Background: People living with HIV (PLWH) constitute a vulnerable population during the COVID-19 pandemic; however, it remains uncertain whether long-term suppressive antiretroviral therapy (ART) restores sufficient immune competence to support robust hybrid immunity. While vaccination followed by breakthrough infection—termed hybrid immunity—typically elicits potent humoral responses in immunocompetent individuals, the functional quality and breadth of these responses against evolving Omicron subvariants remain poorly characterized in PLWH. This study aimed to assess functional antibody responses, including neutralizing activity and Fc effector functions, in vaccinated and unvaccinated PLWH who experienced breakthrough infection with Omicron subvariants BA.4/5 or BF.7. Methods: We enrolled three cohorts between December 5 and December 20, 2022: 25 HIV-negative individuals with breakthrough infection (BTI-HC), 20 ART-experienced PLWH with breakthrough infection following three-dose COVID-19 vaccination (BTI-HIV), and 10 ART-experienced PLWH with primary infection without prior vaccination (PI-HIV). All HIV-positive participants were receiving suppressive ART with regimens based on non-nucleoside reverse transcriptase inhibitors or integrase strand transfer inhibitors for a median of 3.4 years. We measured receptor-binding domain (RBD)-specific IgG, neutralizing antibody titers against ancestral D614G, Delta, BA.1, BA.4/5, BF.7, XDV, KP.2, and KP.3 variants, and antibody-dependent cellular cytotoxicity (ADCC) responses. Results: Despite lower absolute CD4+ T cell counts, BTI-HIV participants mounted RBD-binding IgG, neutralizing antibody, and ADCC responses that were comparable to BTI-HC and significantly exceeded PI-HIV across all tested variants. Both breakthrough infection cohorts exhibited immunological imprinting, with higher neutralizing titers against ancestral D614G than infecting BA.4/5 or BF.7 variants. Emerging variants XDV, KP.2, and KP.3 demonstrated substantial neutralization escape in all groups. PI-HIV showed markedly diminished neutralization breadth and failed to generate enough responses against all tested Omicron strains. Conclusions: Suppressive ART enables PLWH to mount hybrid immunity—conferred by vaccination followed by BF.7 or BA.4/5 breakthrough infection—with neutralizing and ADCC responses comparable to HIV-negative individuals, and significantly exceeding those of unvaccinated PLWH with primary infection. This underscores the critical role of vaccination in establishing effective hybrid immunity in this population. However, we observed immunological imprinting, with higher titers against ancestral strains than against infecting variants, and substantial escape by emerging sublineages XDV, KP.2, and KP.3 across all groups. These findings support prioritizing updated variant-containing vaccines for HIV-positive populations and reinforce the essential role of vaccination in this vulnerable group.

Klebsiella pneumoniae (KP) is a critical global health threat due to carbapenem-resistant and hypervirulent strains, necessitating effective vaccines amid declining antibiotic efficacy. This review provides a timely and systematic analysis of the current KP vaccine landscape. We first outline the epidemiology of classical and hypervirulent KP (hvKP) and the corresponding protective host immunity, establishing a foundation for vaccination. A detailed survey of key antigenic targets, including polysaccharides and proteins, is presented. The core of this review critically assesses the spectrum of vaccine platforms, from traditional whole-cell and subunit vaccines to nanovaccine platforms. Distinctively, we place a dedicated focus on two transformative frontiers: nanovaccines—such as outer membrane vesicles (OMVs) and biosynthetic glycoconjugate nanoparticles—and mucosal vaccination strategies, emphasizing their unparalleled potential to block infection at the primary site of colonization. By synthesizing cutting-edge preclinical advances and addressing persistent translational challenges, this review serves as a timely and comprehensive resource, offering valuable insights to guide the future development of effective immunization strategies against this formidable pathogen.

