During the chemotherapy of tumors,the cytotoxic effect of drugs is vital to kill tumor cells,and the delivery of a chemotherapeutic agent is of great importance for optimal therapeutic effects.The high in vivo clearan...During the chemotherapy of tumors,the cytotoxic effect of drugs is vital to kill tumor cells,and the delivery of a chemotherapeutic agent is of great importance for optimal therapeutic effects.The high in vivo clearance rate and low delivery efficiency of conventional chemotherapeutic agents affect the therapeutic effect.In recent years,the responsive drug delivery nanosystem has received increasing concern owing to its excellent biocompatibility,stable delivery performance,and controlled drug release strategies.To lucidly explain the cytocidal and immunotherapeutic effects of such responsive nanosystems in breast cancer,this review discusses the various stimuli and responses of drug-loaded liposomal nanosystems.The light/magnetic response of drug-loaded bionic membranes nanosystems and the heat/magnetic response of drug-loaded iron oxide nanosystems are also elaborated.Their cancer cell-killing efficacy and antitumor immunotherapeutic effects are also scrutinized.展开更多
This paper researched the enhanced flotation separation performance of ilmenite and titanaugite using the mixed collector benzhydroxamic acid/dodecylamine(BHA/DDA).The interface assembly mechanism was mainly investiga...This paper researched the enhanced flotation separation performance of ilmenite and titanaugite using the mixed collector benzhydroxamic acid/dodecylamine(BHA/DDA).The interface assembly mechanism was mainly investigated through in situ attenuated total reflectance Fourier transform infrared(ATRFTIR)spectroscopy combined with the two-dimensional correlation spectroscopy(2D-COS)and X-ray photoelectron spectroscopy(XPS).It has been found that BHA/DDA mixed collectors successfully separate ilmenite from titanaugite at a molar ratio of 8:1.Zeta potential experiments suggested that,in the presence of mixed collector system,the BHA-DDA complex adsorbed on the ilmenite surface via the chemically adsorbed BHA and the electrostatically adsorbed DDA,however,the complex adsorbed on the surface of titanaugite unstably.According to in situ ATR-FTIR combined with 2D-COS and XPS results,the interface assembly mechanism of BHA/DDA is summarized as:the function group of BHA molecules first binds to the metal sites on minerals to form bidentate ligand,then DDA co-adsorbed with BHA on the surface of minerals through hydrogen bonding.DDA may change the adsorption modes of some BHA on the ilmenite surface from four-membered ring to five-membered ring,while the modes on the titanaugite surface is true opposite.Finally,recommended adsorption configurations of the BHA/DDA complex on the two mineral surfaces are proposed.展开更多
To reveal the resonance suppression mechanism of the blood circulation in dragonfly wings,a numerical modeling method of dragonfly wings based on Voronoi diagrams is proposed,and the changes in mass,aerodynamic dampin...To reveal the resonance suppression mechanism of the blood circulation in dragonfly wings,a numerical modeling method of dragonfly wings based on Voronoi diagrams is proposed,and the changes in mass,aerodynamic damping,and natural frequencies caused by blood circulation in veins are investigated.The equivalent mass of blood,boundary conditions,and aerodynamic damping are calculated theoretically.Modal analysis and harmonic response analysis of wing models with different blood circulation paths are performed using the finite-element method(FEM).The vibration reduction ratioδis introduced to compare the damping efficiency of different mass regions.Finally,a natural frequency testing device is constructed to measure the natural frequencies of dragonfly wings.The results indicate that the shape,mass,and natural frequencies of the dragonfly wing model constructed by numerical method agree well with reality.The mass distribution on the wing can be altered by blood circulation,thereby adjusting the natural frequencies and achieving resonance suppression.The highestδof 1.013 is observed in the C region when blood circulates solely in secondary veins,but it is still lower than theδof 1.017 when blood circulates in complete veins.The aerodynamic damping ratio(1.19–1.79%)should not be neglected in the vibration analysis of the beating wing.展开更多
