Objective To investigate the temporal predictive value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),and myeloid-related protein 8/14(MRP8/14)for secondary acute respiratory distress syndrome(ARDS)in patients with severe pulmonary tuberculosis.Methods A retro-spective cohort study was conducted among patients with severe pulmonary tuberculosis admitted between January 2021 and December 2024.Patients were randomly assigned in an 8∶2 ratio to a training set(n=148)and a valida-tion set(n=37).Serum sTREM-1,PCT,and MRP8/14 were extracted from the electronic medical record at three time points:on admission(day 0),day 3,and day 7.Multivariable logistic regression was used to identify risk factors,and predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results A total of 185 patients were included.In the training set(n=148),27 developed ARDS and 121 did not;in the validation set(n=37),7 developed ARDS and 30 did not.In the training set,serum sTREM-1,PCT,and MRP8/14 levels showed significant temporal changes(P<0.05).At admission,day 3,and day 7,levels of sTREM-1,PCT,and MRP8/14 were higher in the ARDS group than in the non-ARDS group(all P<0.05).At each time point,sTREM-1,PCT,and MRP8/14 were independently associated with the development of ARDS(P<0.05).In the training set,the combination of sTREM-1,PCT,and MRP8/14 at admission yielded the largest area under the ROC curve[AUC=0.976;95%confidence interval(CI),0.952～1.000],with a sensitivity of 88.9%and a specificity of 98.3%.In the validation set,the same combination achieved an AUC of 0.957(95%CI,0.895～1.000),with a sensitivity of 100.0%and a specificity of 86.7%.Conclusion Dynamic changes in sTREM-1,PCT,and MRP8/14 provide temporal predictive value for ARDS in patients with severe pulmonary tuberculosis,and the combined assessment improves early warning accuracy.

Objective To investigate the temporal predictive value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),and myeloid-related protein 8/14(MRP8/14)for secondary acute respiratory distress syndrome(ARDS)in patients with severe pulmonary tuberculosis.Methods A retro-spective cohort study was conducted among patients with severe pulmonary tuberculosis admitted between January 2021 and December 2024.Patients were randomly assigned in an 8∶2 ratio to a training set(n=148)and a valida-tion set(n=37).Serum sTREM-1,PCT,and MRP8/14 were extracted from the electronic medical record at three time points:on admission(day 0),day 3,and day 7.Multivariable logistic regression was used to identify risk factors,and predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results A total of 185 patients were included.In the training set(n=148),27 developed ARDS and 121 did not;in the validation set(n=37),7 developed ARDS and 30 did not.In the training set,serum sTREM-1,PCT,and MRP8/14 levels showed significant temporal changes(P<0.05).At admission,day 3,and day 7,levels of sTREM-1,PCT,and MRP8/14 were higher in the ARDS group than in the non-ARDS group(all P<0.05).At each time point,sTREM-1,PCT,and MRP8/14 were independently associated with the development of ARDS(P<0.05).In the training set,the combination of sTREM-1,PCT,and MRP8/14 at admission yielded the largest area under the ROC curve[AUC=0.976;95%confidence interval(CI),0.952～1.000],with a sensitivity of 88.9%and a specificity of 98.3%.In the validation set,the same combination achieved an AUC of 0.957(95%CI,0.895～1.000),with a sensitivity of 100.0%and a specificity of 86.7%.Conclusion Dynamic changes in sTREM-1,PCT,and MRP8/14 provide temporal predictive value for ARDS in patients with severe pulmonary tuberculosis,and the combined assessment improves early warning accuracy.

