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Summary: Background: Since 1992, when recombinant hepatitis B vaccine was introduced in China, government health officials have used nationally representative serological surveys to monitor progress in prevention and control of hepatitis B. In 2020, we conducted the fourth seroepidemiological survey, which for the first time included medical evaluation of the clinical status of HBsAg positive subjects over the age of 15 and their medical management. We report survey results in comparison with the three previous surveys. Methods: Consistent with previous national surveys, the 2020 survey used a stratified, three-stage cluster random sampling method to select for evaluation 1-69-year-olds in 120 national disease surveillance points. Blood samples were tested for HBsAg, anti-HBV surface antigen (anti-HBs), and anti-HBV core antigen (anti-HBc) in the National Hepatitis Laboratory of the Institute for Viral Disease Control and Prevention of China CDC. HBsAg positive subjects aged ≥15-year were evaluated for evidence of liver disease, and through face-to-face questionnaire-based survey, we determined the healthcare management cascade of HBV-infected individuals. Findings: HBsAg prevalence in 1–69-year-olds was 5.86%; in children 1–4 years of age, seroprevalence was 0.30%; 75 million people were living with HBV nationwide. Among HBsAg-positive individuals 15 years and older, expert medical examination found that 78.03% were HBsAg carriers with no evidence of liver damage, 19.63% had chronic HBV with liver enzyme abnormalities, 0.84% had evidence of cirrhosis, and 0.15% had evidence of liver cancer. 59.78% of HBsAg + individuals were aware that they were positive before the survey, 30 million were unaware; 38.25% of those who knew they were positive (17 million) had medical indications for antiviral treatment, and 17.33% of these individuals (3 million) were being treated with antivirals. Interpretation: The decline in HBsAg prevalence in the general population, from 9.72% in 1992 to 5.86% in 2020, and in 1–4-year-olds from 9.67% in 1992 to 0.30% in 2020, shows progress that continues on track toward WHO targets for prevention of new infections. Implementation of acceptable strategies to identify infected individuals and offer long-term medical monitoring and management will be important to prevent complications from hepatitis B infection and for meeting WHO cascade-of-care targets. Funding: The study was funded by the Major Science and Technology Special Project of China’s 13th 5-Year Plan (grant no. 2017ZX10105015); Central finance-operation of public health emergency response mechanism of Chinese Center for Disease Control and Prevention (131031001000200001, 102393220020010000017).

Low‐level viraemia (LLV) occurs in chronic hepatitis B (CHB) patients despite antiviral treatment, which may cause failed histological regression. Our study aimed to investigate the impact of different LLV types on fibrosis regression. The prospective study enrolled CHB patients with paired liver biopsies before and after 260 weeks of entecavir treatment. Fibrosis regression was defined by the Ishak score or P‐I‐R system. Patients were grouped as the SVR (HBV DNA < 20 IU/mL persistently) or LLV (HBV DNA between 20 and 2000 IU/mL), which were further grouped as very low‐level viraemia (VLLV, HBV DNA < 50 IU/mL), occasionally LLV (OLLV, HBV DNA ≥ 50 IU/mL only once) and multiple LLV (MLLV, HBV DNA ≥ 50 IU/mL more than once). Logistic regression models were used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs). The analysis included 111 CHB patients. In the SVR group (n = 54), 39 (72.2%) patients had fibrosis regression, which was higher than the LLV (56.1%, p = 0.080). The fibrosis regression rates for VLLV (30 patients), OLLV (17 patients) and MLLV (10 patients) were 70.0%, 52.9% and 30.0%, respectively. Compared with SVR, VLLV (aOR = 0.78; 95% CI: 0.28–2.21; p = 0.644) was not associated with fibrosis regression, but patients with non‐VLLV (aOR = 0.27; 95% CI: 0.09–0.85; p = 0.025), especially with MLLV (aOR = 0.19; 95% CI: 0.04–0.97; p = 0.046) is significantly associated with hindered fibrosis regression. Our study suggests that patients with detectable serum HBV DNA levels higher than 50 IU/mL need to be monitored carefully, especially in those with more than once. Trial Registration:ClinicalTrials.gov identifiers NCT01938781 and NCT01938820 [ABSTRACT FROM AUTHOR]