The C-reactive protein-triglyceride-glucose index (CTI) has emerged as a novel biomarker to assess metabolic-inflammatory disorders. However, the relationship between CTI and cardiovascular disease (CVD) in people living with HIV (PLWH) remains unexplored. This cross-sectional study enrolled 505 PLWH who initiated antiretroviral therapy (ART) at Beijing Ditan Hospital between January 2016 and December 2020. Multivariate logistic regression models were constructed to assess the relationship between CTI and CVD prevalence, adjusting for potential confounding factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of CTI for CVD, with the area under the curve (AUC) serving as the primary metric. Furthermore, restricted cubic spline (RCS) analysis was performed to explore the dose–response relationship between CTI and CVD. After adjusting for potential confounders, higher CTI was significantly associated with an increased prevalence of CVD. Each standard deviation (SD) increase in CTI was associated with a 189.0

Background:The development of metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with cardiovascular health (CVH) status and chronic inflammation. Life's Crucial 9 (LC9) is the most recent index to assess CVH; its association with MASLD and liver fibrosis is unclear. This study aimed to investigate the association of LC9 with MASLD and hepatic fibrosis and to reveal for the first time the mediating role of a novel inflammatory marker, neutrophil percentage-to-albumin ratio (NPAR), in the association between LC9 and MASLD. Methods:This study was a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. The United States Fatty Liver Index (US-FLI) ≥ 30 was used to diagnose MASLD, and liver stiffness measurement (LSM) > 8.2 is defined as liver fibrosis. Weighted multifactorial regression, restricted cubic spline analysis (RCS), and subgroup analyses were used to assess the association between LC9 and MASLD and liver fibrosis. Mediation analysis was used to explore the possible mediating role of NPAR in the association of LC9 with MASLD. Results:A total of 9,623 participants were included in this study. After adjusting for all confounders, LC9 was significantly and negatively associated with both MASLD (OR = 0.59, 95% CI: 0.54-0.64) and hepatic fibrosis (OR = 0.66, 95% CI: 0.45-0.97), with each 10-point increase in the LC9 score decreasing the prevalence by 41% and 34%, respectively. In subgroup analyses, interaction tests showed that age, education, deprivation, obesity, smoking, hypertension, diabetes, and hyperlipidemia significantly affected the association between LC9 and MASLD (P for interaction < 0.05). In addition, NPAR was positively associated with the prevalence of MASLD, with a 5% increase in the prevalence of MASLD for each unit increase in NPAR (OR = 1.05, 95% CI: 1.01-1.09). The positive association between NPAR and MASLD was stronger in younger age groups (<60 years), non-drinkers, and participants without diabetes or hyperlipidemia. Mediation analysis showed that NPAR mediated 2.84% of the association between LC9 and MASLD (p < 0.001). Conclusion:Good CVH status (high LC9 score) was associated with lower prevalence of MASLD and liver fibrosis, and NPAR partially mediated the association between LC9 and MASLD. This study provides new epidemiological evidence for preventing MASLD by improving CVH and inflammatory modulation.

Zoonotic opportunistic enteric protozoa represent a significant global health threat to immunocompromised populations, especially individuals with human immunodeficiency virus (HIV). Despite China’s severe HIV burden, molecular epidemiological data on enteric protozoa remain limited in this population. In this study, we investigated the occurrence and molecular characteristics of Cryptosporidium species, Giardia duodenalis, and Enterocytozoon bieneusi among 150 AIDS patients with severe immunodeficiency in Wuhan city, Hubei Province, China. The overall test-positive rate was 5.33% (8/150), comprising Cryptosporidium species (including C. hominis, C. parvum, and C. meleagridis) in 2.00% (3/150) and G. duodenalis (including assemblage A, B, and E) in 3.33% (5/150); E. bieneusi was not detected. Notably, this study reports the first identification of the C. parvum subtype IIcA5G3 in humans in China, certainly indicating possible cross-border transmission. Furthermore, the detection of C. meleagridis IIIbA22G1R1c provided additional molecular evidence for chicken-to-human transmission. The finding of G. duodenalis assemblage E highlights the underrecognized zoonotic spillover risks to immunocompromised populations. These findings emphasize the diversity of infectious reservoirs, and the need for enhanced national molecular surveillance of these neglected zoonotic enteric protozoa, alongside targeted interventions for vulnerable populations.

