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The hospital environment, particularly the intensive care unit (ICU), contributes to the transmission of several nosocomial pathogens, which can survive in this setting for a longer period of time and, in turn, contaminate the surfaces or the medical tools. Thus, appropriate disinfection of these areas and devices are crucial for controlling and preventing further infection. In this study, we examined the effect of different concentrations of chlorine-containing disinfectants (500mg/L, 1000mg/L, and 2000mg/L) on the ICU environment. This quasi-experimental study was based on a convenient sampling method. In this study, High-frequency objects were selected as subjects in ICU, with a total sample of 216.A hall including 6 beds was examined,selecting 4 high-frequency surfaces per bed unit:a bed gear, infusion system, bed end table, and monitor were disinfected with 500, 1000, and 2000 mg/L of chlorine (as Cl2), respectively.The surface dissection was performed at 21:00 o'clock daily, after which ATP fluorescence monitoring and bacterial count detection were performed. There was no significant difference in ATP bioluminescence (F = 2.03, P > 0.05) and bacterial counting (χ2 = 2.03, P > 0.05) when using different concentrations of chlorine-containing disinfectant in the ICU. Yet, compared with high concentration (2000mg/L), a low concentration disinfectant reduced the hospital cost. By reducing the concentration of ICU high-frequency contact table disinfectants, it is possible to reduce the risk of long-term contamination with chlorine-containing disinfectants and reduce the cost of using ICU chlorine-containing disinfectants.

There is a lack of research on hepatitis B virus (HBV) reactivation and prognosis in hepatocellular carcinoma (HCC) patients with undetectable HBV DNA after systemic therapy. This study aims to compare HBV reactivation (HBVr) and prognosis between patients treated with tyrosine kinase inhibitor (TKI) monotherapy and those receiving TKI combined with programmed cell death protein‑1 (PD-1) inhibitors. The retrospective study comprised 877 advanced HCC patients from two medical centers with undetectable HBV DNA, receiving TKI monotherapy ( n  = 419) or TKI plus PD-1 inhibitors ( n  = 458). HBVr rates, tumor progression, and overall survival (OS) were analyzed. The HBVr rate markedly higher in the combination cohort compared to the TKI monotherapy cohort (16.6% vs. 12.5%, P  = 0.018). Multivariable regression analysis identified the combination therapy (HR 1.295, 95%CI 1.010–1.662, P  = 0.042), ALT > 40 U/ml (HR 1.460, 95%CI 1.079–1.978, P  = 0.014), Hepatitis B e antigen (HBeAg) positivity (HR 1.570, 95%CI 1.133–2.174, P  = 0.007), and tumor size > 5 cm (HR 1.394, 95%CI 1.051–1.848, P  = 0.021) as independent predictors of HBVr. Patients receiving antiviral prophylaxis had a lower HBVr rate than those not receiving it (27.4% vs. 33.7%, P  = 0.013). Patients with HBVr had shorter progression-free survival (PFS) ( P  < 0.001) and OS ( P  < 0.001) compared to those without HBVr. TKI plus PD-1 inhibitors increases the risk of HBVr compared to TKI monotherapy, leading to higher tumor progression and shorter OS. Continuous antiviral therapy can help prevent HBVr after systemic treatment in HCC patients.

To evaluate the differences in the agreement between wedged hepatic venous pressure (WHVP) and portal venous pressure (PVP) at different hepatic venous pressure gradient (HVPG) levels to identify specific HVPG thresholds where WHVP can reliably estimate PVP, thus enhancing the accuracy of risk stratification and treatment decision-making for portal hypertension (PHT) patients. A multicenter study of 616 patients with PHT from three centers was stratified into five groups by their HVPG: HVPG < 12 (group A), 12 ≤ HVPG < 16 mmHg (group B), 16 ≤ HVPG < 20 mmHg (group C), 20 ≤ HVPG < 24 mmHg (group D), HVPG ≥ 24 mmHg (group E). Concordance was analyzed using Pearson’s correlation coefficient (R), the intraclass correlation coefficient (ICC), and Bland‒Altman analysis in each HVPG stratum. Correlation and agreement between WHVP and PVP varied by HVPG group. Highest agreement was observed in the range of 20 ≤ HVPG < 24 mmHg. ( R  = 0.55, ICC = 0.68). The proportion of patients with a discrepancy between WHVP and PVP that was greater than 10% of the PVP value was highest in group A (95.7%) and lowest in group D (48.4%). Overestimation of PVP was more common in group E (44.5%), and underestimation of PVP was more common in group A (94.6%). This study does not confirm the usefulness of hepatic vein pressure measurements to predict the PVP and PPG. The means of WHVP and PVP were significantly different in ranges A, B, C, and E.

