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 compare the clinical effects of the two design schemes of heart-shaped incision and "Mercedes-Benz incision" (three-leaf method) in umbilicoplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent umbilicoplasty during abdominoplasty admitted to the Body Contouring & Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from November 2019 to September 2022. During the umbilicalplasty operation, different patients were treated with either a heart-shaped incision or a "Mercedes-Benz incision" three-flap method. The umbilical cord for infection, hematoma and other complications were observed after surgery; a 5-point Likert scale was used to evaluate the aesthetic effect of the new umbilicus 6 months after surgery(3-15 points, the higher the score, the better the aesthetic effect); the Vancouver scar scale (VSS) was used to score the scar condition 6 months after surgery (0-18 points, the higher the score, the better the scar condition). Postoperatively, patients were surveyed on umbilical shape satisfaction, which was divided into three levels: dissatisfied, relatively satisfied, and very satisfied. Normally distributed measurement data were expressed as Mean±SD, and independent samples t-test was used for comparison between two groups. P<0.05 was considered as a statistically significant difference. Results:A total of 35 patients were enrolled, all of whom were female. Among them, 19 cases underwent heart-shaped incision, and 16 cases underwent umbilicoplasty using "Mercedes-Benz incision". The ages of the two groups were (32.3±2.7) years old and (33.7±2.3) years old respectively. At the 6-month follow-up after surgery, the total aesthetic effect score of the umbilical cord in the heart-shaped incision group was higher than that in the "Mercedes-Benz incision" group [(13.3±0.7) points vs. (12.7±0.5) points, P<0.05]. The VSS score of the heart-shaped incision group was lower than that of the "Mercedes-Benz incision" group [(2.6±0.8) points vs. (3.4±0.9) points, P<0.05]. The results of the satisfaction survey after umbilicoplasty showed that in the heart-shaped incision group, 3 cases were relatively satisfied and 16 cases were very satisfied; in the "Mercedes-Benz incision" group, 2 cases were relatively satisfied and 14 cases were very satisfied. Conclusion:Compared with the classic "Mercedes-Benz incision", the heart-shaped incision design can obtain a better-shaped, more natural new umbilicus and a more invisible scar after umbilicoplasty.

Objective:To compare the clinical effects of the two design schemes of heart-shaped incision and "Mercedes-Benz incision" (three-leaf method) in umbilicoplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent umbilicoplasty during abdominoplasty admitted to the Body Contouring & Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from November 2019 to September 2022. During the umbilicalplasty operation, different patients were treated with either a heart-shaped incision or a "Mercedes-Benz incision" three-flap method. The umbilical cord for infection, hematoma and other complications were observed after surgery; a 5-point Likert scale was used to evaluate the aesthetic effect of the new umbilicus 6 months after surgery(3-15 points, the higher the score, the better the aesthetic effect); the Vancouver scar scale (VSS) was used to score the scar condition 6 months after surgery (0-18 points, the higher the score, the better the scar condition). Postoperatively, patients were surveyed on umbilical shape satisfaction, which was divided into three levels: dissatisfied, relatively satisfied, and very satisfied. Normally distributed measurement data were expressed as Mean±SD, and independent samples t-test was used for comparison between two groups. P<0.05 was considered as a statistically significant difference. Results:A total of 35 patients were enrolled, all of whom were female. Among them, 19 cases underwent heart-shaped incision, and 16 cases underwent umbilicoplasty using "Mercedes-Benz incision". The ages of the two groups were (32.3±2.7) years old and (33.7±2.3) years old respectively. At the 6-month follow-up after surgery, the total aesthetic effect score of the umbilical cord in the heart-shaped incision group was higher than that in the "Mercedes-Benz incision" group [(13.3±0.7) points vs. (12.7±0.5) points, P<0.05]. The VSS score of the heart-shaped incision group was lower than that of the "Mercedes-Benz incision" group [(2.6±0.8) points vs. (3.4±0.9) points, P<0.05]. The results of the satisfaction survey after umbilicoplasty showed that in the heart-shaped incision group, 3 cases were relatively satisfied and 16 cases were very satisfied; in the "Mercedes-Benz incision" group, 2 cases were relatively satisfied and 14 cases were very satisfied. Conclusion:Compared with the classic "Mercedes-Benz incision", the heart-shaped incision design can obtain a better-shaped, more natural new umbilicus and a more invisible scar after umbilicoplasty.

Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.

Objective:To investigate the application of the modified double-clamp surgery with the preservation of Scarpa fascia in abdominoplasty.Methods:A retrospective analysis was carried out in 26 female patients with total abdominoplasty who were admitted from March 2020 to January 2022, ranging in age from 26 to 50 years with averaged 36.9 years. The patients were divided into flap clamp group (12 cases) and Scarpa fascia clamp group (14 cases). The surgical time of abdominoplasty (excluding liposuction time), the occurrence of postoperative seroma, and postoperative incision infection were recorded in the two groups.Results:The average surgical time of the patients in the Scarpa fascia clamp group was 136 minutes, which was significantly lower than that of the flap clamp group (153 minutes) ( P<0.05). There was no postoperative seroma and incision infection in the two groups, and the postoperative incision healing grades were I/A. Conclusions:The modified double-clamp procedure with preservation of the Scarpa fascia can effectively reduce the surgical time and improve the operation efficiency.

Objective To investigate the current status of cytotoxicity and mechanical properties of the prosthetic liner on the market in China.Methods Six kinds of liner were collected, namely domestic 6 mm thick foam liner (A), domestic 5 mm thick EVA foam liner (B), German 5 mm thick EVA foam liner (C), Germany 12 mm thick PE foam liner (D), Iceland 3 mm thick silicone liner (E) and Germany 4 mm thick gel liner (F). Microscopic observation and thiazole blue colorimetry were used to detect the cytotoxicity. The content of small organic molecules was determined by the consumption of potassium permanganate. The tensile strength, elongation at break (%), and 100% tensile strength of the prosthetic liner were tested by material mechanics testing machine. The hardness was tested using the Shore hardness tester oo type.Results The cytotoxicity was grade 2 for prosthetic liners A, B, C and D, and was grade 0 for E and F. The redox substance content of prosthetic liners A、B、C exceeded 150 mg/kg. Except the prosthetic liner C, the hardness of the other products were all ≤ 70 HA. Except prosthetic liner D, the tensile strengths were > 1 MPa, breaking elongations were > 120.0%, 100% tensile strengths were > 0.9 MPa for other products.Conclusion Due to materials and production processes, the cytotoxicity and mechanical properties of the six samples are quite different.