OBJECTIVE:Cardiovascular disease (CVD) is a significant concern in patients with primary biliary cholangitis (PBC) due to the combined effects of immune dysregulation and chronic inflammation. Traditional biomarkers may have limited predictive value for CVD in this population. This study aims to investigate the relationship between inflammatory biomarkers and CVD in patients with PBC. METHODS:Patients with PBC who were treated at Beijing Ditan Hospital between January 2018 and December 2022 were included. Multivariate logistic regression models were performed to investigate the association between systemic inflammatory response index (SIRI), systemic immune inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR) and CVD. The predictive value of inflammatory biomarkers for CVD was evaluated using receiver operating characteristic (ROC) curves. In addition, a restricted cubic spline (RCS) fitted with a logistic regression model was used to analyze the relationship between SIRI and CVD. RESULTS:The prevalence of CVD in patients with PBC was 16.9% (n = 71). Multivariate logistic regression analysis showed that SIRI was an independent risk factor for CVD prevalence. Each standard deviation increase in SIRI was associated with a 79.2% increased risk of CVD (OR = 1.792, 95%CI = 1.348-2.382, P < 0.001). SIRI demonstrated moderate predictive ability for CVD, with an area under the curve (AUC) of 0.725. However, it was superior to NLR (AUC = 0.626), MLR (AUC = 0.579) and SII (AUC = 0.599). Subgroup analysis showed that the association between SIRI and CVD risk was robust with respect to gender, body mass index, smoking, drinking, hypertension, and diabetes mellitus, except for older age and cirrhosis status. The RCS analysis showed a stable linear relationship between SIRI and CVD, with significantly increased odds of CVD for SIRI values > 0.65. CONCLUSION:SIRI is a promising inflammatory biomarker and is independently associated with CVD prevalence in patients with PBC. Clinicians may consider incorporating SIRI into clinical practice to better stratify CVD risk and guide preventive strategies in this vulnerable population.

BackgroundNon-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with chronic inflammation and lipid metabolism disorders. The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) is an integrative marker reflecting inflammatory responses and lipid metabolism disorders and is associated with various diseases. This cross-sectional study aimed to determine the association between NHR and NAFLD, MASLD, and liver fibrosis.MethodsData for this study were obtained from the 2017–2020 National Health and Nutrition Examination Survey (NHANES), we employed weighted multiple regression and restricted cubic spline (RCS) analysis to assess the relationship between NHR and NAFLD, MASLD, and liver fibrosis. Additionally, we performed stratified analyses based on gender, age, body mass index, diabetes, hypertension, smoking status, and history of cardiovascular disease to evaluate the consistency of these associations across different subgroups.ResultsA total of 6,526 participants were included in the study. 2,839 (weighted 44.1%) participants were diagnosed with NAFLD and 2,813 (weighted 43.7%) participants were diagnosed with MASLD. After adjusting for confounders, NHR was positively associated with the risk of NAFLD/MASLD, and the correlation was particularly significant in the subgroups of females, those without hypertension, and those without diabetes (p < 0.05). By the NHR quartile, the risk of NAFLD/MASLD increased progressively with higher NHR levels (P for trend <0.001). In addition, RCS analysis showed a nonlinear association between NHR and NAFLD/MASLD and liver fibrosis (P-non-linear <0.05).ConclusionNHR may serve as a potential marker for NAFLD/MASLD and liver fibrosis, and lowering NHR levels could help reduce the incidence of these conditions.

The construction of heterojunctions is a recognized strategy for enhancing photogenerated carrier separation. This research introduces a novel ZnO-Ag 2 MoO 4-AgI photocatalyst with a double Z-type heterojunction, made using a straightforward precipitation technique. The precise position of energy levels endowed the ternary photocatalyst with the ability of directional electron flow, while the Z-type structure exhibits strong redox capabilities and facilitates the effective separation of photogenerated charge carriers. The structural characteristics, the photocatalytic activities, the antibacterial properties, and the cytotoxicity of the catalysts were evaluated. The results demonstrate that the catalytic ability of ternary composites work synergistically, surpassing the individual and binary photocatalysts. Notably, the ternary composites with 30 % AgI content exhibit the highest catalytic activity, achieving complete degradation of Rhodamine B in 30 minutes, and up to 71.2 % degradation of Norfloxacin in 60 minutes. Furthermore, more than 99.998 % of Staphylococcus aureus, and 100 % of Escherichia coli were eliminated within 40 minutes, while Human colorectal adenocarcinoma epithelial cells mortality reached 91.98 % at a dose of 250 mu g/mL. Our study underscores the potential of this strategy for photocatalytic degradation of organic contaminants, and as an antibacterial agent, providing innovative insights into the design of ZnO-based heterostructure photocatalysts.