In this work, a combined design of blade and endwall using the Extended Free Form Deformation technique is proposed and implemented on a transonic compressor rotor (the NASA Rotor 67). The best combined design is explored by numerical investigations and optimization via Kriging surrogate model method. As a result, by only modifying the hub and blade under 15 % span, the peak adiabatic efficiency is increased by 0.4 % and the overall aerodynamic performance for all operating conditions is also improved. An analysis shows that the enlarged dihedral angle between the hub and blade restrains boundary layer intersection and development. Meanwhile, the optimized hub changes the pressure distribution and prevents migration of cross-flow. As a result, the low-energy flow in the corner is accelerated downstream and the separation is limited, leading to an effective improvement in throughflow capability and aerodynamic performance in the corner region. [ABSTRACT FROM AUTHOR]

In this paper, to explore the effects and mechanisms of the blended blade and end wall (BBEW) technique on corner separation control, two different BBEW configurations, including the side blended blade and end wall (S-BBEW) and full blended blade and end wall (F-BBEW), are studied and compared through experimental and numerical analyses. First, for a linear cascade, the S-BBEW and F-BBEW designs are carefully built. Then, both numerical simulations and experiments are conducted for each design, demonstrating a significant reduction in the loss coefficient. The results indicate that the S-BBEW is effective in the control of boundary layer development and delays the initial point of separation, especially at the design working condition. Moreover, the F-BBEW design nearly eliminates the corner separation by the control of both boundary layer development and secondary flow, which provides a higher performance improvement, especially at a large incidence angle. [ABSTRACT FROM AUTHOR]

The adjoint method plays an important role in the aerodynamic design of turbomachinery. However, most optimization objects are only local parts of the fluid domain in turbomachinery, such as blade or end-wall. In this study, a novel parameterization method is adopted in the adjoint optimization framework to merge all design spaces together and then a typical multi-row compressor, Stage 35, is optimized by the in-house adjoint optimizer, TurboSim_un. The adiabatic efficiency of STAGE 35 is improved by 1.7%. Results show that the intersection of shock wave and boundary layer is weakened and the performance in mainstream is significantly improved. [ABSTRACT FROM AUTHOR]

Codonopsis pilosula is a medicinal and edible herb with a rich nutritional value. In Gansu Province, China, its production quality and yield differ during the four seasons. Here, we investigated the differences in the microfloral composition and metabolic functions in the rhizospheric soil and roots of C. pilosula during the four seasons, and we also analyzed their dynamic and synergistic effects on C. pilosula growth and carbohydrate content change. The C. pilosula samples were analyzed for plant physiology, microfloral composition and metabolic functions in the rhizospheric soil and roots using high-throughput sequencing technology. Environmental indices including soil physiochemistry and meteorological conditions were also determined by the coupled chromatography–spectroscopy technique. The results revealed that the C. pilosula growth was affected by temperature, precipitation and light intensity, with the bacterial structures and functions of the soil and root samples showing obvious seasonal changes. Due to the diversity of microbial composition and community metabolic function, and the synergistic effect of microbial and environmental factors, there are significant differences in stress resistance, physiological status and metabolites of C. pilosula in different seasons. Furthermore, the change in seasons was significantly correlated with the quality and yield of C. pilosula. This study provides a scientific basis for soil improvement and the refinement of local Radix C. pilosula cultivation methods. [ABSTRACT FROM AUTHOR]