Objective To investigate the mechanism of 2,6-dimethoxy-1,4-benzoquinone(DMQ),an active ingredients in fermented wheat germ extract,for inhibiting NLRP3 inflammasome activation and alleviating septic shock in mice.Methods Cultured murine bone marrow-derived macrophages(BMDM)stimulated with lipopolysaccharide(LPS)were treated with DMQ,followed by treatment with Nigericin,ATP,and MSU for activating the canonical NLRP3 inflammasome;the non-canonical NLRP3 inflammasome was activated by intracellular transfection of LPS,and AIM2 inflammasome was activated using Poly A:T.In human monocytic THP-1 cells,the effect of Nigericin on inflammasome activation products was examined using Western blotting and ELISA.Co-immunoprecipitation was performed to explore the mechanism of DMQ-induced blocking of NLRP3 inflammasome activation.In a male C57BL/6J mouse model of LPS-induced septic shock treated with 20 and 40 mg/kg DMQ,the levels of IL-1β and TNF-α in the serum and peritoneal lavage fluid were determined using ELISA,and the survival time of the mice within 36 h was observed.Results Treatment with DMQ effectively inhibited LPS-induced activation of canonical NLRP3 inflammasome in mouse BMDM and human THP-1 cells and also inhibited non-canonical NLRP3 inflammasome activation in mouse BMDM,but produced no significant effect on AIM2 inflammasome activation.DMQ significantly blocked the binding between ASC and NLRP3.In the mouse models of septic shock,DMQ treatment significantly reduced the levels of IL-1β in the serum and peritoneal fluid and obviously prolonged survival time of the mice.Conclusion DMQ can effectively block ASC-NLRP3 interaction to inhibit NLRP3 inflammasome activation and alleviate LPS-induced septic shock in mice.

[Objective] To analyze the influence of the cycle length of hepatitis B surface antigen (HBsAg) double reagent positive samples collected from voluntary blood donors in Guangzhou on the detection results. [Methods] A total of 127 044 blood samples from voluntary blood donors at Guangzhou Blood Center from August 10 to December 9, 2023 were selected. Two ELISA reagents were used for HBsAg detection, and samples with HBsAg double reagent positive and S/CO values<10 were tested continuously for 7 days to observe the changes in their S/CO values. [Results] A total of 505 HBsAg double reagent positive samples were detected, of which 52 had S/CO values less than 10. After 7 consecutive days of uninterrupted testing, the S/CO values of Wantai (median 5 decreased to 3) and Xinchuang (median 5 decreased to 3) showed an overall downward trend, and the HBsAg missed detection rate showed an upward trend (from 0 on the first day to 1/10 000 on the seventh day). A total of 13 cases had negative double reagent test results within the 7-day testing cycle. [Conclusion] With the extension of the detection cycle, the S/CO value of HBsAg detection shows a downward trend, and the missed detection rate of HBsAg shows an upward trend. Samples used for HBsAg detection should be tested promptly after sampling to improve the quality of blood testing.

Objective To investigate the mechanism of 2,6-dimethoxy-1,4-benzoquinone(DMQ),an active ingredients in fermented wheat germ extract,for inhibiting NLRP3 inflammasome activation and alleviating septic shock in mice.Methods Cultured murine bone marrow-derived macrophages(BMDM)stimulated with lipopolysaccharide(LPS)were treated with DMQ,followed by treatment with Nigericin,ATP,and MSU for activating the canonical NLRP3 inflammasome;the non-canonical NLRP3 inflammasome was activated by intracellular transfection of LPS,and AIM2 inflammasome was activated using Poly A:T.In human monocytic THP-1 cells,the effect of Nigericin on inflammasome activation products was examined using Western blotting and ELISA.Co-immunoprecipitation was performed to explore the mechanism of DMQ-induced blocking of NLRP3 inflammasome activation.In a male C57BL/6J mouse model of LPS-induced septic shock treated with 20 and 40 mg/kg DMQ,the levels of IL-1β and TNF-α in the serum and peritoneal lavage fluid were determined using ELISA,and the survival time of the mice within 36 h was observed.Results Treatment with DMQ effectively inhibited LPS-induced activation of canonical NLRP3 inflammasome in mouse BMDM and human THP-1 cells and also inhibited non-canonical NLRP3 inflammasome activation in mouse BMDM,but produced no significant effect on AIM2 inflammasome activation.DMQ significantly blocked the binding between ASC and NLRP3.In the mouse models of septic shock,DMQ treatment significantly reduced the levels of IL-1β in the serum and peritoneal fluid and obviously prolonged survival time of the mice.Conclusion DMQ can effectively block ASC-NLRP3 interaction to inhibit NLRP3 inflammasome activation and alleviate LPS-induced septic shock in mice.

