Objective: To investigate the effects of different doses of aspirin on the early osteointegration of titanium alloy implants in the femurs of rats to provide a reference for dental implantation in patients who take aspirin. Methods : Forty-eight 8-week-old SD male rats were randomly divided into four groups, namely, the control, A, B, and C groups. Forty-eight Ti-6Al-4 V implants with a diameter of 1.4 mm and a length of 6 mm were implanted at the distal end of the right femur. In the A, B, and C groups, dosages of aspirin of 8.93 mg/kg/d, 17.86 mg/kg/d, and 26.79 mg/kg/d were administered by gavage starting on the day of surgery, and the control group was given similar doses of 0.9% saline. HE, Masson, BMP-2 immunohistochemical and TRAP staining evaluations were performed in the 2nd and 4th weeks after surgery. Results : Compared with the results in the control group, the HE staining results showed that the amount of new bone formation was reduced, the trabeculae were more sparse, and the bone marrow cavity was enlarged around the implants in the B and C groups, with the C group showing the most obvious effects. The Masson staining results showed that, compared with that in the control group, the red-stained area in the new bone tissue around the implant was reduced in groups B and C, and the reduction in group C was more significant. However, there was no significant difference between group A and the control group. The BMP-2 staining results indicated that the expression of BMP-2 was not significantly different between the control group and the A group (P > 0.05), and the expression in group C was lower than that in the other groups (P < 0.05). The TRAP staining results demonstrated that the number of positive cells per unit area was decreased sequentially in the control, A, B, and C groups, and the difference was statistically significant (P < 0.05). Conclusion Aspirin may reduce the formation of bone tissue by inhibiting the activity of osteoblasts and expression in osteoclasts. This effect on osteogenesis was aspirin dose-dependent, and large doses of aspirin can inhibit osteogenesis more significantly.

OBJECTIVE: To investigate the association between health related quality of life (HRQoL) and severity of depression in patients with major depressive disorder (MDD). METHODS: Short Form 36 Health Survey Questionnaire (SF-36) was administered to 103 MDD patients at the baseline and 6-week follow-up. Hamilton Depression Rating for Depression (HAMD) and Clinical Global Impression (CGI) were administered at the baseline, 2- and 6-week follow-up, respectively. RESULTS: All SF-36 component scores in the 6-week follow-up were significantly higher than those at the baseline (P<0.01). The overall and subscale scores of HAMD except weight and CGI scores at the 2- and 6-week follow-up were significantly lower than those at the baseline (all P<0.01). The role-emotion score of the clinical remission group was significantly lower than that of the non-remission group. After a 6-week antidepressant treatment, all SF-36 component scores in both groups were significantly higher than those at the baseline, except body pain in the non-remission group. While scores of role-physical, general health, vitality, social functioning, role-emotion and mental health were significantly higher in the remission group than those in the non-remission group (P<0.05 or P<0.01). A higher overall score of HAMD, scores of cognitive disturbance and CGI were significantly associated with a worse SF-36 at the baseline (P<0.05 or P<0.01). After the 6-week treatment, a worse health transition was significantly associated with higher scores of HAMD and sleep disturbance at the baseline (P<0.01), a worse general health and role-emotion were strongly associated with higher score of anxiety/somatization at the baseline (both P<0.05). Score of general health was positively associated with reduction rate of cognitive disturbance at the 2-week endpoint (P<0.05) and scores of vitality and reported health transition were positively associated with the reduction rate of sleep disturbance at the 2-week endpoint (both P<0.05). CONCLUSION The increasing severity of depression was significantly associated with a worse HRQoL in patients with MDD. A 6-week antidepressant treatment may result in comparable HRQoL improvements. The components of HRQoL vary with severity of various symptoms of depression at the baseline and their early improvement after the treatment.
Adolescent ; Adult ; Antidepressive Agents ; therapeutic use ; Cognition Disorders ; drug therapy ; etiology ; Depressive Disorder, Major ; complications ; drug therapy ; psychology ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Young Adult

Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.