Hepatic lobular architecture distortion is a deleterious turning point and a crucial histological feature of advanced liver fibrosis in chronic liver diseases. Regression of fibrosis has been documented in chronic hepatitis B (CHB) patients. However, whether lobular architecture could be restored following fibrosis regression after antiviral therapy is still unclear. Glutamine synthetase (GS) is generally expressed by perivenular hepatocytes around hepatic veins (HV). In this study, we defined abnormal lobular architecture (GSPT) as GS expressing in the vicinity of portal tracts (PT), which denotes parenchymal extinction and lobular collapse. We defined normal lobular architecture (GSHV) as GS positivity area not approximating PTs. Therefore, we propose a new GS‐index, defined as the percentage of GSHV/(GSHV + GSPT), to evaluate the extent of architectural disruption and restoration. We evaluated 43 CHB patients with advanced fibrosis (Ishak stage ≥4). Posttreatment liver biopsy was performed after 78 weeks of anti‐HBV therapy. The median GS‐index improved from 7% (interquartile range [IQR]: 0%–23%) at baseline to 36% (IQR: 20%–57%) at Week 78 (p < 0.001). Totals of 22 patients (51%) had significant GS‐index improvement from 0% (IQR: 0%–13%) to 55% (IQR: 44%–81%), while the other half had almost no change between 17% (IQR: 0%–33%) to 20% (IQR: 12%–31%). When GS‐index78w ≥ 50% was used to define hepatic lobular restoration, 37% of patients (16/43) achieved lobular restoration, with much improvement in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels (median value of ∆/Baseline in ALT: restored vs. nonrestored was 79.1% vs. 48.8%, p = 0.018; median value of ∆/Baseline in AST: restored vs. nonrestored was 69.1% vs. 32.5%, p = 0.005). More importantly, lobular restoration correlated with fibrosis regression (median value of ∆/Baseline in Ishak stage: restored vs. nonrestored was 25.0% vs. 0%, p = 0.008). Therefore, in the era of antiviral therapy for CHB, restoration of hepatic lobular architecture is achievable in patients with advanced fibrosis. GS‐index provides additional insight into fibrosis regression that goes beyond collagen degradation. [ABSTRACT FROM AUTHOR]

Due to the demand for higher aerodynamic performance of compressors, thoroughly investigating the high-loss flow in the corner region and effectively controlling it are important. In this paper, a novel parameterization method based on the extended free form deformation (EFFD) technique and the constraints for EFFD's control points is proposed. Then, considering the features of typical control techniques and the degrees of freedom of both the blade and hub geometries, the combined control approach is implemented in the corner region of a linear cascade. Furthermore, large eddy simulation is used to simulate the flow, verify the effects of the combined control approach, and explore the underlying physical mechanisms of corner separation. The numerical results show that the combined control can significantly decrease the mean total pressure loss. The loss reduction at the design point reaches 6.05%, while it decreases by almost 2.5% near the stall/blockage operating conditions. The combined control increases the radial pressure gradient at the rear of the blade by depressing the hub and stretching the suction surface. Consequently, although the radial flow slightly increases the mixing loss in the mainstream at large incidences, the accumulation of low-energy flow in the boundary layer and the corresponding development of the corner vortex are significantly restrained. Moreover, by redistributing the static pressure on the hub, the combined control weakens the migration of crossing flow and obstructs the low-velocity flow from the pressure side involved in the separation. Overall, the combined control contributes to reducing the corner separation and improving the aerodynamic performance. [ABSTRACT FROM AUTHOR]

A petroleum hydrocarbon degrading bacterium Rhodococcus erythropolis KB1 was used to investigate the bioremediation efficiency of the petroleum contaminated desert steppe soils. The total petroleum hydrocarbons (TPHs) removal efficiency in the soils was analyzed with different treatments including natural degradation, bioaugmentation with R. erythropolis cells, biostimulation with nitrogen and phosphorus, and a combination of bioaugmentation and biostimulation. The petroleum contaminated soils were separately inoculated with R. erythropolis cells, nitrogen and phosphorus nutrients, a combination of the bacterial cells and the nutrients. The soil samples were kept at room temperature for 115 days of bioremediation. On the 66th day, the soil samples were strengthened with the same treatments. The results showed that the degradation rate of the natural degradation group was 20.20%. The biodegradation rates of the bioaugmentation group and biostimulation group were 36.02 and 40.10%, respectively. The combination group of bioaugmentation and biostimulation was the most effective way to remediate petroleum-contaminated soils with a degradation rate of 43.89%. In the bioremediation process the saturated hydrocarbons, especially the linear alkanes were the most easily degraded petroleum components. The cultivable bacterial counts of the soils were significantly increased in the bioaugmentation, biostimulation, and combined groups with bioaugmentation and biostimulation. The bacterial diversities of the petroleum contaminated desert steppe soil changed greatly when compared with that of the natural desert steppe soil. The bacterial structure and abundance of the soils in different treatments also changed significantly. [ABSTRACT FROM AUTHOR]

