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.

Peripherally-induced movement disorders (PIMD) are a group of involuntary movements that emerge after an injury to a body part outside the central nervous system. The phenomenology of PIMD encompasses both hyperkinesia and hypokinesia involving multiple parts of the body. The diagnosis of this disease mainly relies on the temporal and spatial relationship between peripheral injuries and movement disorders. The etiology, pathogenesis and treatment of PIMD have been a matter of debate. This article will review the clinical features, classification, diagnosis, treatment and possible pathogenesis of PIMD, and discuss the limitations and controversies of PIMD-related researches, aiming to advance the understanding of PIMD and avoid clinical misdiagnosis.

Objective To investigate the acoustic characteristics of speech prosody in patients after stroke and to select sensitive acoustic parameters of speech prosody.Methods A total of 30 patients after stroke(stroke group)and 30 healthy adults of similar age(control group)were collected.Both groups read short texts aloud,and each syllable and pause of all short sentences in the whole text were recorded under the spectrogram.Acoustic analysis was performed on the inter-rogative sentence"What do you want to buy for your grandson's birthday?"and the stressed sentence"I want to buy toys!"The rhythm(unnatural pause number,speech rate,articulation rate),intonation(whole sentence fundamental frequency,fundamental frequency standard deviation and fundamental frequency slope of interrogative sentences,boundary tone funda-mental frequency and fundamental frequency slope of interrogative sentences,fundamental frequency and fundamental fre-quency slope of four tones),and stress(average intensity of stressed syllables,peak intensity,and stressed syllables dura-tion)of speech prosody were analyzed and compared between the two groups.Results The unnatural pause number and the stressed syllables duration in the stroke group were significantly higher than those in the normal control group(P＜0.01).The speech rate,articulation rate,whole sentence fundamental frequency standard deviation,whole sentence funda-mental frequency slope,and fourth tone fundamental frequency slope in the stroke group were significantly lower than those in the normal control group(P＜0.01).The boundary tone fundamental frequency slope of interrogative sentences and the third tone fundamental frequency slope were significantly lower than those in the normal control group(P＜0.05).Conclu-sion Patients after stroke have poor rhythm control,manifested as excessive pauses and slow speech rate;insufficient into-nation expression,manifested as insufficient interrogative sentence tone,and poor control ability of the third and fourth tones;compensatory expression of stress,characterized by prolonging the expression time of stressed syllables.

Objective:To evaluate the effect of esketamine combined with ultrasound-guided dorsal penile nerve block (DPNB) on negative postoperative behavioral changes (NPOBCs) in pediatric patients undergoing circumcision under general anesthesia.Methods:One-hundred and ninety-five pediatric patients, aged 4-8 yr, with body mass index of 10-35 kg, of American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ, undergoing elective circumcision under general anesthesia, were selected and divided into 3 groups ( n=65 each) using a random number table method: esketamine group (group E), DPNB group (group D) and esketamine combined with DPNB group (group ED). Propofol 1.5 mg/kg was intravenously injected, and the patients were admitted to the operating room after consciousness disappeared in the 3 groups. Esketamine 0.5 mg/kg was intravenously injected in E and ED groups, and the equal volume of normal saline was given in group D. D and ED groups underwent bilateral DPNB with 0.25 % ropivacaine 0.15 ml/kg under ultrasound guidance, with the maximum total amount of the drug not exceeding 10 ml. Fentanyl 1.0 μg/kg and propofol 2.0 mg/kg were intravenously injected prior to the skin incision in the three groups. If intraoperative body movement occurred, propofol 10 mg was added, which could be repeated. The occurrence of intraoperative body movement, respiratory depression and amount of propofol added was recorded. When postoperative pain (FLACC score >4) occurred, flurbiprofen 1 mg/kg was intravenously injected for analgesia, and the usage of flurbiprofen was recorded. When emergence agitation(PEAD score>10) occurred, propofol 1 mg/kg was intravenously injected for sedation, and the occurrence of emergence agitation was recorded. Parents were followed up by telephone at 1, 7 and 30 days postoperatively to assess the occurrence of NPOBCs using the PHBQ scale. Results:Fifty-six patients in group E and 59 patients in D and ED groups finally completed the study.Compared with group E, the incidence of intraoperative body movement was significantly decreased, the amount of additional propofol was reduced, the emergence agitation score, incidence of emergence agitation and severe agitation and usage rate of postoperative flurbiprofen were decreased, and the incidence of separation anxiety at 7 and 30 days postoperatively was decreased in D and ED groups, and the incidence of intraoperative respiratory depression was significantly decreased, and the incidence of NPOBCs at 7 and 30 days postoperatively was decreased in group ED ( P<0.05). Compared with group D, the incidence of intraoperative respiratory depression was significantly decreased, the amount of additional propofol was decreased, the usage rate of postoperative flurbiprofen and incidence of sleep anxiety at 1 day postoperatively were decreased ( P<0.05), and no significant change was found in the incidence of NPOBCs at each time point after operation in group ED ( P>0.05). Conclusions:Esketamine combined with ultrasound-guided DPNB can reduce the occurrence of NPOBCs in pediatric patients undergoing circumcision under general anesthesia.