Background Alagille syndrome (ALGS) is a multisystem genetic disorder frequently characterized by hepatic manifestations. This study analyzed the clinical, pathological, and molecular genetic features of ALGS to improve the efficiency of clinical diagnosis. Methods We retrospectively analyzed the clinical manifestations, pathological examination findings, and genetic testing results of 17 children diagnosed with ALGS based on the revised criteria and hospitalized at our center from January 2012 to January 2022. Results The clinical manifestations are as follows: Cholestasis (16/17, 94%), characteristic facies (15/17, 88%), heart disease (12/16, 75%), butterfly vertebrae (12/17, 71%) and posterior embryotoxon (7/12, 58%). Among the 15 patients who underwent liver pathology examination, 13 (87%) were found to have varying degrees of bile duct paucity. Genetic testing was performed on 15 children, and pathogenic variants of the jagged canonical Notch ligand 1 ( JAG1 ) gene were identified in 13 individuals, including 4 novel variants. No pathogenic variant in the notch homolog 2 ( NOTCH2 ) gene were identified, and 2 children exhibited none of the aforementioned gene pathogenic variants. The median follow-up duration was 7 years. Of the remaining 15 patients (excluding 2 lost to follow-up), 11 remained stable, 4 deteriorated, and no patient died during the follow-up period. Conclusions Among children diagnosed with ALGS, cholestasis stands as the most common feature. To minimize the risk of misdiagnosis, genetic testing should be performed on children exhibiting cholestasis, followed by the application of the revised diagnostic criteria for ALGS. While pharmacological therapy has shown effectiveness for ALGS patients, liver transplantation may be considered in instances of severe pruritus.

Background ABCB4 gene-related cholestatic liver diseases have a wide spectrum of clinical and genetic variations. The correlation between genotype and clinical phenotype still unclear. This study retrospectively analyzed the clinical and pathological characteristics of 23 patients with ABCB4 gene-related cholestatic liver diseases. Next-generation sequencing was used to identify the genetic causes. Results The 23 included patients (15 children and 8 adults) were diagnosed as progressive familial intrahepatic cholestasis type 3 (PFIC3), drug-induced liver injury (DILI), cirrhosis cholestasis, cirrhosis, and mild liver fibrosis. Nineteen patients underwent liver pathological examination of the liver, exhibiting fibrosis, small bile duct hyperplasia, CK7(+), Cu(+), bile duct deletion, and cirrhosis. Thirty ABCB4 variants were identified, including 18 novel variants. Conclusion ABCB4 gene-related cholestatic liver diseases have a wide spectrum of clinical and genetic variations. Biallelic ABCB4 mutation carriers tended to severe PFIC3, which mostly occurs in children; while ABCB4 non-biallelic variants can lead to milder ICP, LACP, DILI or overlapping, mostly in adults. Thus, the ABCB4 genotype has a specific correlation with the phenotype, but there are exceptions. Non-biallelic null mutations can cause severe diseases. The mechanisms underlying this genetic phenotype require further investigation. Graphical Abstract

