Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:To investigate the effect of sevoflurane and propofol on cognitive function, respiratory and circulatory function, and stress response in patients undergoing laparoscopic radical gastrectomy.Methods:A prospective randomized controlled study was conducted. A total of 116 patients who underwent laparoscopic radical gastric cancer surgery in Liangshan Yi Autonomous Prefecture Hospital of Integrated Chinese and Western Medicine from January 2021 to January 2022 were selected, and all patients were divided into the propofol group and the sevoflurane group according to the random number table method, with 58 cases in each group. Propofol anesthesia was used in the propofol group and sevoflurane anesthesia was used in the sevoflurane group. The anesthesia-related indexes and respiratory and circulatory function indexes, oxidative stress parameters and cognitive function indexes neuron-specific enolase (NSE) levels, Mini-Mental State Examination (MMSE) scale score, and complications at different time points were compared between the 2 groups.Results:There were no statistically significant differences in the baseline data between the 2 groups (all P > 0.05). The differences in intraoperative bleeding, pneumoperitoneum time and anesthesia onset time between the 2 groups were not statistically significant (all P > 0.05); eye opening time [(13.2±2.6) min vs. (17.6±3.7) min] and respiratory recovery time [(12.6±2.2) min vs. (16.5±2.3) min] of patients in the sevoflurane group were shorter than those in the propofol group, and the differences were statistically significant ( t values were 7.41 and 9.31, respectively, both P < 0.001). Repeated measurement analysis of variance showed that the temporal, intergroup and temporal-intergroup interaction differences in heart rate, mean arterial pressure and oxygen saturation before induction of anesthesia, immediately after induction of anesthesia, and at the time of anesthesia duration of 10 min, anesthesia duration of 20 min, and anesthesia duration of 30 min between the propofol group and the sevoflurane group were not statistically significant (all P>0.05). The temporal, intergroup and temporal-intergroup interaction differences in the oxidative stress indexes of blood glucose, adrenaline, adrenocorticotropin, and cortisol between the 2 groups were statistically significant (all P < 0.001). The levels of blood glucose, epinephrine, adrenocorticotropin and cortisol in the sevoflurane group were lower than those in the propofol group immediately after induction of anesthesia, and at the time of anesthesia duration of 10 min, anesthesia duration of 20 min, and anesthesia duration of 30 min. The level of NSE before anesthesia in the propofol group and the sevoflurane group was (6.6±0.8) ng/ml and (6.5±0.7) ng/ml, respectively, and there was no statistically significant difference ( P > 0.05). The level of NSE in the sevoflurane group was higher than that in the propofol group immediately after surgery [(8.9±0.8) ng/ml vs. (8.2±0.9) ng/ml], 6 h after surgery [(10.2±1.2) ng/ml vs. (9.5±1.0) ng/ml], and 24 h after surgery [(9.3±1.1) ng/ml vs. (8.2±0.9) ng/ml] and 48 h after surgery [(8.7±0.9) ng/ml vs. (8.1±0.9) ng/ml]; and there were temporal, intergroup and temporal-intergroup interaction differences in NSE level of the 2 groups (all P < 0.001). The MMSE score in the sevoflurane group was lower than that in the propofol group immediately after surgery, 6 h after surgery, 24 h after surgery, 48 h after surgery, the temporal, intergroup and temporal-intergroup interaction differences in MMSE scale score of the 2 groups were statistically significant (all P < 0.001). The incidence of postoperative complications in the propofol group and the sevoflurane group was 24.1% (14/58) and 25.9% (15/58), respectively, and the difference was statistically significant ( χ2 = 2.12, P = 0.833). Conclusions:Sevoflurane and propofol anesthesia have no significant effect on the respiratory and circulatory functions of patients undergoing laparoscopic radical surgery for gastric cancer, whereas propofol has a smaller effect on cognitive functions, and sevoflurane inhibits oxidative stress better. Both of them are worthy of clinical application.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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Systemic light-chain(AL)amyloidosis has an insidious onset and diverse clinical manifestations with high early mortality and can be easily overlooked or misdiagnosed in the elderly.Early diagnosis and deep remission are critical for the long-term survival of AL amyloidosis patients.This article provides a systematic review of the current status of treatment and progress in new drugs for AL amyloidosis.

To compare changes in platelet related parameters in obese patients before and after sleeve gastrectomy (SG), we retrospectively analyzed the clinical data of 31 obese patients who underwent SG in Peking Union Medical College Hospital from December 2012 to September 2020. Results showed that compared with those before surgery, platelet count (PLT) decreased significantly at 2-12 weeks of follow-up ( P=0.009), while platelet distribution width (PDW), mean platelet volume (MPV), and large platelet ratio (P-LCR) increased significantly at the same periods of follow-up after operation ( P<0.001). However, the levels of PDW, MPV, and P-LCR began to decrease at 16-55 weeks when compared with those at 2-12 weeks of follow-up ( P<0.01). PLT was positively correlated with white blood cells and neutrophils at 2-12 weeks of follow-up and positively correlated with high sensitivity C-reactive protein at 16-55 weeks of follow-up after operation ( P<0.05).

Body composition measurement could significantly facilitate evaluating the content of various body components,getting information about the health status and assessing the diagnosis,treatment,test,and prognosis of several diseases.Human health will be seriously affected by the imbalance of body composition.Body composition measurement methods are generally divided into local measurement methods and general measurement methods.The former ones include skinfold thickness measurement,ultrasonic measurement,computed tomography and nuclear magnetic resonance measurement;while the latter ones include anthropometry,underwater weighing measurement,air displacement measurement,biological resistance measurement,near infrared absorption measurement,dual-energy X-ray absorptiometry measurement,isotope dilution measurement,potassium isotope measurement and three-dimensional body scanning measurement,etc.This article reviews a variety of body composition measurement methods and their clinical application.