Objective:To explore the safety of simnotrelvir/ritonavir in the treatment of coronavirus disease 2019 (COVID-19).Methods:The medical records of adult patients with COVID-19 who were hospitalized in Lequn Branch, Hospital of the First Hospital of Jilin University from June 9 to September 30, 2023 and treated with simnotrelvir/ritonavir were collected. According to whether adverse drug reactions (ADR) related to simnotrelvir/ritonavir occurred, the patients were divided into ADR group and non-ADR group. The clinical data, occurrence time of ADR, clinical manifestations, severity, treatment and outcome of patients were analyzed retrospectively.Results:A total of 189 patients were enrolled in this study, including 92 males (48.7%) and 97 females (51.3%), with a median age of 69 (60.5, 74.0) years. The usage and dosage of simnotrelvir/ritonavir were in accordance with the instructions (0.75 g of simnotrelvir and 0.1 g of ritonavir orally, once every 12 hours for 5 days). ADR related to simnotrelvir/ritonavir occurred in 18 of 189 patients (9.5%). There were no significant differences (all P>0.05) in gender, age, smoking status, COVID-19 classification and the proportion of patients with basic diseases such as hypertension, diabetes, cardiovascular disease, cerebrovascular disease, lung disease, and tumor after surgery between the ADR group (18 patients) and non-ADR group (171 patients). The difference in the propation of patients with liver injury and kidney injury between the 2 groups were statistically significant (both P<0.05). A total of 23 cases of ADR occurred in the ADR group. The occurrence time of ADR was 1 to 8 days after taking simnotrelvir/ritonavir. The clinical manifestations of ADR included digestive system symptoms, elevated transaminases, elevated serum creatinine, elevated serum uric acid, decreased platelet count, decreased white blood cell and neutrophil counts, dizziness, headache, etc. Five patients had 2 kinds of symptoms at the same time. The severity of ADR was grade 1 in 12 patients and grade 2 in 6 patients, and no ≥ grade 3 severe ADR occurred. Except one patient who stopped taking medication due to thrombocytopenia, all other patients completed 5-day treatment. The ADR disappeared after discontinuation of simnotrelvir/ritonavir and 1 to 5 days of symptomatic treatments. Conclusions:Simnotrelvir/ritonavir has a good safety in the treatment for COVID-19. The main ADRs are diarrhea and elevated transaminases, with the severity of grade 1-2 and the ADRs disappear after drug withdrawal. The patients with liver and kidney injury should be more alert to the occurrence of ADR when applying simnotrelvir/ritonavir.

Objective:To explore the safety of simnotrelvir/ritonavir in the treatment of coronavirus disease 2019 (COVID-19).Methods:The medical records of adult patients with COVID-19 who were hospitalized in Lequn Branch, Hospital of the First Hospital of Jilin University from June 9 to September 30, 2023 and treated with simnotrelvir/ritonavir were collected. According to whether adverse drug reactions (ADR) related to simnotrelvir/ritonavir occurred, the patients were divided into ADR group and non-ADR group. The clinical data, occurrence time of ADR, clinical manifestations, severity, treatment and outcome of patients were analyzed retrospectively.Results:A total of 189 patients were enrolled in this study, including 92 males (48.7%) and 97 females (51.3%), with a median age of 69 (60.5, 74.0) years. The usage and dosage of simnotrelvir/ritonavir were in accordance with the instructions (0.75 g of simnotrelvir and 0.1 g of ritonavir orally, once every 12 hours for 5 days). ADR related to simnotrelvir/ritonavir occurred in 18 of 189 patients (9.5%). There were no significant differences (all P>0.05) in gender, age, smoking status, COVID-19 classification and the proportion of patients with basic diseases such as hypertension, diabetes, cardiovascular disease, cerebrovascular disease, lung disease, and tumor after surgery between the ADR group (18 patients) and non-ADR group (171 patients). The difference in the propation of patients with liver injury and kidney injury between the 2 groups were statistically significant (both P<0.05). A total of 23 cases of ADR occurred in the ADR group. The occurrence time of ADR was 1 to 8 days after taking simnotrelvir/ritonavir. The clinical manifestations of ADR included digestive system symptoms, elevated transaminases, elevated serum creatinine, elevated serum uric acid, decreased platelet count, decreased white blood cell and neutrophil counts, dizziness, headache, etc. Five patients had 2 kinds of symptoms at the same time. The severity of ADR was grade 1 in 12 patients and grade 2 in 6 patients, and no ≥ grade 3 severe ADR occurred. Except one patient who stopped taking medication due to thrombocytopenia, all other patients completed 5-day treatment. The ADR disappeared after discontinuation of simnotrelvir/ritonavir and 1 to 5 days of symptomatic treatments. Conclusions:Simnotrelvir/ritonavir has a good safety in the treatment for COVID-19. The main ADRs are diarrhea and elevated transaminases, with the severity of grade 1-2 and the ADRs disappear after drug withdrawal. The patients with liver and kidney injury should be more alert to the occurrence of ADR when applying simnotrelvir/ritonavir.

