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.

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.

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 evaluate the prognostic significance of inflammatory biomarkers,prognostic nutritional index and clinicopathological characteristics in tongue squamous cell carcinoma(TSCC)patients who underwent cervical dissection.Methods:The retrospective cohort study consisted of 297 patients undergoing tumor resection for TSCC between January 2017 and July 2018.The study population was divided into the training set and validation set by 7:3 randomly.The peripheral blood indices of interest were preoperative neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),systemic inflammation score(SIS)and prognostic nutritional index(PNI).Kaplan-Meier survival analysis and multivariable Cox regression analysis were used to evaluate independent prognostic factors for overall survival(OS)and disease-specific survival(DSS).The nomogram's accuracy was internally validated using concordance index,receiver operating characteristic(ROC)curve,area under the curve(AUC),calibration plot and decision curve analysis.Results:According to the univariate Cox regression analysis,clinical TNM stage,clinical T category,clinical N category,differentiation grade,depth of invasion(DOI),tumor size and pre-treatment PNI were the prognostic factors of TSCC.Multivariate Cox regression analysis revealed that pre-treatment PNI,clinical N category,DOI and tumor size were independent prognostic factors for OS or DSS(P＜0.05).Positive neck nodal status(N≥1),PNI≤50.65 and DOI＞2.4 cm were associated with the poorer 5-year OS,while a positive neck nodal status(N≥1),PNI≤50.65 and tumor size＞3.4 cm were associated with poorer 5-year DSS.The concordance index of the nomograms based on independent prognostic factors was 0.708(95％CI,0.625-0.791)for OS and 0.717(95％CI,0.600-0.834)for DSS.The C-indexes for external validation of OS and DSS were 0.659(95％CI,0.550-0.767)and 0.780(95％CI,0.669-0.890),respectively.The 1-,3-and 5-year time-dependent ROC analyses(AUC=0.66,0.71 and 0.72,and AUC=0.68,0.77 and 0.79,respec-tively)of the nomogram for the OS and DSS pronounced robust discriminative ability of the model.The calibration curves showed good agreement between the predicted and actual observations of OS and DSS,while the decision curve confirmed its pronounced application value.Conclusion:Pre-treatment PNI,clinical N category,DOI and tumor size can potentially be used to predict OS and DSS of patients with TSCC.The prognostic nomogram based on these variables exhibited good accurary in predicting OS and DSS in patients with TSCC who underwent cervical dissection.They are effective tools for predicting sur-vival and helps to choose appropriate treatment strategies to improve the prognosis.

Objective:To evaluate the current situation of interventional treatment for children with tic disorder and family needs for interventions and to analyze the factors influencing intervention needs.Methods:This cross-sectional study encompassed 362 children and their families who sought medical attention at Children′s Hospital of Chongqing Medical University, from October 2022 to January 2023.Factors influencing their intervention needs were analyzed.Results:A total of 362 children were surveyed.The main therapies of family concern included medication and behavioral intervention.Currently, the predominant therapy employed in the care of these children was medication (102/126, 80.9%), not with standing the fact that 77.8% of parents expressed discontent with its efficacy.Of the children and families included in the survey, 276 (76.2%) gave responses delineating their specific intervention needs.The paramount among these was the need for social support, with the score of (2.69±0.96) points.Multiple linear regression analysis revealed the notable influence of the duration of the ailment, the presence of comorbidities, the gravity of the disorder, the monthly household income, parental anxiety levels, and concerns germane to the therapeutic regimen on the family needs for interventions (all P<0.05). Conclusions:The extant therapeutic approaches applied in tic disorder exhibit a discernable constraint in terms of efficacy.Parents evince a pronounced yearning for interventions.These needs are contingent upon a spectrum of determinants.Clinicians are advised to consider the family needs for interventions when formulating therapeutic strategies, so that they can propound bespoke intervention plans to ameliorate therapeutic outcomes.