ObjectiveHuman identical sequences of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) promoted the coronavirus disease 2019 (COVID-19) progression by upregulating hyaluronic acid (HA) via NamiRNA-enhancer network, based on previous experimental research. This study aimed to investigate the predictive value of HA for the severity of SARS-CoV-2 infection in the post-COVID-19 era.MethodsA total of 217 consecutive patients with COVID-19 were enrolled at Beijing Ditan Hospital between July 2023 and October 2023. HA levels were analyzed using biochemical detector. Logistic regression analysis was used to screen independent factors for severe COVID-19. The predictive performance of HA for severe infection was assessed by ROC curve. Furthermore, the relationship between HA levels and COVID-19 severity was investigated using multivariate logistic regression models after adjustment for potential confounders.ResultsAccording to the cut-off value of HA, COVID-19 patients were divided into HA < 90 ng/mL group (80 cases) and HA ≥ 90 ng/mL group (137 cases). High HA levels were positively associated with the severe SARS-CoV-2 infection, including elevated inflammatory indicators, severe lung involvement, prolonged clinical course, and higher incidence of respiratory failure and death (P < 0.05). Logistic regression analysis suggested that HA was an independent predictor of severe COVID-19 (OR = 4.540, 95% CI = 2.105-9.790, P < 0.001). ROC curve analysis showed that the AUC of HA for severe infection was 0.724. HA levels were significantly higher in COVID-19 cases compared to the healthy population (123.9 (82.6, 174.1) vs. 50.5 (37.8, 66.8), P < 0.001), but similar to those with non-SARS-CoV-2 lung infection (121.6 (78.5, 175.6) vs. 106.0 (66.5, 149.7), P = 0.244). We also found that the first COVID-19 infections had higher HA levels (118.8 (79.5, 174.3) vs. 85.0 (61.1, 128.8), P < 0.001) and a higher proportion of severe infection (37.1% vs. 21.3%, P = 0.043) than re-infections. However, HA expression failed to fully return to normal levels with infection recovery (204.7 (152.9, 242.2) vs. 97.0 (69.3, 137.3), P < 0.001).ConclusionHA was associated with severe SARS-CoV-2 infection and could be used as a novel serum biomarker to predict the risk of COVID-19 progression in the post-COVID-19 era.

Objective: To assess the effects of moxibustion on immune reconstitution inflammatory syndrome (IRIS) in patients with acquired immune deficiency syndrome (AIDS) by tracking T-cell subsets over a 48-week prospective cohort study. Methods: Patients with AIDS who had low viral loads and weakened immune systems were divided into a moxibustion group and a non-moxibustion group. The non-moxibustion group received standard western treatment, including 48 weeks of antiretroviral therapy (ART). The moxibustion group received ART combined with moxibusion therapy, administered three times weekly. Each treatment lasted 10 weeks, with four courses completed over 48 weeks, separated by 2-week breaks. At different time points, plasma levels of CD4(+), CD8(+), CD45RA(+), CD45RO(+), CD4(+)CD28(+), CD8(+)CD38(+), and CD4(+)CD38(+) were compared between the two groups. Results: A total of 200 eligible patients were included and divided into two groups, with 100 in the non-moxibustion group and 100 in the moxibustion group. At Week 24, the CD4(+)T cell count was (180.71 +/- 79.62) cells/mu L in the non-moxibustion group and (218.22 +/- 82.02) cells/mu L in the moxibustion group. By Week 36, the counts were (204.83 +/- 96.78) cells/mu L and (239.35 +/- 81.90) cells/mu L, respectively. At Weeks 24 and 48, the CD8(+) T cell and CD45RO(+) counts were higher in the moxibustion group than in the non-moxibustion group ( P < 0.05). By Week 48, the CD45RA(+) count was also higher in the moxibustion group ( P < 0.05). At Week 24, the CD4(+)CD25(+) count was lower in the moxibustion group than in the non-moxibustion group ( P < 0.05). Conclusion: Moxibustion enhances immune function in patients with AIDS and IRIS by regulating THIVcell subsets and increasing CD4(+) and CD8(+) T lymphocyte counts. (c) 2024 World Journal of Acupuncture - Moxibustion House. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Titanium (Ti) implants are widely used in orthopedic and dental applications due to their excellent biocompatibility and mechanical properties. However, bacterial adhesion and subsequent biofilm formation on implant surfaces pose a significant risk of postoperative infections and complications. Conventional surface modifications often lack long-lasting antibacterial efficacy, necessitating the development of novel coatings with enhanced antimicrobial properties. This study aims to develop a novel Ag-TiO2-OTS (Silver-Titanium dioxide-Octadecyltrichlorosilane, ATO) nanocomposite coating, through a chemical plating method. By employing a 'resist-killing-disintegrate' approach, the coating is designed to inhibit bacterial adhesion effectively, and facilitate pollutant removal with lasting effects. Characterization of the coatings was performed using spectroscopy, electron microscopy, and contact angle analysis. Antibacterial efficacy, quantitatively evaluated against E. coli and S. aureus over 168 h, showed a significant reduction in bacterial adhesion by 76.6% and 66.5% respectively, and bacterial removal rates were up to 83.8% and 73.3% in comparison to uncoated Ti-base material. Additionally, antibacterial assays indicated that the ratio of the Lifshitz-van der Waals apolar component to electron donor surface energy components significantly influences bacterial adhesion and removal, underscoring a tunable parameter for optimizing antibacterial surfaces. Biocompatibility assessments with the L929 cell line revealed that the ATO coatings exhibited excellent biocompatibility, with minimal cytotoxicity and no significant impact on cell proliferation or apoptosis. The ATO coatings provided a multi-functionality surface that not only resists bacterial colonization but also possesses self-cleaning capabilities, thereby marking a substantial advancement in the development of antibacterial coatings for medical implants.

