Objective:To analyze the epidemiological and clinical characteristics of respiratory pathogens in China.Methods:This study was a cross-sectional study, which encompassed 19 core units of the clinical pathogen network and established a three-tiered clinical pathogen surveillance system. Thirty respiratory samples were collected every two weeks from various units from January to December 2024, and the clinical and pathogen diagnostic information were gathered. A total of 11 864 samples were tested using this system. The tier-1 clinical pathogen surveillance system covered influenza A virus (Flu-A), influenza B virus (Flu-B), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The tier-2 clinical pathogen surveillance system focused on 18 key respiratory pathogens. The tier-3 clinical pathogen surveillance system further clarified whether any emerging infectious diseases had occurred.Results:The tier-1 clinical pathogen surveillance system showed Flu-A predominated in December, Flu-B predominated in January, SARS-CoV-2 peaked in March and August, whereas RSV circulated sporadically throughout the year. Geographic trends were broadly consistent across the seven major regions, although Flu-A detection in December was notably higher in Northeast China (48.1%(111/231)) and East China (36.2%(148/409)), and RSV detection was concentrated in the Northwest and South China from January to March. Data from the tier-2 clinical pathogen surveillance system indicated that Streptococcus pneumoniae, Mycoplasma pneumoniae, rhinovirus, and adenovirus were detected year-round, of these, Streptococcus pneumoniae and rhinovirus showed elevated positive detection rates from August to September, while adenovirus peaked in January. Legionella pneumophila was not detected throughout the year, and other pathogens fluctuated throughout the year without a consistent pattern. The predominant etiologic agents of pediatric pneumonia were Mycoplasma pneumoniae (35.0%(105/300)), rhinovirus (25.7%(77/300)), and adenovirus (17.3%(52/300)), whereas adult pneumonia was mainly caused by Streptococcus pneumoniae (10.5%(29/277)), Staphylococcus aureus (6.9%(19/277)), Mycoplasma pneumoniae (6.9%(19/277)), and Flu-A (6.1%(17/277)). The tier-3 clinical pathogen surveillance system did not identify any emerging respiratory pathogens. Conclusion:Respiratory pathogens in China in 2024 exhibit distinct temporal and spatial distribution patterns and vary among different populations.

Objective:Comparative efficacy and safety profiles of tenofovir disoproxil fumarate (TDF) versus tenofovir alafenamide fumarate (TAF) in chronic hepatitis B (CHB) patients with high viral load.Methods:CHB patients with high viral load (hepatitis B virus (HBV) DNA>7 lg IU/mL) receiving TDF ( n=155) or TAF ( n=157) monotherapy were included between December 1st, 2022 and December 1st, 2023, to compare the rates of undetectable HBV DNA (<20 IU/mL), the alanine transaminase (ALT) normalization rate, hepatitis B e antigen (HBeAg) seroconversion rate, renal function and lipid profiles at 48 weeks of treatment. The statistical analysis was performed by the two independent samples t test, Mann-Whitney U test, chi-square test or Fisher′s exact probability test. Results:At week 48 of treatment, the TDF group achieved significantly higher HBV DNA undetectability rates (49.03%(76/155) vs 29.30%(46/157)) and greater mean reduction ((6.05±0.81) lg IU/mL vs (5.57±1.02) lg IU/mL) than the TAF group ( χ2=12.75, t=-4.65, both P<0.001). The ALT normalization rate of patients in the TDF and TAF groups were 77.19%(88/114) and 72.50%(87/120), and HBeAg seroconversion rates were 4.00%(6/150) and 2.67%(4/150), respectively, with no statistically significant differences between the two groups (all P>0.05). The differences in the changes and abnormal rates of serum creatinine and estimated glomerular filtration rate between the two groups of patients were not statistically significant (both P>0.05). The magnitude of decrease (0.15(-0.02, 0.38) mmol/L vs 0.06(-0.06, 0.20) mmol/L) and abnormal rate (27.73%(33/119) vs 16.39%(20/122)) in high-density lipoprotein cholesterol in the TDF group was higher than those in the TAF group, while the increases in low-density lipoprotein cholesterol (-0.09(-0.39, 0.25) mmol/L vs 0.05(-0.31, 0.42) mmol/L), total cholesterol (TC) (-0.23(-0.75, 0.23) mmol/L vs 0.08(-0.35, 0.57) mmol/L), and triglyceride (-0.12(-0.40, 0.06) mmol/L vs 0.00(-0.19, 0.24) mmol/L), as well as the abnormal rate of TC (4.31%(5/116) vs 15.75%(20/127)), in the TDF group were lower than those in the TAF group ( Z=-3.19, χ2=4.51, Z=2.17, Z=4.09, Z=3.71, χ2=8.59, all P<0.05). Conclusion:TDF demonstrated superior efficacy and better safety profiles compared to TAF in high viral load CHB patients.