Under the influence of a strong adverse pressure gradient, secondary flow, and other factors, compressor cascades are prone to corner separation and even to corner stall, which seriously affects aerodynamic performance. In this paper, large eddy simulation is used to investigate the effects and mechanisms of corner stall controlled by the blended blade and end wall (BBEW) technique. Based on this technique, three BBEW control schemes with different chord-direction positions of the maximum BBEW width are designed for the suction side root of a modified NACA (National Advisory Committee for Aeronautics) 65 blade. The influence of the chord-direction position of the maximum BBEW width on control corner stall and the differences of physical mechanisms are deeply explored. The numerical results show that the BBEW technique can improve the flow field structure and aerodynamic performance of a compressor cascade under corner stall conditions to a certain extent. When the maximum BBEW width is located near the leading edge, it provides the most significant reduction in the spanwise height of corner separation and effectively weakens the intersection of boundary layers, so that the boundary layer losses are reduced by 6.27%, and the overall performance is improved. These effects can be attributed to the axial and spanwise forces generated near the maximum BBEW width, with the former increasing the kinetic energy of the surrounding fluid, while the latter transports low-energy fluid upward to reduce accumulation on the end wall. In addition, the increased dihedral angle weakens the intersection of boundary layers and restrains the development of the corner vortex, which is also one of the underlying physical mechanisms. When the maximum BBEW width is located in the middle of the chord, it most effectively delays the corner stall. When it is located near the trailing edge, it is most effective at controlling the development of corner separation, reducing the accumulation of low-energy fluid in the three-dimensional corner region, and reducing corner separation losses by 4.73%. The effect of the increased dihedral angle in weakening the intersection of boundary layers and the corner vortex is the main reason why these two design schemes can improve the aerodynamic performance of the compressor cascade. [ABSTRACT FROM AUTHOR]

We present a novel and simple scheme for all-optical microwave photonic frequency converter, free of electrical components, based on stimulated Brillouin scattering (SBS) effect. An SBS-based frequency shifter is incorporated to generate Stokes wave whose frequency is down-shifted by vb, where vb is defined as the Brillouin frequency shift. With a tunable optical passband filter, the up/down frequency conversion can be realized through the same structure. In the proof-of-concept experiment, the microwave signal at 1 to 15 GHz can be up-converted while the microwave signal at 11 to 29 GHz can be down-converted by the microwave photonic frequency converter. Moreover, the frequency and power stability of the generated signals are also investigated in three hours. To vindicate flexibility, low cost and easy implementation of the proposed all-optical setup, an experiment is carried out, and it turns out that only the frequency-to-be-converted signal source is needed while providing the ultra-wideband up/down conversion. [ABSTRACT FROM AUTHOR]