Objectives: Accumulating evidence has confirmed the efficacy and safety of COVID-19 vaccines against SARS-CoV-2 infection. However, the effect of COVID-19 vaccination on immuno-virological parameters in people with HIV (PWH) is uncertain. Methods: A total of 372 PWH treated at Beijing Ditan Hospital were included. Unvaccinated PWH were matched 1:3 with vaccinated PWH using a propensity score matching algorithm. Differences in immuno-virological markers between the matched groups were analyzed. The Wilcoxon signed rank test was used to test for changes in CD4 and CD8 counts and HIV viral load over two months around vaccination. In addition, we investigated the long-term changes in HIV-related markers in different vaccination dose groups and in the entire vaccinated population. Results: Vaccinated PWH had a higher CD4/CD8 ratio (0.64 (0.49, 0.78) vs. 0.80 (0.56, 1.03), p = 0.037) than unvaccinated PWH within a two-month window after the third dose. There were 337 PWH who received COVID-19 vaccination, and 73.9% (n = 249) received three doses of vaccine. We observed a transient increase in CD4 count and CD4/CD8 ratio within a two-month window after vaccination, especially after the second dose (CD4 count: 583.5 (428.5, 706.8) vs. 618.0 (452.0, 744.0), p = 0.018; CD4/CD8 ratio: 0.70 (0.50, 0.91) vs. 0.71 (0.53, 0.96), p < 0.001)) and the third dose (CD4 count: 575.5 (435.5, 717.0) vs. 577.5 (440.8, 754.8), p = 0.001; CD4/CD8 ratio: 0.70 (0.52, 0.93) vs. 0.79 (0.53, 1.00), p < 0.001)). Recent CD4 counts and CD4/CD8 ratios were lower than after COVID-19 but remained higher than before COVID-19 in vaccinated PWH. In addition, COVID-19 vaccination had no negative effect on HIV viral load. Conclusions: A transient increase in CD4 count and CD4/CD8 ratio was observed after COVID-19 vaccination. However, the enhanced cellular immune response induced by vaccination may diminish over time and return to normal levels. There is no adverse effect of vaccination on HIV viral load.