A facile hydrothermal method was applied to gain stably and highly efficient CuO-CeO_(2)(denoted as Cu1Ce2)catalyst for toluene oxidation.The changes of surface and inter properties on Cu1Ce2 were investigated compari...A facile hydrothermal method was applied to gain stably and highly efficient CuO-CeO_(2)(denoted as Cu1Ce2)catalyst for toluene oxidation.The changes of surface and inter properties on Cu1Ce2 were investigated comparing with pure CeO_(2)and pure CuO.The formation of Cu-Ce interface promotes the electron transfer between Cu and Ce through Cu^(2+)+Ce^(3+)↔Cu^(+)+Ce^(4+)and leads to high redox properties and mobility of oxygen species.Thus,the Cu1Ce2 catalyst makes up the shortcoming of CeO_(2)and CuO and achieved high catalytic performance with T_(50)=234°C and T_(99)=250°C(the temperature at which 50%and 90%C_(7)H_(8)conversion is obtained,respectively)for toluene oxidation.Different reaction steps and intermediates for toluene oxidation over Cu1Ce2,CeO_(2)and CuO were detected by in situ DRIFTS,the fast benzyl species conversion and preferential transformation of benzoates into carbonates through C=C breaking over Cu1Ce2 should accelerate the reaction.展开更多
The growth of dendrites in the lithium(Li)metal anode hinders the commercialization of lithium metal batteries(LMBs).Electrolyte additives have proved to be an effective way to solve the problem of dendrites and impro...The growth of dendrites in the lithium(Li)metal anode hinders the commercialization of lithium metal batteries(LMBs).Electrolyte additives have proved to be an effective way to solve the problem of dendrites and improve the coulombic efficiency.Herein,we propose a strategy of using L-tyrosine(L-Tyr)as an additive to protect the lithium metal anode in situ,where L-Tyr can be electropolymerized in situ to form an ordered array of nanosheets on the surface of the lithium metal anode to uniformly deposit lithium ions.At the same time,the addition of L-Tyr changed the structure of the solvent in the electrolyte,because the carboxyl group on L-Tyr make DME form hydrogen bonds easily.Besides,the reduction of free DME makes more TFSI-involved in the formation of the SEI film on the electrode surface,which increases the proportion of LiF in the SEI film.With 2 wt%L-Tyr,Li||Li symmetric cells superior cycle stability in ether electrolytes,Li|Cu cells y improved stability up to 200 cycles with an average CE of 93.1%in ether electrolytes and Li||Li_(4)Ti_(5)O_(12)(LTO)demonstrated an excellent cycling capabilitie with 119 mAh/g capacity retention by the 5000^(th)cycle.展开更多
A novel coronavirus disease 2019(COVID-19)emerged around December 2019 in Wuhan,China and has spread rapidly worldwide(Lu et al.,2020).Until March 27,2020,the Chinese health authorities had reported 82082 confirmed CO...A novel coronavirus disease 2019(COVID-19)emerged around December 2019 in Wuhan,China and has spread rapidly worldwide(Lu et al.,2020).Until March 27,2020,the Chinese health authorities had reported 82082 confirmed COVID-19 cases in China with 3298 deaths and 381443 confirmed cases with 20787 deaths outside China.The World Health Organization(WHO)named the virus SARS-CoV-2,which belongs to a distinct clade from the human severe acute respiratory syndrome CoV(SARS-CoV)and Middle East respiratory syndrome CoV(MERSCoV)(Zhu et al.,2020).展开更多