At the end of 2019, the coronavirus disease-19 (COVID-19) broke out in Wuhan and has spread throughout the world, bringing great challengees to the public health, prevention, and control work in our country and globally.Although the national medical staff and Public Health Epidemic Prevention personnel are fighting the epidemic, the large numbers of patients and the long-term isolation measures greatly impacted people's lifestyles.The epidemic's development has currently been eased, but the blockades and quarantines in many cities have not been completely lifted.While controlling the coronavirus, lifestyle changes caused by long-term isolation, as well as fear of the disease and economic recession have brought people various negative emotions.These mental health issues may cause or aggravate the occurrence and development of dry eye.Therefore, the authors explore the impact of mental health on dry eye during the COVID-19 epidemic, alongside possible mechanisms, and put forward relevant suggestions for managing eye-related diseases during and after the epidemic.

[Objective]To evaluate the efficacy of topical use of 1 g/L tacrolimus eye drops in the treatment of ocular alkali burns.[Methods]A prospective study was performed to evaluate the efficacy of 1 g/L tacrolimus eye drops in the treatment of 12 patients with ocular alkali burns admittedin Zhongshan Ophthalmic Center of Sun Yat-sen University between May 23,2016 and Jan-uary 18,2017. The patients were treated for 1 ~ 18 weeks,with an average of 8.91 ± 5.56 weeks.The degree of ocular alkali burns was evaluated according to Roper-Hall classification system. In this group of patients,there were 2 cases of gradeⅡburns,5 cases of gradeⅢburns and 5 cases of gradeⅣburns. Each patient was given 1 g/L tacrolimus eye drops 2 times a day after admission. The slit lamp microscope and corneal fluorescein sodium staining examination were performed before and 1th week,2nd week,3rd week, 4th week,6th week,8th week respectively after performing topical tacrolimus treatment. Photos were taken to keep records to dynami-cally observe the epithelial repair and anterior segment lesions. Adobe Photoshop CS6 image processing software was used to calculate the area of corneal epithelium repair. The therapeutic effect was evaluated according to the corneal epithelial repair ,visual acuity and complications. The statistical analysis was carried out by SPSS 19.0 software.[Results]4 cases reached good prognosis ,including 2 cases of gradeⅡ and 2 cases of gradeⅢ burns,the corneal epithelium healed and the visual acuity was greater than 0.3. 5 cases had guarded prognosis,including 3 cases of gradeⅢand 2 cases of gradeⅣburns,corneal epithelium healed in 2 cases,corneal epi-thelial repair rate was greater than 50%in 3 cases,in which corneal neovascularization or corneal conjunctiva occurred,and the visu-al acuity was less than 0.3. 3 cases of gradeⅣ burns had poor prognosis:1 had corneal perforation,1 had long term corneal ulcer, and 1 had secondary glaucoma. In 12 cases,the corneal epithelial healing rate reached 99% in 50% patients,and the healing rate was greater than 50%in 75%patients. The visual acuity of 33.3%patients increased by more than three lines,and 66.6%cases had complications. The main factors affecting the prognosis are:The degree of corneal and corneal limbal burns,complication and corneal epithelial repair rate.[Conclusion]1 g/L tacrolimus eye drops can reduce the inflammatory reaction of ocular alkali burns ,reduce the incidence of glaucoma,promote corneal ulcer healing and corneal epithelial repair,and reduce complications caused by corneal lim-bal burns.

