In the context of global climate change, the impact of ambient temperature change on cardiovascular health has become increasingly significant. Epidemiological studies have shown that both high and low temperature can lead to the occurrence of adverse cardiovascular outcomes. For example, exposure to low temperature and high temperature, and diurnal temperature difference can increase the risk of cardiovascular diseases (CVD) mortality. Exposure to cold and heat, heatwaves and cold spells may induce myocardial infarction. Low temperature, high temperature and variations in temperature can increase the risk of heart failure. There are complex interactions among the effects of temperature and humidity, wind speed, radiation, precipitation and air pollution on adverse cardiovascular outcomes. Valnerable groups such as the elderly, patients with chronic diseases, and outdoor workers are particularly susceptible to temperature-related CVD risks. The mechanisms by which temperature affects adverse cardiovascular outcomes involves hemodynamic changes, autonomic nervous system dysregulation, blood rheology alterations, as well as inflammation and metabolic abnormalities, but many research gaps remain. Future studies should conduct in-depth research on mechanisms, individual differences, climate change impacts, and public health interventions to provide more effective policies and interventions to reduce the burden of CVD.

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 mechanism of Zuogui Pills (ZGP) on improving the stemness of ovarian germline stem cells (OSCs) in ovarian aging rats through the gap junction protein connexin 43 (Cx43) phosphorylation based on the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway. Methods Eight-week-old female SD rats were randomly divided into control(CON),model(cyclophosphamide,CTX),ZGP and dehydroepiandrosterone(DHEA) groups,six rats in each group. CTX was injected intraperitoneally for 15 days to establish a model for ovarian aging,and then ZGP (1.85 g·kg-1) or DHEA (8.1 mg·kg-1) was administered by gavage once daily for 30 days. Follicle count at different stages and pathological changes of ovarian tissues were observed by HE staining. ELISA was used to detect serum levels of anti-mullerian hormone (AMH),follicle-stimulating hormone (FSH),and estradiol(E2). The expression levels of related proteins (PCNA,MVH,Oct4,Cx43,p-Cx43,EGFR,AKT、p-AKT) in ovarian tissue were detected by Western Blot. Results Compared with the CON group,rats in CTX group had significantly reduced body mass(P<0.05) and ovarian mass(P<0.05). The number of primordial follicles decreased significantly(P<0.01). Serum FSH level increased remarkably(P<0.01),while AMH and E2 levels showed a downward trend (P>0.05). The protein expressions of Oct4,MVH,PCNA,EGFR,p-AKT/AKT,p-Cx43(Ser368)/Cx43 and Cx43 in ovarian tissue were obviously decreased(P<0.05,P<0.01). Compared with the model group,the body mass of rats in ZGP group was significantly increased (P<0.05),as well as ovarian mass and ovarian coefficient were remarkably increased (P<0.01). The number of primordial follicles were increased significantly (P<0.01),and E2 level increased significantly (P<0.05). The protein expressions of Oct4,MVH,PCNA,EGFR,p-AKT/AKT,p-Cx43(Ser368)/Cx43 and Cx43 in ovarian tissue were all increased significantly (P<0.05,P<0.01). Conclusion ZGP may ameliorate ovarian aging by maintaining the stemness of OSCs. Its mechanism of actions is related to the PI3K/AKT signaling pathway and gap junction protein phosphorylation.

Objective:To systematically review the correlation between frailty and postoperative adverse outcomes in ovarian cancer patients.Methods:The research on frailty and postoperative adverse outcomes in ovarian cancer patients was systematically searched in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine. The search period was from database establishment to March 27, 2023. Two researchers independently conducted literature screening, quality evaluation, and data extraction, and conducted Meta-analysis using Stata 15.0 software.Results:A total of 17 studies were included. Meta-analysis showed that frailty increased the risk of total postoperative complications [ OR=1.84, 95% CI (1.53, 2.21), P<0.001], severe postoperative complications [ OR=2.34, 95% CI (1.80, 3.03), P<0.001], postoperative 30 day mortality [ OR=1.96, 95% CI (1.68, 2.28), P<0.001], and decreased overall survival [ OR=1.45, 95% CI (1.24, 1.69), P<0.001] in ovarian cancer patients, and it also increased the risk of Intensive Care Unit (ICU) transfer rate [ OR=2.11, 95% CI (1.97, 2.26), P<0.001], non-home discharge [ OR=1.57, 95% CI (1.48, 1.67), P<0.001], and readmission 30 days after surgery [ OR=1.12, 95% CI (1.03, 1.21), P=0.009]. Subgroup analysis showed that age, frailty assessment tools, and whether or not covariates were corrected had no effect on outcomes. Sensitivity analysis showed that all results were reliable. Conclusions:Frailty is a risk factor for postoperative complications, postoperative 30 day mortality, poor overall survival, ICU transfer rate, non-home discharge, and readmission 30 days after surgery in ovarian cancer patients. However, the research findings still need to be further validated through large-scale prospective cohort studies.