Background and aim:Several effective antiviral drugs are now available;however,the risk of liver-related complications is still present.Low-level viremia(LLV),defined as a hepatitis B virus(HBV)deoxy-ribonucleic acid(...Background and aim:Several effective antiviral drugs are now available;however,the risk of liver-related complications is still present.Low-level viremia(LLV),defined as a hepatitis B virus(HBV)deoxy-ribonucleic acid(DNA)load lower than 2000 IU/mL,is one of the major factors responsible for these complications.It has been reported that 22.7e43.1%of patients with HBV experience LLV.Herein,we aimed to explore the risk factors for very LLV(VLLV)during antiviral treatment.Methods:We collected data of patients with chronic hepatitis B(CHB)who received nucleos(t)ide analog treatment from October 2016 to April 2021.VLLV was defined as an HBV DNA load of 9e20 IU/mL.A total of 139 patients with LLV were matched with 139 patients with a sustained virological response at a 1:1 ratio according to age and gender.Results:Seropositivity rates for hepatitis B e antigen(HBeAg)(45.3%vs.17.3%,P<0.001)and hepatitis B surface antigen(HBsAg,3.11±0.68 lg IU/mL vs.2.54±1.04 lg IU/mL,P<0.001)and alanine amino-transferase levels(30.34±15.08 U/L vs.26.15±16.66 U/L,P¼0.040)in the two groups were significantly different.The multivariate analysis showed that both HBeAg seropositivity(adjusted odd ratio(aOR),3.63;95% confidence interval(CI):1.98±6.64;P<0.001)and HBsAg levels(aOR,2.21;95% CI:1.53±3.20;P<0.001)are independent risk factors for VLLV.During the multivariate analysis in the subgroup of HBeAg-positive patients,male gender(aOR,3.68;95% CI:1.23±10.76;P=0.017)and high HBsAg(aOR,4.86;95%CI:1.73e13.64;P¼0.003)levels were significantly correlated with VLLV.However,this was not the case in HBeAg-negative patients(P>0.050).HBeAg seropositivity(aOR,5.08;95% CI:2.15±12.02;P<0.001 vs.aOR,2.78;95% CI:1.16±7.00;P=0.022)and HBsAg levels(aOR,2.75;95% CI:1.41e5.37;P=0.003 vs.aOR,2.10;95% CI:1.27±3.46;P=0.004)significantly increased the risk of VLLV,irrespective of the age group.Both HBsAg(area under the receiver operating characteristic curve(AUC),0.681;95% CI:0.623±0.736;P<0.001)and HBeAg(AUC,0.640;95% CI:0.581±0.697;P<0.001)had certain pre-dictive value for VLLV.Conclusion:HBeAg seropositivity and higher HBsAg levels were not only risk factors for VLLV but also predicted its occurrence.When a patient with CHB remains HBeAg seropositive with high HBsAg levels after antiviral treatment for 48 weeks,emphasis should be placed on the potential occurrence of VLLV,warranting the use of highly sensitive HBV DNA detection methods.展开更多
Redundancy is an important attribute of a resilient urban drainage system.While there is a lack of knowledge on where to increase redundancy and its contribution to resilience,this study developed a framework for the ...Redundancy is an important attribute of a resilient urban drainage system.While there is a lack of knowledge on where to increase redundancy and its contribution to resilience,this study developed a framework for the optimal network structure of urban drainage systems that considers pipeline redundancies.Graph theory and adaptive genetic algorithms were used to obtain the initial layout and design of the urban drainage system.The introduction of additional water paths(in loop)/redundancies is suggested by the results of complex network analysis to increase resilience.The drainage performances of the urban drainage system with pipeline redundancies,and without redundancies,were compared.The proposed method was applied to the study area in Dongying City,Shandong Province,China.The results show that the total overflow volume of the urban drainage system with pipeline redundancies under rainfall exceeding the design standard(5 years) is reduced by 20-30%,which is substantially better than the network without pipeline redundancies.展开更多
