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.

OBJECTIVE To explore the efficacy of platelet-rich plasma （PRP） intrauterine infusion combined with Gushen antai pills in the treatment of recurrent abortion （RSA） and its impacts on endometrial receptivity and hormone levels in patients. METHODS A total of 108 patients with RSA treated in our hospital from January 2021 to January 2024 were selected and evenly divided into control group and study group using the random number table method， with 54 cases in each group. On the basis of conventional treatment， patients in the control group were administered with Gushen antai pills， while patients in the study group received PRP intrauterine infusion combined with Gushen antai pills. The clinical efficacy， TCM syndrome scores before and after treatment， endometrial receptivity [endometrial thickness （EST）， spiral artery resistance index （RI）， and pulsatility index （PI）]， hormone [progesterone （P）， estradiol （E2）， and human chorionic gonadotropin （HCG）] levels， as well as pregnancy outcomes， were compared between the two groups. Additionally， the occurrence of adverse reactions in both groups was recorded. RESULTS The total effective rate （91.44% vs. 81.48%） and infant live birth rate （96.30% vs. 83.33%） of the study group were significantly higher than those of the control group （P＜0.05）. Following treatment， various TCM syndrome scores and total score， spiral artery RI and PI levels in both groups were markedly lower than those in the same groups before treatment， with the study group showing significantly lower levels than the control group（P＜0.05）. Conversely， the P， E2， HCG and EST levels in both groups were significantly higher than those in the same groups before treatment， and the study group exhibited notably higher levels than the control group （P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS PRP intrauterine infusion combined with Gushen antai pills has good clinical efficacy in the treatment of RSA. It can improve TCM syndromes， enhance endometrial receptivity， regulate hormone levels and improve pregnancy outcomes， and it is highly safe.

Objective : To investigate the role of caspase recruitment domain-containing protein 9(Card9) inAspergillus fumigatus(A.fumigatus) keratitis and the effect of its deficiency on macrophage resistance to fungal infection. Methods : (1) C57BL/7 mice aged 6-8 weeks were selected and the mice pretreated Card9 siRNA and Blank siRNA, respectively, and the expression of Card9 in each group was detected by Western blot and RT-PCR. The corneal epithelium of the mice was scraped away 72 hours later, andA.fumigatusspore suspension was injected into the corneal stroma. The corneal scores were recorded at 1 d, 3 d, 5 d and 7 d after infection. The expression of Card9, nuclear factor κB(NF-κB), interleukin 1β(IL-1β), interleukin 6(IL-6) and tumor necrosis factor α(TNF-α) in each group was detected by RT-PCR and immunohistochemical(IHC).(2) Human corneal epithelial cells(HCECs) and human monocytic-leukemia cells(THP-1)in vitro, RT-PCR was used to examine the expression of Card9 gene in the two cells, and a stable cell line of THP-1 cells was constructed using shRNA vectors. The expression of Card9 in the cell line was detected by Western Blot and RT-PCR. The cells were induced into macrophages and stimulation byA.fumigatus, and the expression of Card9, NF-κB, IL-1β, IL-6 and TNF-α was detected by RT-PCR. Results : Card9 expression increased inA.fumigatuskeratitis, mainly distributed in cytoplasm of immune cells. The expression of Card9 in the cornea of mice treated with Card9 siRNA was significantly reduced. After inhibiting the expression of Card9 gene, the expressions of Card9, NF-κB, IL-1β, IL-6 and TNF-α significantly decreased and the changes of IL-1β were most significant. Inin vitrostudies, Card9 exhibited negligible expression in human corneal epithelial cells, contrasting with its pronounced expression in THP-1 cells. After the induction of macrophages, Card9, NF-κB, IL-1β, IL-6, and TNF-α were significantly upregulated under the stimulation ofA.fumigatus. After inhibiting the expression of Card9, the stimulated expression of these factors was significantly reduced, with the most notable change observed in IL-1β. Conclusion Card9 is involved in the inflammatory development and healing process ofA.fumigatuskeratitis. Card9 deficiency can cause functional impairment of macrophages and inhibit the expression of inflammatory factors to a certain extent, in which IL-1β has the greatest effect.

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.