To study the effect of antiviral therapy during pregnancy on the frequency of natural killer (NK) cells in peripheral blood of women with HBV DNA positive chronic hepatitis B (CHB). In total 124 female subjects were divided into four groups: 11 healthy non-pregnant women (Normal group), 26 non-pregnant women in immune tolerance period of chronic hepatitis B virus (HBV) infection (CHB group), 41 pregnant CHB women without antiviral treatment during pregnancy (Untreated group), and 46 pregnant CHB women receiving antiviral treatment during pregnancy (Treated group). The frequency of NK cells in peripheral blood were detected by flow cytometry. The frequency of NK cells in healthy women [15.30 (12.80, 18.40)] was higher than that in women with HBV infection, but there was no significant statistical difference ( =0.436). The frequency of NK cells in CHB group [10.60 (6.00, 18.30)] was higher than those in pregnant CHB women [Untreated: 6.90 (4.89, 10.04), =0.001; Treated: 9.42 (6.55, 14.10), =0.047]. The frequency of NK cells in treated group was significantly higher than that in untreated group ( = 0.019). The frequencies of NK cells, CD56 NK cells and NKp46 NK cells at 12 and 24 weeks postpartum in the untreated group were increased significantly than those before delivery. In treated group, the frequencies of NK cells, CD56 NK cells, NKp46 NK cells and NKp46 NK cells were significantly increased at 6 and 12 weeks than those before delivery. The frequencies of NK cells and CD56 NK cells postpartum were increased significantly in treated group than those in untreated group. The frequencies of CD56 NK cells decreased significantly after delivery in treated than those in untreated patients. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) significantly increased after delivery than those before delivery. The results showed that the postpartum ALT level was weak positive correlated with NKp46 frequency ( =0.199) and was weak negative correlated with NKp46 frequency ( = -0.199). Antiviral treatment during pregnancy could significantly increase the frequency of NK cells postpartum. Postpartum hepatitis may be related to the immune injury caused by change of NK cell frequency and HBV infection.

ObjectiveTo explore the correlation between postpartum hepatitis and changes of plasmacytoid dendritic cells’ (pDC) function and frequency in hepatitis B e antigen (HBeAg)-positive pregnant women with chronic hepatitis B virus (HBV) infection.MethodsPregnant women with chronic HBV infection receiving antiviral treatment (treated group) or not receiving antiviral treatment (untreated group) were enrolled and demographic information was collected before delivery. Clinical biochemical, virological serology, pDC frequency and functional molecular expression were tested before delivery and at 6, 12, 24 weeks after delivery.Results90 eligible pregnant women were enrolled, 36 in the untreated group and 54 in the treated group. 36 patients developed postpartum hepatitis, including 17 (17/36, 47.2%) in the untreated group and 19 (19/54, 35.2%) in the treated group (χ2 = 1.304 p=0.253), and 22 cases of hepatitis occurred at 6 weeks postpartum, 12 at 12 weeks postpartum, and 2 at 24 weeks postpartum. The alanine transaminase (ALT) levels at any time postpartum were significantly higher than that of the antepartum, especially at 6 weeks and 12 weeks postpartum. However, the frequencies of pDCs, CD83+ pDCs and CD86+ pDCs antepartum had no significant difference from any time postpartum. The frequencies of CD83+ pDCs, CD86+ pDCs in the treated group antepartum were significantly higher than those in the untreated group [12.70 (9.46, 15.08) vs. 10.20 (7.96, 11.85), p=0.007; 22.05 (19.28, 33.03) vs. 18.05 (14.33, 22.95), p=0.011], and the same at 12 weeks postpartum [12.80 (10.50, 15.50) vs. 9.38 (7.73, 12.60), p=0.017; 22.50 (16.80, 31.20) vs. 16.50 (12.65, 20.80), p=0.001]. The frequency of CD86+ pDCs in the treated group was significantly higher than that in the untreated group at 24 weeks postpartum [22.10 (16.70, 30.00) vs. 17.10 (13.70, 20.05), p=0.006].ConclusionsPostpartum hepatitis in HBV infected women mainly occurs at 6-12 weeks postpartum. Antiviral treatment during pregnancy can significantly increase the frequencies of CD83+ pDCs and CD86+ pDCs in pregnant women with chronic HBV infection.