Objective:To study the agreements between transperineal ultrasound (TPUS) and endoanal ultrasound in assessing obstetrics anal sphincter injury (OASI), and to analyse the diagnostic efficacy of OASI in predicting AI relationship between OASI and anal incontinence (AI).Methods:A total of 217 women were prospectively recruited from the clinic in the Second Xiangya Hospital of Central South University from January 2021 to May 2022. Symptoms of AI were determined using the St Mark′s Incontinence Score (SMIS). TPUS and EAUS were performed by the same operator with the same machine on every participant for detecting OASI: OASI grades 3a, 3b, 3c, and 4 were performed according to the extent of the injuries in the anal sphincter complex. The angle of the defect in the external anal sphincter (EAS) was measured. A "significant EAS defect" was diagnosed as a defect affecting at least 2/3 of the length of the EAS with a defect angle of ≥30° in each slice.Ultrasound findings were compared between the two methods. The diagnostic efficacy of "ultrasound OASI" in predicting AI was analysed by logistic regression.Results:Of 217 women, twenty-eight (12.9%) suffered from AI with SMIS ranging from 5~20(11.9±4.5). On TPUS, 79 (36.4%) cases were suspected of OASI, that was 50 OASI 3a, 13 OASI 3b, and 16 OASI 3c/4. On EAUS, 78 (35.9%) cases were suspected of OASI that was 23 OASI 3a, 22 OASI 3b, 15 OASI 3c, and 18 OASI 4. Twenty-four "significant EAS defects" were diagnosed by TPUS and twenty-eight by EAUS, TPUS had excellent agreement with EAUS (weighted Kappa=0.91, P<0.001). Logistic regression analysis showed that "ultrasound OASI" was associated with AI symptoms. ROC curve analysis showed that the area under the curve (AUC) was 0.92, 0.87, 0.89, 0.92 for TPUS OASI 3b+ , EAUS OASI 3b+ , TPUS "Significant EAS defect" , and EAUS "Significant EAS defect" for predicting AI, respectively. Conclusions:TPUS has good agreement with EAUS in detecting OASI. OASI 3b+ and "significant EAS defect" on TPUS and EAUS had good performance in predicting AI symptoms.

Objective To analyze driver genes status and its clinical characteristics of advanced lung adenocarcinoma, then evaluate the status of first-line treatment in a single centric real-world. Methods EGFR, ALK, ROS-1 gene in 204 advanced lung adenocarcinoma tissue were tested by ARMS-PCR method. And the relationship between driver genes status and clinical characteristics was analyzed as the first line treatment in real clinical practice. Results The positive rate of driver genes status in 204 advanced lung adenocarcinoma was 53.9％ (110/204) , including EGFR mutation 46.1％ (94/204) , ALK positive 6.4％ (13/204) and ROS1 positive 1.5％ (3/204). The driving genes status was significantly correlated with gender, smoking history, tumor staging and serosal invasion (P < 0.05). There were significantly differences among the proportion of first-line standard treatment in different subgroup (P = 0.000) , the first-line standard treatment rate of EGFR mutation, ALK/ROS1 positive and drive gene negative were 77.7％, 37.5％, and 46.8％ respectively. And the ratio of using 1 st generation EGFR-TKIs in all patients is 70.6％ (60/85). Conclusion More than half of advanced lung adenocarcinoma have driver genes changes, and EGFR-TKI first-line treatment has higher acceptability in real-word.

Objective The prediction of the fatality rate of COVID-19 pandemic is of great significance for in-depth understanding of the severity of the new coronavirus,rational allocation of medical resources,and targeted epidemic prevention strategies.Methods This study divides the development of the epidemic into four periods based on the dominant strain of the new coronavirus variant.Six countries including the United States,India,Brazil,Mexico,Peru,China,and the global average case fatality rate were selected as study subjects.Six models including the Grey Model,Exponential Smoothing Model,ARIMA,SVM,Prophet and LSTM are used for fitting and forecasting,the advantages,disadvantages and applicability of each model are discussed,and the model with the best effect is selected to forecast the fatality rate in the world and key countries.Results Model comparison shows that various models have their own advantages and disadvantages.It is predicted that the growth rate of the cumulative number of confirmed cases and cumulative deaths in most countries has slowed down,and the development trend has gradually stabilized.Conclusion The study suggests that traditional time series model is suitable for the prediction of stable development trend and limited samples,and the machine learning model is more suitable for fluctuating data,which can be used for large sample predictions.Depending on the features of these models,application can be extended to other fields.