Objective:To explore the effect of Simo decoction improving the low duodenal inflammation and protecting the du-odenal mucosal barrier in rats with functional dyspepsia(FD).Methods:Sixty SD rats were randomly divided into control group(10 rats)and model group(50 rats),and the modeling rats were prepared by multivariate intervention method.After successful modeling,the modeling rats were randomly divided into model group,Simo decoction high-dose,medium-dose,low-dose group and mosapride group,with 10 rats in each group.The high-dose,medium-dose,and low-dose groups of Simo decoction were ga-vage given 5.62 g/kg,2.81 g/kg,and 1.40 g/kg,respectively,and the mosapride group was gavage given 0.305 mg/kg of mosapride,and the control group and model group were gavage given the same amount of distilled water for 14 days.The body weight of rats was observed;gastric emptying rate and small bowel propulsion rate were measured;transmission electron microscopy was used to observe the morphology of duodenal epithelial cells;ELISA detected serum levels of IL-17A and IL-22;Western blot and immunohistochemis-try were used to detect the expressions of protease-activated receptor 2(PAR-2)and tight junction protein(ZO-1,claudin-1)in the duodenum.Results:Compared with the control group,the body weight,gastric emptying rate and small intestinal propulsion rate of the model group were significantly reduced(P<0.01),transmission electron microscopy showed widening of the duodenal epithelial cell space,serum IL-17A and IL-22 levels were significantly increased(P<0.01),the expression of PAR-2 in duodenal tissue was in-creased,and the expressions of ZO-1 and claudin-1 were downregulated(P<0.01).Compared with model group,the gastric emptying rate and small intestinal propulsion rate in Simo decoction high-dose,medium-dose and mosapride group were increased(P<0.05,P<0.01),the contents of IL-17A and IL-22 in serum decreased(P<0.05,P<0.01),and the expression of PAR-2 in duodenal tissues was down-regulated,the expressions of ZO-1 and claudin-1 was significantly increased(P<0.01).The low-dose group of Simo soup could improve weight loss(P<0.01),reduce IL-17A content and PAR-2 expression,and increase ZO-1 and claudin-1 expression(P<0.05,P<0.01),while the effect on other indexes was not obvious.Conclusion:Simo decoction may reduce low-grade duodenal in-flammation to repair the mucosal barrier by down-regulating the levels of IL-17A and IL-22 and the expression of PAR-2,and up-regu-lating the expression of ZO-1 and claudin-1,so as to exert the effect of FD treatment.

Objective:To investigate the status of development and application of information system of central sterile supply department(CSSD)in hospitals of China,so as to provide references for the promotion of CSSD information system in hospital.Methods:Hierarchical sampling method was adopted to combine with CSSD Professional Committee of Chinese Nursing Association to design questionnaire for Questionnaire Star Network Survey about basic information,CSSD information system,whether the CSSD information system connected with equipment,tracing links and tracing levels,identification method of apparatuses,automation of equipment in 3,074 hospitals of 22 provinces,4 municipalities directly under the central government,and 5 autonomous regions.Results:In 3,074 hospitals,1,811 hospitals(accounting for 58.91%)adopted the CSSD information system.The utilization rate of tertiary hospitals was 81.90%for the information system,which was higher than that(34.51%)in secondary hospitals,and the difference was statistically significant(x2=636.65,P<0.05).The proportion of hospitals that included the recycling,cleaning,disinfection,inspection and packaging,sterilization,storage,and distribution links of CSSD internal management into information management was all>88%,while the utilization link only accounted for 15.18%.The proportion that surgical apparatuses and the apparatuses of clinical diagnosis and treatment were included in management was higher in 1811 hospitals that used CSSD information system,which were respectively 88.02%and 84.70%,while the proportion of surgical soft endoscope was lower,which only was 49.20%.A total of 84.37%of hospitals conducted informatization management for using extracorporeal apparatuses and implants.The connection rates of the main CSSD equipment,which included the washing and disinfection machine,the pressure steam sterilizer and the low-temperature sterilizer,were connected with information system were respectively 56.60%,63.06%and 43.95%.The full compatibility between the information system and all monitoring methods did not be realized in these hospitals.Barcode was the main identification form(69.91%)of the CSSD information system,and personnel management was the most common management module(53.62%)of the information system.The utilization rate(2.93%-5.14%)of automated equipment was low,and 35.45%of the CSSD information systems had the function of automatic emergency handling.Conclusion:The CSSD informatization management of China has achieved remarkable results,but there are still problems such as insufficient connection of equipment,inclusion of monitoring data,and insufficient automation and intelligence.It is necessary to increase the promotion efforts to promote the high-quality development of hospitals.

Tricellulin, a key tricellular tight junction (TJ) protein, is essential for maintaining the barrier integrity of acinar epithelia against macromolecular passage in salivary glands. This study aims to explore the role and regulatory mechanism of tricellulin in the development of salivary gland hypofunction in Sjögren's syndrome (SS). Employing a multifaceted approach involving patient biopsies, non-obese diabetic (NOD) mice as a SS model, salivary gland acinar cell-specific tricellulin conditional knockout (Tric^CKO) mice, and IFN-γ-stimulated salivary gland epithelial cells, we investigated the role of tricellulin in SS-related hyposalivation. Our data revealed diminished levels of tricellulin in salivary glands of SS patients. Similarly, NOD mice displayed a reduction in tricellulin expression from the onset of the disease, concomitant with hyposecretion and an increase in salivary albumin content. Consistent with these findings, Tric^CKO mice exhibited both hyposecretion and leakage of macromolecular tracers when compared to control animals. Mechanistically, the JAK/STAT1/miR-145 axis was identified as mediating the IFN-γ-induced downregulation of tricellulin. Treatment with AT1001, a TJ sealer, ameliorated epithelial barrier dysfunction, restored tricellulin expression, and consequently alleviated hyposalivation in NOD mice. Importantly, treatment with miR-145 antagomir to specifically recover the expression of tricellulin in NOD mice significantly alleviated hyposalivation and macromolecular leakage. Collectively, we identified that tricellulin deficiency in salivary glands contributed to hyposalivation in SS. Our findings highlight tricellulin as a potential therapeutic target for hyposecretion, particularly in the context of reinforcing epithelial barrier function through preventing leakage of macromolecules in salivary glands.
Sjogren's Syndrome/complications* ; Animals ; Xerostomia/etiology* ; Mice ; Mice, Inbred NOD ; MARVEL Domain Containing 2 Protein/metabolism* ; Humans ; Mice, Knockout ; Disease Models, Animal ; Interferon-gamma ; Salivary Glands/metabolism* ; Tight Junctions/metabolism* ; MicroRNAs/metabolism* ; Female