Objective:To investigate the role of circular RNA (circRNA) circSEPT9 in the radioresistance of glioma and its molecular mechanism.Methods:Pathological samples were collected from 40 glioma patients who underwent surgery and postoperative radiotherapy in the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2022. All patients were divided into the radiation-sensitive and radiation-resistant groups. The expression levels of circSEPT9 were assessed using real-time reverse transcription PCR (RT-qPCR) in two groups. The radiation-resistant glioma cell U251R was constructed based on human glioma cell U251. The U251R cells were divided into the negative control (si-NC), circSEPT9 knockdown (si-circSEPT9), negative control combined with irradiation (si-NC+4 Gy), circSEPT9 knockdown combined with irradiation (si-circSEPT9+4 Gy), circSEPT9 knockdown combined with control inhibitor and irradiation (si-circSEPT9+NC inhibitor+4 Gy), and circSEPT9 knockdown combined with miR-432-5p inhibitor and irradiation (si-circSEPT9+miR-432-5p inhibitor+4 Gy) groups. The targeting relationship between circSEPT9 and miR-432-5p was verified through dual-luciferase reporter assay. Colony formation assay was employed to assess the survival rate of U251R cells. Flow cytometry was adopted to measure the apoptosis rate. The expression level of circSEPT9 in glioma tissues was statistically analyzed using independent sample t-test. The survival and apoptosis rates in each group were evaluated using one-way ANOVA. Results:The expression level of circSEPT9 was up-regulated in the glioma tissues of patients in the radiation-resistant group (1.00±0.18 vs. 3.25±0.13, P<0.05). Compared to the si-NC group, the U251R cells in the si-circSEPT9 group exhibited a significant reduction in survival fraction and a notable increase in apoptosis rate (9.24±0.83 vs. 19.36±2.13, both P<0.05). After radiation exposure at 4, 6 and 8 Gy, si-circSEPT9 treatment significantly decreased the survival fraction in U251R cells (all P<0.05). Compared with the si-NC+4 Gy group, the apoptosis rate was increased in the si-circSEPT9+4 Gy group (18.83±1.94 vs. 35.23±3.56, P<0.05). Dual-luciferase reporter assay showed that circSEPT9 could target and negatively regulate the expression level of miR-432-5p. Compared with the si-circSEPT9+NC inhibitor+4 Gy group, the survival fraction of U251R was significantly increased in the si-circSEPT9+miR-432-5p inhibitor+4 Gy group ( P<0.05). Conclusion:Knockdown of circSEPT9 enhances the radiosensitivity of glioma cells by regulating cell apoptosis through targeting the miR-432-5p.

Primary sclerosing cholangitis(PSC)is a cholestatic disease characterized by chronic progressive bile duct inflammation and has a low incidence rate and poor prognosis in China.There is still no drug therapy that can change the course of PSC,and liver transplantation is the only effective treatment for PSC,with a 5-year survival rate of 85%after transplantation.Drug therapy for PSC is facing great challenges based on the current status of PSC.At present,drugs for the treatment of PSC are in the stage of clinical trials and have shown certain application prospect,among which ursodeoxycholic acid is the most widely studied and commonly used drug.In addition,there are many emerging drugs in the pipeline.This article summarizes the latest advances in drug therapy for PSC.

Objective:To assess the impact of preoperative short-course radiotherapy combined with neoadjuvant chemotherapy on elderly patients with locally advanced rectal cancer after a 2-year follow-up.Methods:In this retrospective cohort study, we included 446 consecutive cases of elderly patients diagnosed and treated for locally advanced rectal cancer(stage Ⅱ-Ⅲ with T3-T4 and/or positive regional lymph nodes)at the First People's Hospital of Shangqiu city from January 2012 to December 2019.The patients were divided into two groups based on the treatment method: an observation group(107 cases)and a control group(339 cases).The patients in the observation group underwent preoperative short-course radiotherapy combined with neoadjuvant chemotherapy.The regimen included short-term radiotherapy(25 Gy over 1 week in 5 fractions)followed by 4 courses of chemotherapy(CAPOX regimen).On the other hand, the control group received concurrent radiotherapy and chemotherapy.The regimen involved 50 Gy over 5 weeks in 25 fractions and concurrent capecitabine chemotherapy.Afterward, total rectal mesentery resection was performed, and postoperatively, 2 and 6 courses of CAPOX chemotherapy were continued.Follow-up was conducted until 31 December 2021, with the primary observation being the disease-free survival(DFS)of patients in both groups.Secondary observations included overall survival(OS)time, lesion progression-free survival(PFS)time, local recurrence rate, and the rate of acute toxicity events.Cox regression analyses were conducted to compare the factors influencing DFS.Results:Among the 446 patients, 303(67.9%)were male and 143(32.1%)were female.The patients in the observation group were found to be younger and had a higher proportion of Eastern Collaborative Oncology Group(ECOG)physical status score 0 compared to the control group(both P<0.05).Additionally, the two groups differed significantly in terms of MRI T stage, N stage, distance from the external anal verge, rectal mesorectal fascial infiltration, pathological stage, and chemotherapy-to-surgery time interval(all P<0.05).Throughout a mean follow-up period of(20.7±3.5)months, there were 76 deaths, 89 distant metastases, and 32 local recurrences.The results of Kaplan-Meier survival analysis revealed that the observation group had a higher disease-free survival(DFS)rate at 2 years of follow-up compared to the control group[73.8%(79/107) vs.68.1%(231/339), Log-rank χ2=2.676, P=0.041].Additionally, the median DFS time was longer in the observation group[19(12, 22)months]compared to the control group[16(11, 19)months]( Z=2.774, P=0.038).Furthermore, the observation group exhibited a significantly longer OS time[26(21, 33)months]compared to the control group[22(18, 14)months]( Z=2.879, P=0.032).However, the median PFS time was similar in both groups[20(14, 25)months vs.16(12, 21)months]( Z=1.545, P=0.123).The incidence of distant metastasis was 18.7%(20/107)in the observation group and 20.4%(69/339)in the control group(Log-rank χ2=0.341, P=0.708), indicating no significant difference.Similarly, there was no significant difference in the risk of local recurrence between the observation group[9.3%(10/107)]and the control group[6.5%(22/339)](Log-rank χ2=0.996, P=0.318).In terms of adverse reactions, there was no statistically significant difference in the incidence of grade≥3 acute toxic reactions between the two groups[19.6%(21/107) vs.12.1%(41/339), Log-rank χ2=1.661, P=0.148].A multifactorial Cox regression analysis revealed that age( HR=0.586, P=0.005), ECOG score( HR=0.721, P=0.028), MRI T-stage( HR=0.605, P=0.008), rectal mesenteric fascial infiltration( HR=1.649, P=0.012), and distance from the external anal verge( HR=0.638, P=0.041)were associated with DFS. Conclusions:The findings indicate that the combination of preoperative short-course radiotherapy and neoadjuvant chemotherapy in elderly patients with locally advanced rectal cancer demonstrates favorable short-term effectiveness and safety.This approach shows promise in improving outcomes for elderly patients with locally advanced rectal cancer.