【Objective】 To explore the correlation between serological screening of human T-lymphotropic virus antibodies (anti HTLV) and Western blot(WB) confirmatory tests among blood donors, so as to explore the infection status of HTLV Ⅰ/Ⅱ in Guangzhou. 【Methods】 The anti HTLV Ⅰ/Ⅱ enzyme-linked immunosorbent assay(ELISA) kit was used to screen voluntary blood donors from Guangzhou Blood Center from July 2016 to August 2022. WB was used to confirm 395 reactive blood samples by ELISA. The correlation between the S/CO values of anti HTLV Ⅰ/Ⅱ ELISA reagents and the confirmatory test was analyzed using ROC curves. 【Results】 The results showed that 25 out of 395 initially screened reactive blood donor samples were confirmed as HTLV positive by WB, while 16 were uncertain. ROC curve analysis showed a correlation between the S/CO values by ELISA and the confirmatory test results: the S/CO value at the highest Youden index was 3.789, which was the optimal threshold. The S/CO value had a certain correlation with the predicted positive rate of confirmatory results (P<0.05): the larger the S/CO value, the higher the predicted positive value. The overall prevalence of HTLV in Guangzhou is relatively low. 【Conclusion】 The prevalence of HTLV among blood donors in Guangzhou is low.Since the false positive rate of HTLV Ⅰ/Ⅱ antibody by ELISA serological screening is high, the confirmatory testing is particularly important.

This article reports a case of rare common variable immunodeficiency with intestinal infection at Department of Gastroenterology in Qilu Hospital of Shandong University aiming to improve the clinicians' understanding of the rare diseases of the digestive tract.

Objective:To investigate the relationship between the expression of hepatocyte nuclear factor-1 α (HNF-1α) and the occurrence and development of liver inflammation and fibrosis in liver tissues of patients with chronic hepatitis B.Methods:Sixty-four patients with chronic hepatitis B who were diagnosed and treated in our hospital from 2011 to 2018 were selected. All patients underwent ultrasound-guided aspiration liver biopsy. The pathological results of liver biopsy were collected for inflammation grading and fibrosis staging. The liver puncture biopsies was collected by paraffin sectioning. The expression of HNF1α in the liver tissue was detected by immunohistochemical staining. Mantel-Haenszel χ2 test was used for bidirectional ordered grouping data, and Spearman’s rank-correlation test was used for rank correlation analysis. Results:There were varying degrees of inflammatory necrosis and fibrosis in the liver tissues of patients with chronic hepatitis B. There was a linear relationship between the expression of HNF1α and the level of inflammation in liver tissues ( χ2MH = 40.70, P < 0.05). The expression of HNF1α in liver tissues of patients with chronic hepatitis B was decreased with the increase of liver inflammation. The expression intensity of HNF1α was negatively correlated with the inflammation grade ( rs = -0.815, P < 0.05). There was a linear relationship between the expressions of HNF1α and the degree and stage of liver fibrosis ( χ2MH = 31.95, P < 0.05). The expression level of HNF1α in liver tissue was gradually decreased with the aggravation of liver fibrosis. The expression intensity of HNF1α was negatively correlated with fibrosis stage ( rs = -0.713, P < 0.05). Conclusion:HNF1α is closely related to the occurrence and development of liver tissue inflammation and fibrosis, and is expected to be a sensitive indicator for evaluating the level of liver tissue inflammation and fibrosis in patients with chronic hepatitis B. In addition, its down-regulation may be involved in the process of occurrence and development of liver inflammation and liver fibrosis, and may become a new target for the treatment of chronic hepatitis B.