Acquired immunodeficiency syndrome is a systemic infectious disease caused by human immunodeficiency virus infection, which could attack the bones and heart. However, the relationship between Nuclear Complex Associated 3 Homolog (NOC3L) and DEAD box helicase 17 (DDX17) and acquired immunodeficiency complicated with viral myocarditis and osteoporosis is unclear. The acquired immune deficiency dataset GSE140713, GSE147162 and the osteoporosis dataset (GSE230665), and viral myocarditis dataset (GSE150392) configuration files were generated from gene expression omnibus. The differentially expressed genes (DEGs) were screened and performed weighted gene co-expression network analysis. Construction and analysis of protein-protein interaction network. Functional enrichment analysis, gene set enrichment analysis, immune infiltration analysis, gene expression heatmap, and comparative toxicogenomics database analysis were performed. TargetScan screens miRNAs of DEGs. Thousand three hundred thirty-five DEGs were identified. According to gene ontology, they are mainly concentrated in the regulation of RNA biosynthesis, cytoplasmic ribosome, and the DNA binding transcription factor activity. In Kyoto Encyclopedia of Genes and Genomes analysis, they are mainly concentrated in TGF-beta signal pathway, Notch signaling pathway, cAMP signaling pathway, and Apelin signaling pathway. Gene set enrichment analysis shows that DEGs are mainly enriched in cytoplasmic ribosome, transcriptional regulator activity, DNA binding transcription factor activity, TGF-beta signal pathway, and Notch signal pathway. In the enrichment project of Metascape, tyrosine kinase receptor signaling, growth regulation, and enzyme-linked receptor protein signaling pathways can be seen in the gene ontology enrichment project. Four core genes (NOC3L, WDR46, SDAD1, and DDX17) were obtained. Core genes (NOC3L, WDR46, SDAD1, and DDX17) were low expressed in both acquired immunodeficiency and osteoporosis samples. Comparative toxicogenomics database analysis showed that core genes (NOC3L, WDR46, SDAD1, and DDX17) were associated with inflammation necrosis. The expressions of NOC3L and DDX17 are low in acquired immunodeficiency combined with viral myocarditis and osteoporosis.

Objective The effect of the functionally unknown gene C6orf120 on autoimmune hepatitis was investigated on C6orf120 knockout rats (C6orf120-/-) and THP-1 cells. Method Six–eight-week-old C6orf120-/- and wild-type (WT) SD rats were injected with Con A (16 mg/kg), and euthanized after 24 h. The sera, livers, and spleens were collected. THP-1 cells and the recombinant protein (rC6ORF120) were used to explore the mechanism in vitro. The frequency of M1 and M2 macrophages was analyzed using flow cytometry. Western blotting and PCR were used to detect macrophage polarization-associated factors. Results C6orf120 knockout attenuated Con A-induced autoimmune hepatitis. Flow cytometry indicated that the proportion of CD68+CD86+M1 macrophages from the liver and spleen in the C6orf120-/- rats decreased. C6orf120 knockout induced downregulation of CD86 protein and the mRNA levels of related inflammatory factors TNF-α, IL-1β, and IL-6 in the liver. C6orf120 knockout did not affect the polarization of THP-1 cells. However, rC6ORF120 promoted the THP-1 cells toward CD68+CD80+M1 macrophages and inhibited the CD68+CD206+M2 phenotype. Conclusion C6orf120 knockout alleviates Con A-induced autoimmune hepatitis by inhibiting macrophage polarization toward M1 macrophages and reducing the expression of related inflammatory factors in C6orf120-/- rats.

ObjectiveInflammation contributes to the development of metabolic bone diseases. The C-reactive protein-to-albumin ratio (CAR) is an inflammation-based marker with a prognostic value for several metabolic diseases. This study investigated the relationship between the CAR and osteoporosis (OP) in patients with primary biliary cholangitis (PBC).MethodsPatients with PBC treated at Beijing Ditan Hospital between January 2018 and June 2023 were enrolled. Logistic regression analysis was performed to investigate the factors influencing OP. The predictive value of CAR for OP was evaluated using receiver operating characteristic (ROC) curves. Moreover, a restricted cubic spline (RCS) fitted with a logistic regression model was used to analyze the relationship between CAR and OP.ResultsThe prevalence of OP among the patients with PBC was 26.9% (n = 82). CAR levels were higher in the OP group than in the non-OP group (0.33 (0.09, 0.61) vs. 0.08 (0.04, 0.18), P < 0.001). Logistic regression analysis showed that CAR was an independent predictor of OP in patients with PBC (odds ratio = 2.642, 95% confidence interval = 1.537-4.540, P < 0.001). CAR exhibited a good predictive ability for OP, with an areas under the curve (AUC) of 0.741. We found that individuals with CAR values > 0.1 have higher odds of OP. In addition, high CAR levels were associated with an increased prevalence of fragility fractures and high 10-year fracture risk.ConclusionHigh CAR levels were associated with greater odds of developing OP, and the CAR could serve as an independent predictor of OP in patients with PBC.