Background: Chronic hepatitis B (CHB) in children presents a significant global health challenge, with liver inflammation and fibrosis being critical concerns for disease progression and long-term outcomes. Methods: This retrospective study analyzed 1629 pediatric CHB patients from the Fifth Medical Center of Chinese PLA General Hospital, spanning from January 2000 to December 2021. Liver biopsies were performed to assess the severity of liver inflammation and fibrosis, which were graded using the Scheuer scoring system. Key clinical indicators, including age, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT), were evaluated for their predictive value in determining disease severity using restricted cubic spline regression models. Results: Significant nonlinear associations were found between the clinical indicators and liver pathology. Older age was strongly associated with increased risks of moderate to severe inflammation (OR 2.21, 95% CI: 1.34–3.63, p = 0.002) and significant fibrosis (OR 2.22, 95% CI: 1.31–3.77, p = 0.003). Elevated ALT levels (≥80 U/L) were correlated with a higher likelihood of moderate to severe inflammation (OR 1.82, 95% CI: 1.05–3.15, p = 0.033), while higher GGT levels (≥50 U/L) were significantly associated with advanced fibrosis (OR 2.62, 95% CI: 1.72–3.99, p < 0.001). Conclusions: Regular monitoring of clinical indicators such as ALT, AST, and GGT levels plays a critical role in identifying pediatric CHB patients at higher risk of moderate to severe inflammation and significant fibrosis. Our findings highlight the value of integrating age and key biochemical markers into non-invasive diagnostic algorithms for the early detection and management of liver pathology in children.

Fault diagnosis of rolling bearings is crucial for ensuring the safe operation of mechanical equipment. Traditional methods rely on manual feature extraction, such as spectrum analysis and wavelet packet decomposition, but they suffer from low efficiency and poor generalization under complex working conditions [1-3]. With the development of deep learning technology, convolutional neural networks (CNNs) have been widely applied due to their powerful ability for automatic feature extraction. This paper proposes an intelligent diagnosis framework that integrates continuous wavelet transform (CWT) and convolutional neural network (CNN). By extracting time-frequency features of vibration signals using CWT and generating high-resolution time-frequency maps as inputs to the CNN, end-to-end fault classification is achieved. Experiments were conducted using the Case Western Reserve University bearing dataset, covering four fault categories: normal, inner race, rolling element, and outer race. The results show that the proposed method achieved 100% classification accuracy on the test set. TSNE visualization revealed the hierarchical nature of CNN feature learning. This study provides theoretical support for the intelligent operation and maintenance of industrial equipment.

Background and Aims Functional cure is difficult to achieve using current antiviral therapies; moreover, limited data are available regarding treatment outcomes in children. This retrospective study aimed to assess the frequency of functional cure among children undergoing antiviral treatment for active chronic hepatitis B (CHB). Methods A total of 372 children aged 1–16 years, with active CHB were enrolled and underwent either nucleos(t)ide analog monotherapy or combination therapy with interferon-α (IFN-α) for 24–36 months. All children attended follow-up visits every 3 months. Functional cure was defined as evidence of hepatitis B virus (HBV) DNA loss, circulating hepatitis B e antigen (HBeAg) loss/seroconversion, and hepatitis B surface antigen (HBsAg) loss. Results After 36 months of antiviral treatment and/or follow-up visits, children with CHB aged 1– < 7 years exhibited higher rates of HBV DNA clearance, HBeAg seroconversion, and HBsAg loss than CHB children ≥ 7–16 years of age (93.75% versus [vs.] 86.21% [ p  < 0.0001]; 79.30% vs. 51.72% [ p  < 0.0001]; and 50.78% vs. 12.93% [ p  < 0.0001], respectively). Longitudinal investigation revealed more rapid dynamic reduction in HBV DNA, HBeAg, and HBsAg levels in children aged 1–7 years than in those aged ≥ 7–16 years with CHB. According to further age-stratified analysis, HBsAg loss rates were successively decreased in children with CHB who were 1– < 3, 3– < 7, 7– < 12, and 12–16 years of age (62.61% vs. 41.13% vs. 25.45% vs. 1.64%, respectively; p  < 0.0001) at 36 months. In addition, baseline HBsAg level < 1,500 IU/mL was found to favor disease cure among these pediatric patients. No serious adverse events were observed throughout the study period. Conclusion Results of the present study demonstrated that children aged 1– < 7 years, with active CHB can achieve a high functional cure rate by undergoing antiviral therapy compared to those aged ≥ 7 years, who undergo antiviral therapy. These data support the use of antiviral treatment at an early age in children with CHB. However, future prospectively randomized controlled trials are necessary to validate the findings of this study. Graphical Abstract The younger age, the higher functional cure rate in children with chronic hepatitis B undergoing on-time antiviral treatment.