Purpose To study the association between ultrasonography signs of midurethral sling(MUS)and postoperative bladder neck mobility,and urethral segmental mobility,to explore ultrasound parameters that measure the biomechanical effects of MUS and to analyze the relationship between them and the clinical outcomes.Materials and Methods This was a retrospective analysis of the clinical material and ultrasound imaging data of the patients who underwent MUS surgery and had postoperative clinic follow-up in the Second Xiangya Hospital,Central South University,from September 2017 to July 2022.According to the surgical outcome,all patients were divided into three groups:stress urinary incontinence(SUI)cure group,SUI recurrence group and postoperative voiding dysfunction(VD)group.Bladder neck mobility,urethral segmental mobility,MUS position,and sling-pubic gap(SPG)during maximal Valsalva manoeuvre were measured by pelvic floor ultrasound.Ultrasound results among the three groups were compared,respectively.The relationships between ultrasound signs of the sling(MUS position and SPG),bladder neck and urethral mobility,and the surgical outcomes were analyzed,respectively.Results A total of 117 women had valid data.The median follow-up interval was 10(6,18)months.On clinical examination and diagnosis,44 women(37.6％)had cured SUI,46(39.3％)had recurrence SUI,and 27(23.1％)had postoperative VD.The mean SPG of the 117 slings was(12.0±3.5)mm(range 4.7 to 23.0 mm),and the mean position of the MUS was the 53％(range 33％-75％).There was no significant difference in MUS position and SPG between the SUI cured group and the postoperative VD group(P＞0.05).The SUI recurrence group had farther MUS position[(56±11)％vs.(49±10)％,P=0.003]relative to the bladder neck and wider SPG[(13.9±3.7)mm vs.(11.2±2.7)mm,P＜0.001]than SUI cure group.No significant correlation was found between the ultrasound signs of MUS(MUS position and SPG)and bladder neck mobility(r=-0.138-0.205,all P≥0.05).MUS position and SPG were correlated with midurethral mobility(MUS position vs.point 2 and 3,r=0.322,0.322,both P＜0.01;SPG vss.point 3 to 6,r=0.288-0.434,all P＜0.01):the closer the MUS position was relative to the distal urethra,the higher the midurethral mobility.The wider the SPG,the higher the midurethral mobility.Logistic regression showed a positive correlation between SPG and SUI recurrence with an odds ratio(OR)of 1.401(95％CI 1.189-1.652,P＜0.001),and a negative correlation with postoperative VD with an OR of 0.755(95％CI 0.627-0.909,P=0.003).Conclusion SPG during the Valsalva manoeuvre can be used to measure the tightness of MUS.The larger the measured value of SPG,with the looser the MUS,the greater the likelihood of postoperative SUI recurrence,and the lower the risk of postoperative VD.

Objective To propose strategies for developing clinical predictive models,aiming to assist researchers in conducting standardized clinical prediction model studies.Methods Literature review was conducted to summarize the operational steps and content for developing clinical predictive models.Then,a methodological framework was summarized and refined through expert consultation.Results The 11-step methodological framework for developing clinical predictive models was obtained by synthesizing the experience of 456 clinical predictive modeling studies and expert consultation,and the details were analyzed and elaborated.Conclusions This study presents methodological strategies and recommendations for the development of clinical predictive models,intended to serve as a guide for researchers.

Clinical comprehensive evaluation of drugs is an important technical tool for drug supply assurance decision - making，which requires evaluation subjects to use multiple evaluation methods and tools to carry out a comprehensive evaluation of multi-dimensional and multi -level evidence for drugs . Multi-criteria decision analysis （MCDA）is an important method for clinical comprehensive evaluation of drugs ，including weight assignment and comprehensive evaluation . Step-wise weight assessment ratio analysis（SWARA）is a weighting method for MCDA ，which can determine indicator weight concisely and accurately compared to other methods . This paper introduces the method of SWARA ，and systematically reviews the application of SWARA in the comprehensive clinical evaluation of drugs . Currently，the SWARA method is used in various research areas . Within the field of pharmaceuticals，researchers use the SWARA method to build MCDA models and calculate specific weight values for each drug evaluation criterion by consulting a team of experts . The advantage of SWARA is that it provides a brand -new way of assigning the weight of drug evaluation criterion by consulting experts ’opinions or judgments according to corresponding steps to solve the MCDA problem in the medical field ；however，it has certain subjectivity and uncertainty in solving complex decision -making problems，and there may also be problems such as insufficient screening of evaluation criterion and incomplete coverage of topics ， which should be paid attention to in application .