Objective:To compare the clinical characteristics of patients with drug-induced liver injury (DILI) caused by Polygonum multiflorum and other drug-induced liver injuries (DILI).Methods:A retrospective cohort study was conducted. Clinical data of seventy-three cases confirmedly diagnosed with DILI caused by Polygonum multiflorum, 168 cases diagnosed with DILI caused by other traditional Chinese medicines, and 225 cases diagnosed with DILI caused by modern medicines admitted to Peking University First Hospital, the Fipth People's Hospital of Wuxi, Yantai Qishan Hospital, and Qinhuangdao Third Hospital from January 1995 to August 2019 were selected and collected as the research subjects. The Mann-Whitney U test was used for comparison of skewed distribution of continuous data between two groups. The Kruskal-Wallis rank-sum test was used for comparison between three groups. The χ2 test was used for comparing count data between groups. Results:Among the 73 cases with DILI caused by Polygonum multiflorum, 11 (15.1%) took a single herb of Polygonum multiflorum (including its powder and boiled water), 37 (50.7%) took traditional Chinese patent medicines containing Polygonum multiflorum, and 25 (34.2%) took a traditional Chinese medicine formula containing Polygonum multiflorum. The age of the DILI group caused by Polygonum multiflorum was 48 years old, which was lower than the other two groups (the DILI group caused by other traditional Chinese medicines: 55 years old, the DILI group caused by modern medicines: 52 years old; P<0.01). The levels of alanine aminotransferase (ALT), aspartate aminotransferase, and alkaline phosphatase were all higher than the other two groups ( P<0.05). The proportion of patients with antinuclear antibody positivity rate and severity of liver damage grade 3 was higher in the DILI group induced by Polygonum multiflorum than those in the modern drug-induced DILI group ( P<0.05). The liver cell injury type accounted for 96.6% (57/59) in the DILI group caused by Polygonum multiflorum, which was higher than that in the modern drug-induced DILI group (69.3%, 156/225) ( P<0.001). There was no statistically significant difference ( P>0.05) in gender, age, medication duration, and various biochemical indicators between patients with DILI caused by Polygonum multiflorum monotherapy and compound preparations in terms of compatibility. The ALT level in the DILI group caused by raw Polygonum multiflorum was higher than that in the DILI group caused by processed Polygonum multiflorum [the DILI group caused by raw Polygonum multiflorum: 1 289.0(921.8, 1 851.8)U/L, the DILI group caused by processed Polygonum multiflorum: 890.0(304.0,1 320.0)U/L; P<0.05] according to the comparison of processing methods. Conclusion:The degree of DILI caused by Polygonum multiflorum is more obvious than that caused by other drugs. There was no difference in the degree of DILI caused by the single and the compound formulation. However, the liver damage caused by raw Polygonum multiflorum was more severe than that caused by processed Polygonum multiflorum.