Background and aim:Hepatitis C virus(HCV)infection is one of the major global health challenges,leading to a significant increase in rates of hepatic fibrosis,cirrhosis and hepatocellular carcinoma.A comprehensive nat...Background and aim:Hepatitis C virus(HCV)infection is one of the major global health challenges,leading to a significant increase in rates of hepatic fibrosis,cirrhosis and hepatocellular carcinoma.A comprehensive nationwide survey of trends in prevalence and associated factors could facilitate pre-ventive behavioral interventions.Herein,we sought to determine prevalence,diagnosis,treatment,and risk factors for HCV infection in the general United States(US)population.Methods:This was a secondary analysis of the publicly available data from the US National Health and Nutrition Examination Survey(NHANES).The prevalence of HCV-RNA-positive(HCV-RNAþ)was weighted using patient serum sample data collected from 1999 to 2018.A propensity score matching model was used due to the imbalance in the number of HCV-RNAþand HCV-RNA-negative(HCV-RNA?)patients.Matched variables included gender,age,educational level,marital status,language,household size,alcohol consumption,smoking,number of family members and family income to poverty ratio.Results:The weighted prevalence of HCV-RNAþwas 1.11%(95%confidence interval(CI):1.02e1.20),1.58%(95%CI:1.42e1.74)for men and 0.67%(95%CI:0.57e0.77)for women aged 20 years or older in the US from 1999 to 2018.The weighted prevalence of HCV-RNAþincreased from 0.87%(95%CI:0.62e1.12)in 2013e2014,0.95%(95%CI:0.68e1.22)in 2015e2016 to 1.00%(95%CI:0.72e1.28)in 2017e2018,respectively.In propensity-matched analysis,patients with HCV-RNAþwere more likely to be non-Hispanic black,and have had drug use and blood transfusions.Meanwhile,the weighted diagnostic and treatment rates were 56.27%(95%CI:50.90e61.64)and 35.40%(95%CI:27.64e43.16)from 1999 to 2018,respectively.Conclusions:Active HCV infection rate increased between 2013 and 2018,varied by demographic and risk variables.In the direct-acting antiviral era,affordable treatment and universal screening have the potential to improve overall national health.展开更多
基金funded by the Basic Scientific Research Funds of Department of Education of Zhejiang Province(KYQN202103 and KYZD202103)A Project Supported by Scientific Research Fund of Zhejiang Provincial Education Department(Y202249203)+4 种基金General Program of the National Natural Science Foundation of China(61976075 to XX)the Key Research and Development Program of Zhejiang Province(2019C03002 to XX)National Innovation and Entrepreneurship Training Program for College Students(202213023011)Innovation and Entrepreneurship Training Program for College Students of Zhejiang Province(S202213023052)Zhejiang Provincial Natural Science Foundation of China under Grant No.LTGY23H180019.
文摘During the chemotherapy of tumors,the cytotoxic effect of drugs is vital to kill tumor cells,and the delivery of a chemotherapeutic agent is of great importance for optimal therapeutic effects.The high in vivo clearance rate and low delivery efficiency of conventional chemotherapeutic agents affect the therapeutic effect.In recent years,the responsive drug delivery nanosystem has received increasing concern owing to its excellent biocompatibility,stable delivery performance,and controlled drug release strategies.To lucidly explain the cytocidal and immunotherapeutic effects of such responsive nanosystems in breast cancer,this review discusses the various stimuli and responses of drug-loaded liposomal nanosystems.The light/magnetic response of drug-loaded bionic membranes nanosystems and the heat/magnetic response of drug-loaded iron oxide nanosystems are also elaborated.Their cancer cell-killing efficacy and antitumor immunotherapeutic effects are also scrutinized.
基金This work was supported by the National Natural Science Foundation of China(Nos.51904249 and 51922091)the Sichuan Science and Technology Program(No.SYZ202074)the Open Research Fund of State Key Laboratory of Complex Nonferrous Metal Resources Clean Utilization(No.CNMRCUKF2001).