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.

Objective To investigate the clinical application value of blood routine parameters such as white blood cells(WBC),neu-trophils(NEU),lymphocytes(LYM),monocytes(MON),platelets(PLT),neutrophil to lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR)and C-reactive protein(CRP)in children with influenza A(Flu A)virus infection.Methods 317 children with upper respiratory tract symptoms visited Department of Pediatrics,Affiliated Jiangning Hospital of Nanjing Medical University from September 2023 to May 2024 were retrospectively analyzed.According to the six kinds of nucleic acid test results of upper respiratory tract,the children were divided into the Flu A group(n=150)and disease control group(n=167).In addition,97 healthy children who underwent physical examination in our hospital during the same period were selected as the healthy control group.The finger blood of the children was collected for the detection of blood routine parameters and CRP.The Kruskal-Wallis H non-parametric test was used to compare the differences of these parameters among the three groups.The receiver operating characteristic(ROC)curve was drawn,and the area under the ROC curve(AUCROC)was used to evaluate the diagnostic value of each indicator for influenza A virus infection.Results The NLR and PLR in the Flu A group were significantly higher than those in the disease control group and healthy control group,while the levels of WBC and LYM were significantly lower than those in the disease control group and healthy control group(P＜0.05).The level of CRP in the Flu A group was higher than that in the healthy control group but lower than that in the disease control group(P＜0.05).The indicator with the best diagnostic efficacy for influenza A virus infection was LYM,whose AUCROC was 0.79.When the optimal diagnostic threshold was 1.55×109/L,its sensitivity and specificity were 0.620 and 0.837,respectively.Next were PLR and NLR,with AUCROC of 0.735 and 0.723,specificity of 0.754 and 0.826,and sensitivity of 0.693 and 0.553,respectively.The diagnostic efficacy of MON,PLT,and CRP was relatively low.The AUCROC of the combined detection of LYM,NLR,PLR,MON,PLT,and CRP for the diagnosis of influenza A virus infection could increase to 0.838.Conclusion The blood routine parameters of children with influenza A virus infection show a decrease in the level of LYM and an increase in NLR and PLR.The combined detection of LYM,NLR,PLR,MON,PLT,and CRP can improve the accuracy of early diagnosis of influenza A virus infection in children.

Objective To analyze the value of serum neutrophil count (NEUT), homocysteine (Hcy), adiponectin (APN) and blood glucose in predicting the occurrence of acute myocardial infarction (AMI) in patients with coronary heart disease. Methods The clinical data of 98 patients with coronary heart disease who were admitted to the hospital from March 2022 to March 2024 were collected retrospectively. Patients included were divided into AMI group (n=33) and non-AMI group (n=65) according to the presence and absence of AMI. Baseline data, complications, ultrasound examination data and laboratory examination data were collected. Multivariate logistic regression analysis was performed to identify the influencing factors of AMI in patients with coronary heart disease. The receiver operating characteristic curves were used to evaluate the predictive value of NEUT, Hcy, APN and blood glucose for AMI in patients with coronary heart disease. Results The levels of fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), glycosylated hemoglobin (HbA1c), NEUT, APN, Hcy, N-terminal pro B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), red blood cell distribution width (RDW) and white blood cell (WBC) in the AMI group were higher than those in the non-AMI group (P<0.05). Logistic regression analysis found that FPG, 2hPG, HbA1c, NEUT, APN, Hcy, NT-proBNP, CRP, RDW, and WBC were independent influencing factors of AMI in patients with coronary heart disease (P<0.05). ROC curves indicated that the levels of FPG, 2hPG, HbA1c, NEUT, APN and Hcy were abnormally elevated in patients with coronary heart disease. Above indicators were helpful for predicting the occurrence of AMI. The area under the curve (AUC) and sensitivity of FPG for predicting AMI in patients with coronary heart disease were the best (P<0.05). Conclusion Abnormal elevated levels of FPG, 2hPG, HbA1c, NEUT, APN and Hcy are independent risk factors for AMI in patients with coronary heart disease. All of these indicators have predictive value.