To explore effect of Astragalus polysaccharides(APS)through TLR4/NF-κB signal pathway on intesti-nal immune inflammation of rats with dampness stagnancy due to spleen deficiency syndrome based on fecal microbiota transplantation.Methods:Rats with dampness stagnancy due to spleen deficiency syndrome were fed with high-fat and low-protein diet and subjected to exhaustive swimming,transplant flora microbiota after intervention of APS.General condition,changes in weight gain,time of weight exhaustion swimming,spleen index and thymus index were tested.Pathological manifestations of duodenal tissue inflammation were observed by HE staining.Serum IL-1β,IL-6 and TNF-α concentrations of rats were determined by ELISA.Protein levels of TLR4,NF-κB p65 and IκBα in colon were determined by Western blot.Results:Compared with model group,general condition rating,changes in weight gain and time of weight exhaustion swimming in APS-FTG group were increased significantly(P<0.01);spleen index and thymus index were increased;pathological manifestations of duodenal inflammation were significantly relieved;serum IL-1β,IL-6 and TNF-α concentrations were decreased significantly(P<0.01),TLR4 and NF-κB p65 levels in colon were decreased significantly(P<0.05 and P<0.01),IκBα level was in colon increased significantly(P<0.01).Conclusion:APS improves intestinal microbiota of rats with dampness stagnancy due to spleen deficiency syndrome and inhibits TLR4/NF-κB pathway activation through intestinal flora,thus improving intestinal immune inflammation status in rats with dampness stagnancy due to spleen deficiency syndrome.

Objective:To explore the applied effectiveness of the Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate (SECURE) nursing pathway based on action research method in the prevention process of medical device-related pressure injuries (MDRPI) of patients in the Intensive Care Unit (ICU). Methods:The SECURE nursing pathway based on action research method included the establishment of a skin care team to identify problems,and the formulation of conducting intervention plan,and the development of targeting nursing interventions to prevent the occurrence of MDRPI. A total of 84 patients hospitalized in the ICU of Hebei General Hospital from March 2022 to March 2023 were selected,and they were randomly divided into a control group and an observation group,with 42 patients in each group. The control group implemented routine method to prevent MDRPI during ICU treatment,while the observation group implemented SECURE nursing pathway based on action research method to conduct prevention. The MDRPI incidence,the quality scores of ICU nursing,the scores of the Short Form Health Survey-36 (SF-36) of patients,the assessment of the improvement of MDRPI patients,and the satisfaction of patients for nursing care were compared between the two groups. Results:The MDRPI incidence during ICU treatment in the observation group was 4.76％ (2/42),which was significantly lower than that in the control group,with a statistically significant difference (x2=11.052,P<0.05). The average scores for device usage,prevention assessment,positioning management and preventive nursing after nursing intervention in the observation group were respectively (88.45±2.05),(89.36±2.11),(89.25±2.15) and (91.45±2.25),all of which were significantly higher than those in the control group,with statistically significant differences (t=11.425,12.052,10.052,13.478,P<0.05). After nursing intervention,the average scores for physical function,social function,psychological function and material life as the SF-36 scale in the observation group were (85.47±2.05),(86.48±2.05),(88.46±2.15) and (90.25±2.44),respectively,which were respectively higher than those in the control group,with statistically significant differences (t=12.414,11.045,10.252,10.478,P<0.05). The occurrence time,improvement time of wound and ICU treatment time of presenting MDRPI patients in the observation group were respectively (4.05±0.54) days,(3.45±0.15) days,and (8.12±2.14) days. Compared to the control group,the occurrence time of the observation group was longer,while both the improvement time of wound and ICU treatment time of the observation group were shorter,with statistically significant differences (t=8.485,10.012,13.001,P<0.05). The satisfaction degree of nursing care of patients in the observation group was 95.24％ (40/42),which was significantly higher than that in the control group (x2=12.054,P<0.05). Conclusion:The SECURE nursing pathway based on action research method,which prevents MDRPI of ICU patients,can reduce the MDRPI incidence rate of ICU patients,and enhance the work quality of nursing care for MDRPI. It is helpful to the recovery of ICU patients,which can also shorten the treatment time of ICU patients.