文摘This paper researched the enhanced flotation separation performance of ilmenite and titanaugite using the mixed collector benzhydroxamic acid/dodecylamine(BHA/DDA).The interface assembly mechanism was mainly investigated through in situ attenuated total reflectance Fourier transform infrared(ATRFTIR)spectroscopy combined with the two-dimensional correlation spectroscopy(2D-COS)and X-ray photoelectron spectroscopy(XPS).It has been found that BHA/DDA mixed collectors successfully separate ilmenite from titanaugite at a molar ratio of 8:1.Zeta potential experiments suggested that,in the presence of mixed collector system,the BHA-DDA complex adsorbed on the ilmenite surface via the chemically adsorbed BHA and the electrostatically adsorbed DDA,however,the complex adsorbed on the surface of titanaugite unstably.According to in situ ATR-FTIR combined with 2D-COS and XPS results,the interface assembly mechanism of BHA/DDA is summarized as:the function group of BHA molecules first binds to the metal sites on minerals to form bidentate ligand,then DDA co-adsorbed with BHA on the surface of minerals through hydrogen bonding.DDA may change the adsorption modes of some BHA on the ilmenite surface from four-membered ring to five-membered ring,while the modes on the titanaugite surface is true opposite.Finally,recommended adsorption configurations of the BHA/DDA complex on the two mineral surfaces are proposed.
基金sponsored by the Shandong Natural Science Foundation of the People's Republic of China(No.ZR2022ME213,ZR2023ME081).
文摘To reveal the resonance suppression mechanism of the blood circulation in dragonfly wings,a numerical modeling method of dragonfly wings based on Voronoi diagrams is proposed,and the changes in mass,aerodynamic damping,and natural frequencies caused by blood circulation in veins are investigated.The equivalent mass of blood,boundary conditions,and aerodynamic damping are calculated theoretically.Modal analysis and harmonic response analysis of wing models with different blood circulation paths are performed using the finite-element method(FEM).The vibration reduction ratioδis introduced to compare the damping efficiency of different mass regions.Finally,a natural frequency testing device is constructed to measure the natural frequencies of dragonfly wings.The results indicate that the shape,mass,and natural frequencies of the dragonfly wing model constructed by numerical method agree well with reality.The mass distribution on the wing can be altered by blood circulation,thereby adjusting the natural frequencies and achieving resonance suppression.The highestδof 1.013 is observed in the C region when blood circulates solely in secondary veins,but it is still lower than theδof 1.017 when blood circulates in complete veins.The aerodynamic damping ratio(1.19–1.79%)should not be neglected in the vibration analysis of the beating wing.
基金financially supported by the China Postdoctoral Science Foundation(No.2018M643090)the National Natural Science Foundation of China(No.52000077)+3 种基金the National Key Research and Development Project of Research(No.2017YFC0212805)the National Natural Science Foundation of China(No.51878292)the Natural Science Foundation of Guangdong Province,China(No.2015B020236002)the China Postdoctoral Science Foundation(No.2020M682715).
文摘A facile hydrothermal method was applied to gain stably and highly efficient CuO-CeO_(2)(denoted as Cu1Ce2)catalyst for toluene oxidation.The changes of surface and inter properties on Cu1Ce2 were investigated comparing with pure CeO_(2)and pure CuO.The formation of Cu-Ce interface promotes the electron transfer between Cu and Ce through Cu^(2+)+Ce^(3+)↔Cu^(+)+Ce^(4+)and leads to high redox properties and mobility of oxygen species.Thus,the Cu1Ce2 catalyst makes up the shortcoming of CeO_(2)and CuO and achieved high catalytic performance with T_(50)=234°C and T_(99)=250°C(the temperature at which 50%and 90%C_(7)H_(8)conversion is obtained,respectively)for toluene oxidation.Different reaction steps and intermediates for toluene oxidation over Cu1Ce2,CeO_(2)and CuO were detected by in situ DRIFTS,the fast benzyl species conversion and preferential transformation of benzoates into carbonates through C=C breaking over Cu1Ce2 should accelerate the reaction.