Objective:To analyze the epidemiological and clinical characteristics of respiratory pathogens in China.Methods:This study was a cross-sectional study, which encompassed 19 core units of the clinical pathogen network and established a three-tiered clinical pathogen surveillance system. Thirty respiratory samples were collected every two weeks from various units from January to December 2024, and the clinical and pathogen diagnostic information were gathered. A total of 11 864 samples were tested using this system. The tier-1 clinical pathogen surveillance system covered influenza A virus (Flu-A), influenza B virus (Flu-B), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The tier-2 clinical pathogen surveillance system focused on 18 key respiratory pathogens. The tier-3 clinical pathogen surveillance system further clarified whether any emerging infectious diseases had occurred.Results:The tier-1 clinical pathogen surveillance system showed Flu-A predominated in December, Flu-B predominated in January, SARS-CoV-2 peaked in March and August, whereas RSV circulated sporadically throughout the year. Geographic trends were broadly consistent across the seven major regions, although Flu-A detection in December was notably higher in Northeast China (48.1%(111/231)) and East China (36.2%(148/409)), and RSV detection was concentrated in the Northwest and South China from January to March. Data from the tier-2 clinical pathogen surveillance system indicated that Streptococcus pneumoniae, Mycoplasma pneumoniae, rhinovirus, and adenovirus were detected year-round, of these, Streptococcus pneumoniae and rhinovirus showed elevated positive detection rates from August to September, while adenovirus peaked in January. Legionella pneumophila was not detected throughout the year, and other pathogens fluctuated throughout the year without a consistent pattern. The predominant etiologic agents of pediatric pneumonia were Mycoplasma pneumoniae (35.0%(105/300)), rhinovirus (25.7%(77/300)), and adenovirus (17.3%(52/300)), whereas adult pneumonia was mainly caused by Streptococcus pneumoniae (10.5%(29/277)), Staphylococcus aureus (6.9%(19/277)), Mycoplasma pneumoniae (6.9%(19/277)), and Flu-A (6.1%(17/277)). The tier-3 clinical pathogen surveillance system did not identify any emerging respiratory pathogens. Conclusion:Respiratory pathogens in China in 2024 exhibit distinct temporal and spatial distribution patterns and vary among different populations.

Objective:Comparative efficacy and safety profiles of tenofovir disoproxil fumarate (TDF) versus tenofovir alafenamide fumarate (TAF) in chronic hepatitis B (CHB) patients with high viral load.Methods:CHB patients with high viral load (hepatitis B virus (HBV) DNA>7 lg IU/mL) receiving TDF ( n=155) or TAF ( n=157) monotherapy were included between December 1st, 2022 and December 1st, 2023, to compare the rates of undetectable HBV DNA (<20 IU/mL), the alanine transaminase (ALT) normalization rate, hepatitis B e antigen (HBeAg) seroconversion rate, renal function and lipid profiles at 48 weeks of treatment. The statistical analysis was performed by the two independent samples t test, Mann-Whitney U test, chi-square test or Fisher′s exact probability test. Results:At week 48 of treatment, the TDF group achieved significantly higher HBV DNA undetectability rates (49.03%(76/155) vs 29.30%(46/157)) and greater mean reduction ((6.05±0.81) lg IU/mL vs (5.57±1.02) lg IU/mL) than the TAF group ( χ2=12.75, t=-4.65, both P<0.001). The ALT normalization rate of patients in the TDF and TAF groups were 77.19%(88/114) and 72.50%(87/120), and HBeAg seroconversion rates were 4.00%(6/150) and 2.67%(4/150), respectively, with no statistically significant differences between the two groups (all P>0.05). The differences in the changes and abnormal rates of serum creatinine and estimated glomerular filtration rate between the two groups of patients were not statistically significant (both P>0.05). The magnitude of decrease (0.15(-0.02, 0.38) mmol/L vs 0.06(-0.06, 0.20) mmol/L) and abnormal rate (27.73%(33/119) vs 16.39%(20/122)) in high-density lipoprotein cholesterol in the TDF group was higher than those in the TAF group, while the increases in low-density lipoprotein cholesterol (-0.09(-0.39, 0.25) mmol/L vs 0.05(-0.31, 0.42) mmol/L), total cholesterol (TC) (-0.23(-0.75, 0.23) mmol/L vs 0.08(-0.35, 0.57) mmol/L), and triglyceride (-0.12(-0.40, 0.06) mmol/L vs 0.00(-0.19, 0.24) mmol/L), as well as the abnormal rate of TC (4.31%(5/116) vs 15.75%(20/127)), in the TDF group were lower than those in the TAF group ( Z=-3.19, χ2=4.51, Z=2.17, Z=4.09, Z=3.71, χ2=8.59, all P<0.05). Conclusion:TDF demonstrated superior efficacy and better safety profiles compared to TAF in high viral load CHB patients.