Purpose:Hyaluronic acid (HA) is a novel inflammatory biomarker with a prognostic value for several infectious diseases. This study investigated the association of HA with severity and prognosis in hospitalized patients with community-acquired pneumonia (CAP). Patients and Methods:We analyzed the differences of HA levels in different groups. Logistic regression analysis was performed to identify independent risk factors for severe CAP (SCAP). The predictive value of HA for SCAP was assessed using receiver operating characteristic (ROC) curves. Kaplan-Meier survival analysis was used to compare 30-day mortality between the high and low HA groups. Results:Compared to healthy controls (49.2 ± 15.3 ng/mL), patients with CAP exhibited significantly elevated levels of HA (P < 0.001). In CAP patients, increased HA levels were more pronounced in those with SCAP (SCAP vs non-SCAP:135.6 ± 51 ng/mL vs 100.7 ± 47.8 ng/mL, P < 0.001). Compared to survivors (109.9 ± 48.7 ng/mL), HA levels in non-survivors were significantly higher (180.9 ± 67.8 ng/mL) (P < 0.001). HA was an independent predictor of SCAP [odds ratio (OR): 1.013, 95% confidence interval (CI): 1.003-1.022, P = 0.011] with high diagnostic accuracy [areas under the curve (AUC): 0.709, 95% CI: 0.622-0.797, P = 0.001]. Additionally, HA was independently associated with death risk in patients with CAP (OR: 1.022, 95% CI: 1.005-1.039, P = 0.010). Kaplan-Meier survival curves indicated that CAP patients in the high HA group exhibit a higher 30-day mortality rate compared to those in the low HA group (8.6% vs 1.5%, P = 0.008). Post hoc analysis indicated that our study possessed 98.857% statistical power. Conclusion:In conclusion, High HA levels are associated with severity and mortality in patients with CAP, and HA could serve as a novel serum biomarker to predict the risk of CAP progression.

Objective: To analyze the effects of moxibustion +ART on intestinal bacterial community structure in HIV/AIDS patients, and to provide new ideas and methods for improving immune reconstitution in patients from the perspective of intervention of intestinal disorders and inhibition of immune activation. Methods: 16S rRNA high-throughput sequencing was used to compare and analyze the differences in the intestinal bacterial composition between the patients in ART group and moxibustion + ART group. Results: PCA score chart results show that the distribution of patients in the ART group and the moxibustion group was similar at baseline. After 48 weeks of treatment, the distribution locations and the phase limits of the samples in the ART group and the moxibustion group were significantly different, and compared with the ART group, the points represented by the moxibustion group after treatment and before treatment were far apart, that is, the composition and structure of microorganisms in the moxibustion group after treatment and before treatment were significantly different. Conclusion: moxibustion can improve the intestinal microbiological composition of HIV patients, and differ from the ART therapy that can improve the dominant bacteria.

ObjectivePrevious research has shown that human identical sequences of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) promote coronavirus disease 2019 (COVID-19) progression by upregulating hyaluronic acid (HA). However, the association of HA with mortality and long COVID in SARS-CoV-2 reinfection and first infection is unclear.MethodsPatients with COVID-19 at Beijing Ditan Hospital from September 2023 to November 2023 were consecutively enrolled. SARS-CoV-2 reinfections were matched 1:2 with first infections using a nearest neighbor propensity score matching algorithm. We compared the hospital outcomes between patients with COVID-19 reinfection and first infection. The association between HA levels and mortality and long COVID in the matched cohort was analyzed.ResultsThe reinfection rate among COVID-19 hospitalized patients was 25.4% (62 cases). After propensity score matching, we found that reinfection was associated with a better clinical course and prognosis, including lower levels of C-reactive protein and erythrocyte sedimentation rate, fewer cases of bilateral lung infiltration and respiratory failure, and shorter viral clearance time and duration of symptoms (p < 0.05). HA levels were significantly higher in patients with primary infection [128.0 (90.5, 185.0) vs. 94.5 (62.0, 167.3), p = 0.008], those with prolonged viral clearance time [90.5 (61.5, 130.8) vs. 130.0 (95.0, 188.0), p < 0.001], and deceased patients [105.5 (76.8, 164.5) vs. 188.0 (118.0, 208.0), p = 0.002]. Further analysis showed that HA was an independent predictor of death (AUC: 0.789), and the risk of death increased by 4.435 times (OR = 5.435, 95% CI = 1.205–24.510, p = 0.028) in patients with high HA levels. We found that patients with HA levels above 116 ng/mL had an increased risk of death. However, the incidence of long COVID was similar in the different HA level groups (p > 0.05).ConclusionSerum HA may serve as a novel biomarker for predicting COVID-19 mortality in patients with SARS-CoV-2 reinfection and first infection. However, HA levels may not be associated with long COVID.