Background: De novo combination of lamivudine (Lam) and adefovir (Adv) was not rarely used in clinical practice. However, head-to-head comparisons of entecavir (Etv) monotherapy with this combination in hepatitis B virus (HBV)-related compensated cirrhosis patients are unavailable. This study aimed to compare the efficacy and safety of Etv monotherapy with combination therapy in patients with HBV-related compensated liver cirrhosis. Methods: Treatment-naïve patients with HBV-related compensated liver cirrhosis were recruited to receive either Etv monotherapy or a de novo combination of Lam and Adv. Data were collected at baseline and every 6 months thereafter. Results: A total of 578 patients (485 in Etv group, 93 in combination group) were included. Baseline characteristics were comparable between the two groups. At the end of 1, 2, and 3 years, HBV DNA was undetectable in 82.7%, 96.2%, and 94.3% of patients in the Etv group and 88.9%, 81.7%, and 84.6% in the combination group, respectively (all P>0.05). The cumulative virological breakthrough rate at 1, 2, and 3 years was 2.7%, 6.7%, and 9.8% in the Etv group and 2.9%, 13.3%, and 32.2% in the combination group, respectively (P=0.003). After propensity-score adjustment for age, sex, and baseline HBeAg, ALT, and total bilirubin, virological breakthrough was higher in the de novo combination of Lam and Adv (HR 2.83, 95% CI 1.37–5.86; P<0.01). The cumulative rate of liver-related events, including decompensation and hepatocellular carcinoma, at 1, 2, and 3 years was 2.9%, 4.2%, and 6.1% in the Etv group and 2.2%, 2.2%, and 6.7% in combination group, respectively (P=0.83). Biochemical response and serological response were similar between the groups. Conclusion: Etv treatment had less virological breakthrough and potentially higher HBV-DNA suppression than de novo combination of Lam and Adv during 3 years in treatment-naïve HBV-related compensated liver cirrhosis. [ABSTRACT FROM AUTHOR]

In this study, we focused on the plant-growth-promoting properties of two strains isolated from Codonopsis pilosula , and the effect of inoculation with different strain treatments on physiological and metabolite accumulation of C. pilosula. The strains RHBA19 and RHBA17 were isolated and identified as Geobacillu sp. and Pseudomonas fluorescens , respectively. The two strains produced indole acetic acid (IAA), siderophore, biofilm, and various exoenzymes. Based on the pot experiments, inoculation of RHBA19 (G group) and the two mixed bacteria (M group) significantly improved the growth, root development, and photosynthesis of C. pilosula. Compared with the no-inoculation group (CK), the total polysaccharide content of root in the G and M groups was dramatically enhanced by 59.27% and 96.07%, and the lobetyolin (root) improved by 58.4% and 66.0%, respectively. After inoculation with bacteria agents, the activities of antioxidant enzymes (CAT, POD, SOD) of C. pilosula increased differentially. Inoculation with two types of bacterial agents significantly increased the activities of sucrose synthase (SS) and sucrose phosphate synthase (SPS) in root, and phenylalanine ammonia lyase (PAL) in leaf of C. pilosula. In addition, the content of signaling molecules (NO and H 2 O 2) in three types of tissue increased significantly. The magnitude of these results was higher with mixtures than with individual strains. These results imply that the two types of bacterial agents induce physiological metabolism changes to accumulate polysaccharides and lobetyolin by regulating stress resistance enzymes and signal molecules, especially NO and H 2 O 2. [Display omitted] • Endophytic bacteria can promote growth and accumulation of metabolites. • Endophytic bacteria can enhance the stress-resistant system of C. pilosula. • Endophytic bacteria enhance the activity of metabolic enzymes in C. pilosula. • Endophytic bacteria burst the content of signal molecules in C. pilosula. [ABSTRACT FROM AUTHOR]

Codonopsis pilosula is a traditional Chinese herbal medicinal plant and contains various bioactive components, such as C. pilosula polysaccharides (CPPs) and lobetyolin (Lob). Hydrogen peroxide (H 2 O 2) and nitric oxide (NO) are gaseous molecule and have been well known for their ability to relieve some adverse influences on plant from abiotic stress. Endophytic fungus is non-pathogenic plant-associated fungus that could play a significant role in improving plant tolerance by signal molecule. In this work, we determined how inoculation of Trichoderma strain RHTA01 with C. pilosula changed the plant's growth, metabolite accumulation, and related enzyme activity. Results demonstrated that application of Trichoderma strain RHTA01 significantly improved the growth of C. pilosula. Moreover, it noticeably decreased antioxidant enzyme superoxide dismutase (SOD) and catalase (CAT) activity in C. pilosula leaves, reduced the content of H 2 O 2 and malondialdehyde (MDA), and weakened the peroxidation of cell membrane lipids, which reduced the damage of abiotic stress to C. pilosula. Research has shown that it had obvious effects on levels of nitrogen and carbon metabolic enzymes. For example, sucrose synthase (SS) and acid invertase (AI) levels in C. pilosula roots were nearly 1.43 and 1.7 times higher, respectively, than those in the control (CK) group. In addition, it was notable that the production of CPPs and Lob, the most significant secondary metabolites in C. pilosula , were influenced by Trichoderma strain RHTA01. The obtained results indicate that inoculating C. pilosula with Trichoderma stimulates the carbon and nitrogen metabolism of the plant, and helps to increase the content of CPPs and Lob in the root of the plant. [Display omitted] • Application of FG (Trichoderma) can improve the growth of C. pilosula. • With FG applied, it improved the antioxidant properties of C. pilosula. • The FG improves the content of CPPs and Lob of C. pilosula. • The possible mechanisms are explored between Trichoderma and C. pilosula. [ABSTRACT FROM AUTHOR]