基金the financial supports from the National Natural Science Foundation of China(No.21978251)a project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe financial supports from the National Natural Science Foundation of China(No.22102141)。
文摘The growth of dendrites in the lithium(Li)metal anode hinders the commercialization of lithium metal batteries(LMBs).Electrolyte additives have proved to be an effective way to solve the problem of dendrites and improve the coulombic efficiency.Herein,we propose a strategy of using L-tyrosine(L-Tyr)as an additive to protect the lithium metal anode in situ,where L-Tyr can be electropolymerized in situ to form an ordered array of nanosheets on the surface of the lithium metal anode to uniformly deposit lithium ions.At the same time,the addition of L-Tyr changed the structure of the solvent in the electrolyte,because the carboxyl group on L-Tyr make DME form hydrogen bonds easily.Besides,the reduction of free DME makes more TFSI-involved in the formation of the SEI film on the electrode surface,which increases the proportion of LiF in the SEI film.With 2 wt%L-Tyr,Li||Li symmetric cells superior cycle stability in ether electrolytes,Li|Cu cells y improved stability up to 200 cycles with an average CE of 93.1%in ether electrolytes and Li||Li_(4)Ti_(5)O_(12)(LTO)demonstrated an excellent cycling capabilitie with 119 mAh/g capacity retention by the 5000^(th)cycle.
基金This work was supported by the Natural Science Foundation of Guangdong Province(2018A030313652)the National Mega Project on Major Infectious Disease Prevention(2017ZX10103011).
文摘A novel coronavirus disease 2019(COVID-19)emerged around December 2019 in Wuhan,China and has spread rapidly worldwide(Lu et al.,2020).Until March 27,2020,the Chinese health authorities had reported 82082 confirmed COVID-19 cases in China with 3298 deaths and 381443 confirmed cases with 20787 deaths outside China.The World Health Organization(WHO)named the virus SARS-CoV-2,which belongs to a distinct clade from the human severe acute respiratory syndrome CoV(SARS-CoV)and Middle East respiratory syndrome CoV(MERSCoV)(Zhu et al.,2020).
基金This work was supported by the grant from Zhuhai Medical and Health Technology Project(20181117E030074)the Department of Science and Technology of Guangdong Province of China(2021A1515010458).
文摘Background and aim:Several effective antiviral drugs are now available;however,the risk of liver-related complications is still present.Low-level viremia(LLV),defined as a hepatitis B virus(HBV)deoxy-ribonucleic acid(DNA)load lower than 2000 IU/mL,is one of the major factors responsible for these complications.It has been reported that 22.7e43.1%of patients with HBV experience LLV.Herein,we aimed to explore the risk factors for very LLV(VLLV)during antiviral treatment.Methods:We collected data of patients with chronic hepatitis B(CHB)who received nucleos(t)ide analog treatment from October 2016 to April 2021.VLLV was defined as an HBV DNA load of 9e20 IU/mL.A total of 139 patients with LLV were matched with 139 patients with a sustained virological response at a 1:1 ratio according to age and gender.Results:Seropositivity rates for hepatitis B e antigen(HBeAg)(45.3%vs.17.3%,P<0.001)and hepatitis B surface antigen(HBsAg,3.11±0.68 lg IU/mL vs.2.54±1.04 lg IU/mL,P<0.001)and alanine amino-transferase levels(30.34±15.08 U/L vs.26.15±16.66 U/L,P¼0.040)in the two groups were significantly different.The multivariate analysis showed that both HBeAg seropositivity(adjusted odd ratio(aOR),3.63;95% confidence interval(CI):1.98±6.64;P<0.001)and HBsAg levels(aOR,2.21;95% CI:1.53±3.20;P<0.001)are independent risk factors for VLLV.During the multivariate analysis in the subgroup of HBeAg-positive patients,male gender(aOR,3.68;95% CI:1.23±10.76;P=0.017)and high HBsAg(aOR,4.86;95%CI:1.73e13.64;P¼0.003)levels were significantly correlated with VLLV.However,this was not the case in HBeAg-negative patients(P>0.050).HBeAg seropositivity(aOR,5.08;95% CI:2.15±12.02;P<0.001 vs.aOR,2.78;95% CI:1.16±7.00;P=0.022)and HBsAg levels(aOR,2.75;95% CI:1.41e5.37;P=0.003 vs.aOR,2.10;95% CI:1.27±3.46;P=0.004)significantly increased the risk of VLLV,irrespective of the age group.Both HBsAg(area under the receiver operating characteristic curve(AUC),0.681;95% CI:0.623±0.736;P<0.001)and HBeAg(AUC,0.640;95% CI:0.581±0.697;P<0.001)had certain pre-dictive value for VLLV.Conclusion:HBeAg seropositivity and higher HBsAg levels were not only risk factors for VLLV but also predicted its occurrence.When a patient with CHB remains HBeAg seropositive with high HBsAg levels after antiviral treatment for 48 weeks,emphasis should be placed on the potential occurrence of VLLV,warranting the use of highly sensitive HBV DNA detection methods.