Objective To study the validity of a new material, to verify the influence of gender and age differences on normal school children, and give advice to establishing the norms of mean nasalance for normal school children.Methods The mean nasalance of 190 school children in Shanghai was obtained by reading the new, old material and the vowel /a/,/o/,/e/,/i/,/u/, and /ü/, the mean nasalance was analyzed for the standard deviations.The gender and age score differences were compared.Results The new material was more stable than the old.In the test of /i/ and/ü/and the nasal material, the girls'' MNS was higher than the boys''.In testing the vowels /a/,/o/,/e/,/i/,/u/, and /ü/and the new material, there were differences in different ages.Conclusion The validity of new material is more stable than the old.The MNS of the normal children in Shanghai show that it is higher for the girls than the boys, and also higher for the older children than for the younger.

Background and purpose:Retinoic acid-induced gene G (RIG-G) is a tumor suppressor gene which is cloned by NB4 cell line from a acute promyelocytic leukemia cell. This study aimed to investigate the effect ofRIG-G in lung cancer cells A549 by constructing a lentiviral vector expressing RIG-G under doxycycline (DOX) regulation.Methods:RIG-G gene ampliifcation was performed by quantitative real-time PCR (qRT-PCR). pLenti6/TO/V5-GIM-RIG-G lentiviral vector withGFP was built by LR recombination system. The concentration of pLenti6/TO/V5-GIM-RIG-G lentiviral vector andTet-on lentiviral vector were measured by virus titer method. After infecting A549 cells, stably transfected lines were selected via limiting dilution analysis.RIG-G gene expression was examined by immunolfuorescence staining and Western blot assay. Cellular proliferation was determined by CCK-8 assay.Results:The concentrations of pLenti6/TO/V5-GIM-RIG-G lentiviral vector andTet-on lentiviral vector were 1.0×108TU/mL and 4×109 VP/mL, respectively. RIG-G was expressed in lentivirus infected A549 cells after adding DOX, and the amount of cells withGFP could be observed by lfuorescence microscopy.After the expression of RIG-G protein, the prolif-eration activity of A594 cell was signiifcantly inhibited compared to the control group (1.168±0.107vs 2.099±0.162, P<0.05).Conclusion:The regulated expression ofRIG-G gene was established in A549 lung cancer cell line. The RIG-G protein has potential abilities to inhibit the proliferation of lung cancer cell A549.

OBJECTIVEThe aim of this study was to investigate the mechanism of cigarette smoking (CS)-induced lung cancer growth in mice.

METHODSRelA/p65⁻/⁻ mice and WT mice were used to establish mouse models of lung cancer. Both mice were divided into two groups: air group and CS group, respectively. Tumor number on the lung surface was counted and maximal tumor size was evaluated using HE staining. Kaplan Meier (K-M) survival curve was used to analyze the survival rate of the mice. Expression of Ki-67, TNF-α and CD68 in the tumor tissue was determined by immunohistochemical analysis, and cyclin D1 and c-myc proteins were examined by Western blot. Apoptosis of tumor cells was analyzed using TUNEL staining. The concentrations of inflammatory cytokines TNF-α, IL-6 and KC in the mouse lung tissues were evaluated by ELISA.