Objective To evaluate the efficacy and safety of intense pulsed light(IPL)combined with micro-crosslinked hyaluronic acid injected by Shuiguang needle in skin photoaging.Methods Patients with skin photoaging who were treated in Hangzhou Plastic Surgery Hospital from January 2021 to February 2023 were selected.According to the different treatment methods,they were divided into 3 groups:one group was treated with micro-crosslinked hyaluronic acid injected by Shuiguang needle(Shuiguang treatment group),one group was treated with IPL alone[broad band light(BBL)treatment group],and one group was treated with IPL combined with micro-crosslinked hyaluronic acid injected by Shuiguang needle(combined treatment group).The patients were followed up 3 months after treatment.Global scores for photoaging(GSP)were used to evaluate the photoaging degree on the whole face.Global aesthetic improvement scale(GAIS)was used to evaluate the improvement of the overall appearance after treatment.The data of facial wrinkles,texture,pores,brown spots and red areas of patients was collect by using VISIA complexion analysis system.The visual analog scale(VAS)wasused for pain assessment,and adverse effects were recorded.Results GSP score of combined treatment group was lower than that of Shuiguang treatment group and BBL treatment group(P＜0.05).GAIS improvement scores for wrinkles and texture in combined treatment group were higher than those of Shuiguang treatment group and BBL treatment group(P＜0.05),and the GAIS improvement score for pores in combined treatment group was higher than that in BBL treatment group(P＜0.05).The analysis results of VISIA skin test showed that the values of wrinkles and brown spots in combined treatment group after the operation were lower than those in Shuiguang treatment group and BBL treatment group(P＜0.05),and the value of the red area in combined treatment group was lower than that in Shuiguang treatment group(P＜0.05).The effective rates of wrinkle,texture and pore in combined treatment group was 88.2％,94.1％and 94.1％,respectively,higher than those in other two groups.The complications were immediate erythema,acupuncture reaction,and papule,which could be relieved within a few hours.Conclusion IPL combined with micro-crosslinked hyaluronic acid injection in skin photoaging appears to be effective,durable and safety for skin photoaging.

Objective:To explore the applied effectiveness of the Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate (SECURE) nursing pathway based on action research method in the prevention process of medical device-related pressure injuries (MDRPI) of patients in the Intensive Care Unit (ICU). Methods:The SECURE nursing pathway based on action research method included the establishment of a skin care team to identify problems,and the formulation of conducting intervention plan,and the development of targeting nursing interventions to prevent the occurrence of MDRPI. A total of 84 patients hospitalized in the ICU of Hebei General Hospital from March 2022 to March 2023 were selected,and they were randomly divided into a control group and an observation group,with 42 patients in each group. The control group implemented routine method to prevent MDRPI during ICU treatment,while the observation group implemented SECURE nursing pathway based on action research method to conduct prevention. The MDRPI incidence,the quality scores of ICU nursing,the scores of the Short Form Health Survey-36 (SF-36) of patients,the assessment of the improvement of MDRPI patients,and the satisfaction of patients for nursing care were compared between the two groups. Results:The MDRPI incidence during ICU treatment in the observation group was 4.76％ (2/42),which was significantly lower than that in the control group,with a statistically significant difference (x2=11.052,P<0.05). The average scores for device usage,prevention assessment,positioning management and preventive nursing after nursing intervention in the observation group were respectively (88.45±2.05),(89.36±2.11),(89.25±2.15) and (91.45±2.25),all of which were significantly higher than those in the control group,with statistically significant differences (t=11.425,12.052,10.052,13.478,P<0.05). After nursing intervention,the average scores for physical function,social function,psychological function and material life as the SF-36 scale in the observation group were (85.47±2.05),(86.48±2.05),(88.46±2.15) and (90.25±2.44),respectively,which were respectively higher than those in the control group,with statistically significant differences (t=12.414,11.045,10.252,10.478,P<0.05). The occurrence time,improvement time of wound and ICU treatment time of presenting MDRPI patients in the observation group were respectively (4.05±0.54) days,(3.45±0.15) days,and (8.12±2.14) days. Compared to the control group,the occurrence time of the observation group was longer,while both the improvement time of wound and ICU treatment time of the observation group were shorter,with statistically significant differences (t=8.485,10.012,13.001,P<0.05). The satisfaction degree of nursing care of patients in the observation group was 95.24％ (40/42),which was significantly higher than that in the control group (x2=12.054,P<0.05). Conclusion:The SECURE nursing pathway based on action research method,which prevents MDRPI of ICU patients,can reduce the MDRPI incidence rate of ICU patients,and enhance the work quality of nursing care for MDRPI. It is helpful to the recovery of ICU patients,which can also shorten the treatment time of ICU patients.