基金This study was supported by the Chinese National Natural Science Foundation(Grant No.51739011 and 52192671)the Research Fund of the State Key Laboratory of Simulation and Regulation of Water Cycles in River Basins(Grant No.SKL2022TS11).
文摘Redundancy is an important attribute of a resilient urban drainage system.While there is a lack of knowledge on where to increase redundancy and its contribution to resilience,this study developed a framework for the optimal network structure of urban drainage systems that considers pipeline redundancies.Graph theory and adaptive genetic algorithms were used to obtain the initial layout and design of the urban drainage system.The introduction of additional water paths(in loop)/redundancies is suggested by the results of complex network analysis to increase resilience.The drainage performances of the urban drainage system with pipeline redundancies,and without redundancies,were compared.The proposed method was applied to the study area in Dongying City,Shandong Province,China.The results show that the total overflow volume of the urban drainage system with pipeline redundancies under rainfall exceeding the design standard(5 years) is reduced by 20-30%,which is substantially better than the network without pipeline redundancies.
基金This work was supported by grants from Natural Science Foundation of Guangdong Province (2021A1515010458) of China.
文摘Background and aim:Hepatitis C virus(HCV)infection is one of the major global health challenges,leading to a significant increase in rates of hepatic fibrosis,cirrhosis and hepatocellular carcinoma.A comprehensive nationwide survey of trends in prevalence and associated factors could facilitate pre-ventive behavioral interventions.Herein,we sought to determine prevalence,diagnosis,treatment,and risk factors for HCV infection in the general United States(US)population.Methods:This was a secondary analysis of the publicly available data from the US National Health and Nutrition Examination Survey(NHANES).The prevalence of HCV-RNA-positive(HCV-RNAþ)was weighted using patient serum sample data collected from 1999 to 2018.A propensity score matching model was used due to the imbalance in the number of HCV-RNAþand HCV-RNA-negative(HCV-RNA?)patients.Matched variables included gender,age,educational level,marital status,language,household size,alcohol consumption,smoking,number of family members and family income to poverty ratio.Results:The weighted prevalence of HCV-RNAþwas 1.11%(95%confidence interval(CI):1.02e1.20),1.58%(95%CI:1.42e1.74)for men and 0.67%(95%CI:0.57e0.77)for women aged 20 years or older in the US from 1999 to 2018.The weighted prevalence of HCV-RNAþincreased from 0.87%(95%CI:0.62e1.12)in 2013e2014,0.95%(95%CI:0.68e1.22)in 2015e2016 to 1.00%(95%CI:0.72e1.28)in 2017e2018,respectively.In propensity-matched analysis,patients with HCV-RNAþwere more likely to be non-Hispanic black,and have had drug use and blood transfusions.Meanwhile,the weighted diagnostic and treatment rates were 56.27%(95%CI:50.90e61.64)and 35.40%(95%CI:27.64e43.16)from 1999 to 2018,respectively.Conclusions:Active HCV infection rate increased between 2013 and 2018,varied by demographic and risk variables.In the direct-acting antiviral era,affordable treatment and universal screening have the potential to improve overall national health.