RESULTSCompared with the WT air group, the lung weight, lung tumor multiplicity, as well as maximum tumor size in the WT mice exposed to CS were (1.5 ± 0.1)g, (64.8 ± 4.1) and (7.6 ± 0.2) mm, respectively, significantly increased than those in the WT mice not exposed to CS (P < 0.05 for all). However, there were no statistically significant differences between RelA/p65⁻/⁻ mice before and after CS exposure (P > 0.05 for all). Kaplan-Meier survival analysis showed that CS exposure significantly shortened the life time of WT mice (P < 0.05), and deletion of RelA/p65 in myeloid cells resulted in an increased survival compared with that of the WT mice (P < 0.05 for all). The ratios of Ki-67 positive tumor cells were (43.4 ± 2.9)%, (60.6 ± 5.4)%, (12.8 ± 3.6)% and (15.0 ± 4.2)% in the WT air group, WT CS groups, RelA/p65⁻/⁻ air groups and RelA/p65⁻/⁻ CS groups, respectively. After smoking, the number of Ki-67-positive cells was significantly increased in the WT mice (P < 0.05). However, there was no significant difference between the RelA/p65⁻/⁻ groups before and after smoking (P > 0.05). The apoptosis rate of WT air, WT CS, RelA/p65⁻/⁻ air and RelA/p65⁻/⁻ CS groups were (11.6 ± 1.7)%, (13.0 ± 2.0)%, (13.2 ± 2.0)% and (11.0 ± 1.4)%, respectively, with no significant difference among them (P > 0.05). Expression of cyclin D1 and c-myc was induced in response to CS exposure in lung tumor cells of WT mice. In contrast, their expressions were not significantly changed in the RelA/p65⁻/⁻ mice after smoke exposure. CS exposure was associated with an increased number of macrophages infiltrating in the tumor tissue, in both WT and RelA/p65⁻/⁻ mice (P < 0.05). The concentrations of IL-6, KC and TNF-α were significantly increased after CS exposure in the lungs of WT mice (P < 0.05).

CONCLUSIONSCigarette smoking promotes the lung cancer growth in mice. Myeloid cell RelA/p65 mediates CS-induced tumor growth. TNFα regulated by RelA/p65 may be involved in the lung cancer development.

Animals ; Cytokines ; Interleukin-6 ; metabolism ; Lung ; metabolism ; Lung Neoplasms ; chemically induced ; Macrophages ; Male ; Mice ; Myeloid Cells ; metabolism ; Proto-Oncogene Proteins c-myc ; metabolism ; Smoking ; adverse effects ; Transcription Factor RelA ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

BACKGROUNDHemifacial spasm (HFS) is a facial nerve disorder characterized by episodic involuntary ipsilateral facial muscle contraction. Information on Chinese patients with HFS has not been well-characterized. This study aimed to evaluate the clinical feature and the treatment status of HFS across China.

METHODSA cross-sectional study including 1003 primary HFS patients had been carried out in 15 movement disorder clinics in China in 2012. The investigated information was acquired from questionnaires and medical records including demographic data, site of onset, aggravating and relieving factors, treatments prior to the investigation, etc.

RESULTSIn this study, the ratio of male to female was 1.0:1.8, the mean age at onset was (46.6 ± 11.5) years. About 1.0% patients were bilaterally affected. The most often site of initial onset was the orbicularis oculi muscle. The most often affected sites were orbicularis oculi, zygomatic, and orbicularis oris muscles. Stress/anxiety and relaxation were most often aggravating and relieving factors, respectively; 2.3% patients had family history, 28.4% cases were combined with hypertension, and 1.4% patients were with trigeminal neuralgia. Botulinum toxin type A (BTX-A) injection was the most commonly used treatment, followed by acupuncture and oral medication. BTX-A maintained the highest repeat treatment ratio (68.7%), while 98.4% patients gave up acupuncture. The mean latency of BTX-A effect was (5.0 ± 4.7) days, the mean total duration of the effect was (19.5 ± 11.7) weeks, and 95.9% patients developed improvements no worse than moderate in both severity and function. The most common side effect was droopy mouth.

CONCLUSIONSThe onset age of HFS in China is earlier than that in western countries. The most often used two treatments are BTX-A injection and acupuncture, while the latter kept the poor repeat treatment ratio because of dissatisfactory therapeutic effect.

Adult ; Botulinum Toxins, Type A ; therapeutic use ; China ; Cross-Sectional Studies ; Female ; Hemifacial Spasm ; diagnosis ; drug therapy ; Humans ; Male ; Middle Aged ; Neuromuscular Agents ; therapeutic use