Introduction: Portal hypertension progression can be relieved after controlling the etiology of liver cirrhosis. Whether beta-blockers could additionally enhance the effects during treatment, particularly for small esophageal varices (EV), was unclear. This study aims to assess the efficacy of add-on carvedilol to delay EV progression during anti-hepatitis B virus (HBV) treatment in HBV-related cirrhosis., Methods: This randomized controlled trial enrolled patients with virologically suppressed HBV-compensated cirrhosis and small/medium EV. The participants were randomly assigned to receive nucleos(t)ide analog (NUC) or carvedilol 12.5 mg plus NUC (1:1 allocation ratio). The primary end point was the progression rate of EV at 2 years of follow-up., Results: A total of 238 patients (small EV, 77.3%) were randomized into 119 NUC and 119 carvedilol plus NUC (carvedilol [CARV] combination group). Among them, 205 patients (86.1%) completed paired endoscopies. EV progression rate was 15.5% (16/103) in the NUC group and 12.7% (13/102) in the CARV combination group (relative risk = 0.79, 95% confidence interval 0.36-1.75, P = 0.567). Subgroup analysis on medium EV showed the CARV combination group had a more favorable effect in promoting EV regression (43.5% vs 13.1%, P = 0.022) than NUC alone, but not in small cases ( P = 0.534). The incidence of liver-related events (decompensation, hepatocellular carcinoma, or death/liver transplantation) within 2 years was similar between the 2 groups (11.2% vs 10.4%, P = 0.881)., Discussion: The overall results did not show statistically significant differences between the added carvedilol strategy and NUC monotherapy in preventing EV progression in patients with virologically suppressed HBV-compensated cirrhosis. However, the carvedilol-added approach might offer improved outcomes specifically for patients with medium EV (NCT03736265)., (Copyright © 2023 by The American College of Gastroenterology.)

Background/aims: Existing hepatocellular carcinoma (HCC) prediction models are derived mainly from pretreatment or early on-treatment parameters. We reassessed the dynamic changes in the performance of 17 HCC models in patients with chronic hepatitis B (CHB) during long-term antiviral therapy (AVT)., Methods: Among 987 CHB patients administered long-term entecavir therapy, 660 patients had 8 years of follow-up data. Model scores were calculated using on-treatment values at 2.5, 3, 3.5, 4, 4.5, and 5 years of AVT to predict threeyear HCC occurrence. Model performance was assessed with the area under the receiver operating curve (AUROC). The original model cutoffs to distinguish different levels of HCC risk were evaluated by the log-rank test., Results: The AUROCs of the 17 HCC models varied from 0.51 to 0.78 when using on-treatment scores from years 2.5 to 5. Models with a cirrhosis variable showed numerically higher AUROCs (pooled at 0.65-0.73 for treated, untreated, or mixed treatment models) than models without (treated or mixed models: 0.61-0.68; untreated models: 0.51-0.59). Stratification into low, intermediate, and high-risk levels using the original cutoff values could no longer reflect the true HCC incidence using scores after 3.5 years of AVT for models without cirrhosis and after 4 years of AVT for models with cirrhosis., Conclusion: The performance of existing HCC prediction models, especially models without the cirrhosis variable, decreased in CHB patients on long-term AVT. The optimization of existing models or the development of novel models for better HCC prediction during long-term AVT is warranted.