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:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective To investigate whether diffusion kurtosis imaging(DKI)can be predictive in high-aggressive prostate cancer (PCa).Methods 51 patients with pathologically confirmed PCa underwent preoperative DK-MR imaging(b of 0,700,1 400 and 2 100 s/mm2).Data was post-processed by mono-exponential and non-Gauss DK model,respectively,for quantitation of apparent diffusion coefficient(ADC),apparent non-Gaussian diffusion coefficient(Dapp)and apparent non-Gauss kurtosis coefficient(Kapp). The ability of Dapp,Kapp and ADC for predicting high-aggressive(Gleason score>4+3)PCa was analyzed by ROC regression.Results There were 29 low-aggressive and 33 high-aggressive PCa on pathologic findings.High-aggressive PCa had significantly lower ADC[(0.764 ± 0.114)×10-3mm2/s vs(0.825 ± 0.116)×10-3mm2/s,P=0.004],lower Dapp[(1.212 ± 0.194)×10-3mm2/s vs (1.472 ± 0.297)×10-3mm2/s,P< 0.001],while higher Kapp(1.114 ± 0.177 vs 0.835 ± 0.192,P<0.001)than that for low-aggressive PCa.Dapp and Kapp had significantly higher sensitivity(Dapp:75.3%;Kapp:74.1%),specificity(Dapp:85.4%;Kapp:86.7%)and area under curve(AUC)(Dapp:0.889;Kapp:0.894)than that for ADC(64.1%;76.4%;0.738;P<0.01)in differentiating low-aggressive from high-aggressive PCa.Conclusion DKI can be a reliable way for predicting high-aggressive PCa.

Objective To detect the expression of advanced glycation end-products (AGEs) in the sun exposure and non-exposure skin,to observe the elastic protein in the same location,and to explore the relationship between non-enzymatic glycation reactions and,photo-aging skin morphological changes.Methods In the exposure and non-exposure specimens from 30 patients,elastic fibers were stained with Gomori staining,and immunohistochemistry for AGEs was performed.Results AGEs expressed clearly positive in all elastic fibers of degeneration markedly (+ + above) of exposure skin,and appeared line-like in markedly(+ + above)elastic fibers.While in all non-exposure skin,AGEs expressed negative.In the exposure skin with middle or old age,compared with non-exposure skin,AGEs expressed more and elastic fibers were hyperplasia with thickening,curling and irregular distribution.The skin parts of AGEs expressed accorded with where elastic fibers degenerated.Conclusions Ultraviolet radiation can induce denaturation of elastic fibers and non-enzymatic glycation may contribute to the mechanism of skin photo-aging.

The damage to the barrier of colonic mucosal epithelial cells is the fundamental cause of bacterial translocation.The tight junction among epithelial cells forms the most important constituent part of the mechanical barrier of the organism to prevent bacterial translocation from happening in the intestinal canal.The para-colonic-mucosal-epithelial-cell space is closed by protein complexes which are considered to be used for regulating the permeability between cells.ZO-1,Claudin-1 and Occludin are the most representative among the numerous protein complexes.They have become the important index to judge the damage degree of the barrier of colonic mucosal epithelial cells in test.The endotoxin is the product released by bacteria.Anti-endotoxin is one of the methods to protect the colonic mucosal barrier,to prevent and treat bacterial translocation.There are anti-endotoxin drugs.However,there has not been any drug widely recognized clinically up to now.Qingyi Decoction and Chaiqin Chengqi Decoction are the traditional Chinese medicine with the function of protecting the intestinal mucosal barrier and suppressing the transloeation of enteric bacteria.Oxymatrine has many pharmacological effects such as anti-bacterial,anti-inflammatory and immunoragulation.The recent animal experiments showed that oxymatrine has protective effect on the intestinal mucosa during severe infection.However,the mechanism of the drug action has not been completely known and needs to be studied in depth.Our traditional Chinese medicine applies extensively in clinical application of the prevention of the damage to the colonic mucosal epithelial cells during severe infection.

Objective To investigate the application value of breast scale membrane marking method to locate breast tumor lesion in neoadjuvant chemotherapy.Methods Before neoadjuvant chemotherapy for 120 cases of breast cancer,adopt scale membrane marking method was used to mark the position and boundaries of breast tumor lesion in the mean time.For non-protuberant breast tumor lesion,scale membrane was adhered directly to the breast and positive mark was made.For tumor lesion with vague boundaries,its boundaries was defined under the direction of ultrasound.For protuberant breast tumor lesion,scale membrane was only adhered to normal mammary skin beyond the tumor lesion and reverse mark was made.After two courses of treatment of TEC scheme,mark was made again and combined with ultrasound,molybdenum target and MRI results to comprehensive judgment of clinical curative efficacy so as to decide whether operation or change to TP scheme for continuous chemotherapy.Before operation,the first marking results were reset and then operation was conducted according to the position and boundaries of the marked tumor lesion.Results There were 26 cases of complete remission,76 cases of partial remission,10 cases of stabile disease and 8 cases of progressive desease.According to mark by scale membrane,breast conserving operations were conducted in 24 cases of complete remission and in 18 cases of partial remission according to position+ boundaries of the tumor lesion and tumor lesion position+ 1.5-2.0 cm beyond the original boundaries of tumor lesion marked by scale membrane,respectively.The simplified radical mastectomy was conducted in other 78 cases according to boundaries of the tumor lesion marked by scale membrane,in which 13 cases had insufficient locally advanced skin edges and adopted abdominal full-thickness free skin flap to cover the wound.Conclusion Tumor lesion location in neoadjuvant chemotherapy for breast cancer and scale membrane positioning method have the advantage of precision and non-invasion,which effectively save normal breat tissues and skin around tumor lesion with high patient compliance and tremendously outmatches traditional coordinate method,body surface tattoo method and mental marker method.Scale membrane marking method is easy to be operated with low cost,which is convenient for popularization and generalization.