OBJECTIVE:To prepare and evaluate the quality of Quetiapine fumarate solid lipid nanoparticles(QF-SLN)in situ nasal gel. METHODS:With the oil phase of dissoned glycerin monostearate,emulsifier of sorbitan oleate,and co-emulsifier of n-butyl alcohol,the proportion of emulsifier and co-emulsifier (Km) was screened by ternary phase diagrams. QF-SLN was pre-pared through the micro-emulsion technology,the gelling temperature was set as index,the mass fraction of poloxamerln 407 (P407)and P188 of in situ gel formulation was optimized by the central composite design-response surface methodology. in situ for-mation of QF-SLN was examined by transmission electron microscope,the particle size and potential distribution were determined by Malvern laser granularity equipment,and the encapsulation efficiency and stability were determined by the ultrafiltration centri-fuge tube and HPLC. RESULTS:The formulation of solid lipid nanoparticlesl was biggest at Km=1∶9. The optimized formulation was with 21% P407,5.6% P188 and 73.4% water. The prepared QF-SLN in situ nasal gel was uniform sphere,with an average particle size of (136.3 ± 6.4) nm and encapsulation efficiency of (97.60 ± 0.48)%. There were no obvious changes in the particle size and entrapment efficiency at 4℃within one month. CONCLUSIONS:The QF-SLN in situ nasal gel is successfully prepared.

Objective To investigate the risk factors of reoperation in patients with Crohn's disease recurrence.Methods The clinical data of 108 patients with Crohn's disease who were admitted to the Peking Union Medical College Hospital from March 2004 to September 2013 were retrospectively analyzed.Of the 108 patients,82 received single operation and 26 received reoperation.Twenty-five factors which might influence the reoperation were analyzed,which were gender,age,blood type,preoperative levels of white blood cells,neutrophils,lymphocytes hemoglobin,albumin,prealbumin,high sensitive-C reactive protein (hs-CRP),anti-saccharomyces cerevisiae antibody (ASCA),anti-neutrophil cytoplasmic antibody (ANCA),location and type of the lesions,extraintestinal manifestation,perianal lesions,history of smoking,appendectomy,course of the disease before the first operation,pre-operative administration of immunosuppressants,body mass index (BMI) before the first operation,onodera prognostic nutrition index (OPNI),enteral nutrition,emergent operation,complications after the first operation.The univariate analysis was done using the chi-square test or Fisher exact probability,and the multivariate analysis was done using the Logistic regression model.Results The results of univariate analysis showed that the level of preoperative prealbumin,hs-CRP,location and type of the lesion,the history of smoking,preoperative administration of immunosuppressants,enteral nutrition before the first operation were the risk factors of reoperation in patients with Crohn's disease (x2=5.928,4.805,7.491,12.363,5.229,9.026,16.506,P ＜ 0.05).The results of multivariate analysis showed that the lesion located at the ileocolon,administration of immunosuppressants prior to the first operation for 1 year and energy provided by enteral nutrition under 500 kcal/d before the first operation were the independent risk factors of reoperation (OR =1.908,3.535,5.489,95％ confidence interval:1.035-3.518,1.087-11.494,1.816-16.590,P＜0.05).Conclusions Patients with lesions located at the ileocolon,administration of immunosuppresants prior to the first operation for 1 year and energy provided by enteral nutrition under 500 kcal before the first operation have higher risk of Crohn's disease recurrence and reoperation.

Objective To explore self-emulsifying particle size characterization methods and compare the regularity of various methods. Methods By setting the clarity level of turbidity standard solution, with two less soluble drugs-diterpene lactone compounds Chuanhuning and dihydropyridine drug nifedipine as model drugs, 10-12 clarity level prescriptions were selected from six different ternary phase diagram. Laser particle size scanner was used to determine the particle size, and UV-visible spectrophotometry to determine its absorbance. Three methods of particle size characterization rules were compared by drawing charts. Results There was a positive correlationship among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in the same phase diagram. But, there was no regularity among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in different phase diagram. Conclusion The droplet particle size of emulsion formed by prescription containing the same drugs and excipients in different proportions can be compared by clarity with visual method or absorbance with UV-visible spectrophotometer.

Objective To explore the antidepressant effects of low dose fisetin combined with piperine and its possible mechanism. Methods The tail suspension test and the forced swimming test were used to explore the antidepressant ef-fects of low dose fisetin combined with piperine. In addition, the locomotor activity test was used to exclude the false positive effect in behavioral despair tests. High performance liquid chromatography (HPLC) was used to determine the expression of monoamine. The monoamine oxidase activity in the mouse brain was also determined by fluorospec-trophotometry. Results The results showed that fisetin (1.25 mg/kg, 2.5 mg/kg and 5 mg/kg, ig) combined with piperine (2.5 mg/kg, ip) significantly reduced the duration of immobility in both tail suspension and forced swimming tests. The effective doses did not alter locomotor activity. Moreover, neurochemical assays showed that its produced an increase in monoamine levels in the hippocampus, fronal cortex and amygdala. Monoamine oxidase (MAO) activity in the mouse brain was inhibited while MAO-B activity was not affected. Conclusion These findings suggestde that low dose fisetin combined with piperine exerted antidepressant effect in behavioral despair tests and the underlying mechanism may in-volve the inhibition monoamine oxidase activity in the mouse brain.