Objective:To compare the clinical characteristics of patients with drug-induced liver injury (DILI) caused by Polygonum multiflorum and other drug-induced liver injuries (DILI).Methods:A retrospective cohort study was conducted. Clinical data of seventy-three cases confirmedly diagnosed with DILI caused by Polygonum multiflorum, 168 cases diagnosed with DILI caused by other traditional Chinese medicines, and 225 cases diagnosed with DILI caused by modern medicines admitted to Peking University First Hospital, the Fipth People's Hospital of Wuxi, Yantai Qishan Hospital, and Qinhuangdao Third Hospital from January 1995 to August 2019 were selected and collected as the research subjects. The Mann-Whitney U test was used for comparison of skewed distribution of continuous data between two groups. The Kruskal-Wallis rank-sum test was used for comparison between three groups. The χ2 test was used for comparing count data between groups. Results:Among the 73 cases with DILI caused by Polygonum multiflorum, 11 (15.1%) took a single herb of Polygonum multiflorum (including its powder and boiled water), 37 (50.7%) took traditional Chinese patent medicines containing Polygonum multiflorum, and 25 (34.2%) took a traditional Chinese medicine formula containing Polygonum multiflorum. The age of the DILI group caused by Polygonum multiflorum was 48 years old, which was lower than the other two groups (the DILI group caused by other traditional Chinese medicines: 55 years old, the DILI group caused by modern medicines: 52 years old; P<0.01). The levels of alanine aminotransferase (ALT), aspartate aminotransferase, and alkaline phosphatase were all higher than the other two groups ( P<0.05). The proportion of patients with antinuclear antibody positivity rate and severity of liver damage grade 3 was higher in the DILI group induced by Polygonum multiflorum than those in the modern drug-induced DILI group ( P<0.05). The liver cell injury type accounted for 96.6% (57/59) in the DILI group caused by Polygonum multiflorum, which was higher than that in the modern drug-induced DILI group (69.3%, 156/225) ( P<0.001). There was no statistically significant difference ( P>0.05) in gender, age, medication duration, and various biochemical indicators between patients with DILI caused by Polygonum multiflorum monotherapy and compound preparations in terms of compatibility. The ALT level in the DILI group caused by raw Polygonum multiflorum was higher than that in the DILI group caused by processed Polygonum multiflorum [the DILI group caused by raw Polygonum multiflorum: 1 289.0(921.8, 1 851.8)U/L, the DILI group caused by processed Polygonum multiflorum: 890.0(304.0,1 320.0)U/L; P<0.05] according to the comparison of processing methods. Conclusion:The degree of DILI caused by Polygonum multiflorum is more obvious than that caused by other drugs. There was no difference in the degree of DILI caused by the single and the compound formulation. However, the liver damage caused by raw Polygonum multiflorum was more severe than that caused by processed Polygonum multiflorum.

Hepatitis B virus core antibody（anti-HBc）is widely used in the disease staging，prediction of liver inflammation and fibrosis，antiviral efficacy and virus reactivation after drug withdrawal in patients with chronic hepatitis B（CHB）. Recent studies have found that the positive anti-HBc status may interact with disease progression and prognosis in patients with other viral infections（such as HCV，HDV and HIV），malignant tumors，autoimmune liver diseases，metabolic-associated fatty liver disease，and rheumatic diseases. This article reviews the research progress on the application of anti-HBc detection in these special patients，to provide reference for their disease assessment and clinical treatment.