Objective:To investigate the feasibility, safety and effectiveness of colonic interposition with vascular anastomosis in reconstructing the entire esophagus and hypopharynx after resection of hypopharyngeal cancer with esophageal cancer.Methods:We conducted a retrospective analysis of 4 male patients with simultaneous multiple primary cancers of the hypopharynx and esophagus, aged 47 to 58, treated in the Department of Head and Neck Surgery at the Hunan Cancer Hospital from February to August 2019. All cases underwent total hypopharyngectomy and total esophagectomy, of whom, three cases presented with total laryngectomy and one case with larynx preservation. Colonic interposition was performed using the left colic artery as a pedicle, with an average colonic length of 48.5 cm. The colon was elevated through the esophageal bed to the neck, and the branch of the colonic mesenteric artery was anastomosed to one of the neck arteries, including the inferior thyroid artery in one case, the transverse cervical artery in two cases, and the superior thyroid artery in one case, and all venous anastomoses were performed with the internal jugular veins.Results:The postoperative neck and abdominal wounds healed well without anastomotic leakage, and all patients were able to resume a regular oral diet within 21-30 days postoperatively. During the follow-up of 48-52 months, two cases died due to tumor recurrence, while the remaining two cases were disease-free survivals.Conclusion:Colonic interposition with vascular anastomosis is a safe and reliable reconstruction method suitable for repairing long-segment upper digestive tract defects after resection of hypopharyngeal cancer with esophageal cancer.

Objective:To evaluate the repair protocols for intraoperative cerebrospinal fluid (CSF) leaks after endoscopic endonasal clival malignancy resection (EECR) and to analyze the risk factors of surgical complication.Methods:The clinical data of patients who underwent EECR and had intraoperative CSF leaks in XuanWu Hospital, Capital Medical University between January 2012 and January 2024 were reviewed. The pathological results, imaging data, location of the dural defect, degree of intraoperative CSF leaks, repair materials, complications such as postoperative central nervous system (CNS) infections, types of antibiotics used, bacterial culture and drug sensitivity results, secondary repair, and follow-up results were collected. IBM SPSS 26 software was used to evaluate the effectiveness of the repair. Additionally, statistical analysis was conducted on perioperative complications such as CNS infections.Results:Twenty-eight patients underwent 31 EECR and 36 skull base reconstructions. There were 14 females and 14 males, aged from 4 to 70 years old, with a median of 53 years. For the repair, autologous materials such as free turbinate flap, free nasoseptal flap, pedicled nasoseptal flap, and fascia lata combined with mashed muscle were used. Initial reconstruction was successful in 26 cases, while 5 patients required a second repair, which was also successful. Postoperatively CNS infections occurred in 4 patients, and all of whom were cured. Follow-up ranged from 3 to 146 months, with no delayed CSF leak reported. The infection rate was significantly higher in patients whose first repair failed compared to those whose repair was successful (Fisher exact test, P<0.001). Conclusions:The use of different autologous materials based on the patient′s condition can effectively repair CSF leakage that occurs during EECR. Howerver, the success rate of initial repair requires improvement, as the risk of CNS infection significantly increases after a failed repair..