Objective We invented mammary lump skin-positioning membrane (named scare membrane) to facilitate localization of mammary lump during ultrasound scan.This study is to measure the radius of mammary of Chinese adult women for designing different types of skin-positioning membrane.MethodsThe radius of mammary glands in 236 cases of adult females was detected with color Doppler ultrasound at 5 different clock positions:12:00,3:00,6:00,9:00 and 10:30 or 1:30.SPSS 16.0 statistical software was used to analyze the data.The cut-off values of mammary glands radius at 99％,95％,75％ and 50％ were calculated.Paired t tests or nonparametric tests (relative sample rank sum tests) were used to verify the consistency of mammary gland radius between left and right sides.ResultsThe cut-off value of 95％ mammary gland radius was:7.700cm at 12:00,7.810 cm at 13:00,8.100 cm at 3:00,5.330 cm at 6:00 and 6.300 cm at 9:00 for left mammary gland ; 7.500 cm at 12:00,6.015 cm at 3:00,5.500 cm at 6:00,8.510 cm at 9:00 and 7.930 cm at 10:30 for right mammary gland.In comparison of left and right mammary gland radius,the difference had statistical significance between the group of left side at 1:30 and right side at 10:30,the group of left side at 3:00 and right side at 9:00(P ＜0.05).The right mamma was relatively larger.The cut-off values of the right mamma at the above two clock points were taken as radius of scale membranes while the average of percentage cut-off values at 12:00,3:00 of both mammas,left side at 9:00 and right side at 3:00 are taken as radius of scale membranes.ConclusionsAccording to the cut-off values of 99％,95％,75％ and 50％ radius of adult female mammary glands,mammary lump skin-positioning membrane radius can be classified into 4 size-types:extra large,large,medium and small.The precise classification of radius of mammary scale membranes according to mammary glands of adult females provides convenience for production,manufacture and clinical application of mammary lump skin-positioning membrane.

Objective To develop an LC-MS/MS method for determining the concentration of wogonin in dog plasma and investigate the pharmacokinetics and bioavailability by different administrations of wogonin in Beagle's dogs. Methods LC-MS/MS was employed in determining the concentration of wogonin with the selected ion monitoring model after liquid-liquid extraction with ethyl acetate of dog plasma samples. The lower limit of quantification was 0.105 μg/L. Target ions were at m/z 285.0→270.0 for wogonin and 373.3→305.3 for finasteride. In a randomized, self-control, and cross-over study, six male Beagle's dogs were treated with different administration methods in three test periods. Pharmacokinetic parameters were calculated with DAS software (Ver. 2.0). Results The calibration curve was linear in the range of 0.105-107.36 μg/L for wogonin in dog plasma samples. The main pharmacokinetic parameters of ig administration (native drug of 15 mg/kg and solution preparation of 5 mg/kg) and iv route were as follows: Cmax (2.5 ± 1.1), (7.9 ± 3.3), and (6838.7 ± 1322.1) μg/L, tmax (0.7 ± 0.3) and (0.3 ± 0.2) h for the both former, AUC0-1 (7.1 ± 2.0), (21.0 ± 3.2), and (629.7 ±111.8) μg·h/L. The absolute bioavailability of native and solution of wogonin were (0.59 ± 0.35)% and (3.65 ± 2.00)%, respectively. Conclusion The validated method is convenient, sensitive, and specific, and the improvement of wogonin solubility could remarkably increase the absolute bioavailability.

Objective To explore the significance of palpation-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction.Methods 46 cases of small breast tumors with the diameter from 0.5 cm to 1.0 cm were double labeled with methylene blue under the guide of ultrasound l hour preoperatively.The tumors were fixed,drew outward with percutaneous suture and resected accurately.All the 46 cases were rechecked by ultrasound to verify whether residual or false resection occurred 1 month later.Results All the 58 tumors of the 46 patients were accurately resected.No residue or false resection occurred.The average operation duration was 10 min to 20 min.Conclusion Palpable-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction has the advantages of small invasion,accurate positioning and short operation duration.