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.

Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
Humans ; Female ; Pelvic Organ Prolapse/epidemiology* ; Middle Aged ; Risk Assessment/methods* ; China/epidemiology* ; Multifactorial Inheritance ; Aged ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease ; Case-Control Studies ; Adult ; Polymorphism, Single Nucleotide ; Genetic Risk Score ; East Asian People

Objective: To investigate the effects of micronutrient supplementation for the elderly on plasma homocysteine level and cognitive function in institutional older adults. Methods: A total of 98 older adults with the score≤11 by mini nutritional assessment short-form aged 65-100 years were enrolled and assigned to either intervention group or control group (n=49 each), with either a package of micronutrient pack or placebo daily, for three months. Fasting blood samples were collected both at baseline and the end of study to detect serum vitamin B₁₂, folate and plasma homocysteine (Hcy) concentrations. Global cognitive function was assessed using the mini-mental state examination (MMSE). The paired t test was used to compare the continuous variables between the two groups after intervention. The relationship between changes in MMSE score and changes in plasma Hcy concentrations was examined by least-squares linear regression. Results: Eighty-two patients completed the study, and 17 patients withdrew from the study due to diarrhea and hospital discharge with the drop rate of 17.3%. Compared to the control group, concentrations of serum vitamin B₁₂ (128.8±34.8 vs 13.3±16.0 pmol/L, P=0.003) and folate (21.1±1.6 vs 0.6±0.5 nmol/L, P<0.01) significantly increased in the intervention group over 3-month supplementation, while plasma Hcy levels were remarkably reduced (-5.3±0.7 vs 1.7±0.3 μmol/L, P<0.01). The incidences of deficiency of folate, deficiency of serum vitamin B₁₂and high Hcy all decreased in intervention group. Although individual item scores in MMSE were not changed markedly, change of total MMSE score in intervention group were higher than that in the control group (1.2±3.0 vs -0.2±2.5, P<0.05). Conclusions The supplementation of the micronutrient pack in long-term care facilities can reduce the incidence of hyperhomocysteinemia, and improve the total MMSE score.

Objective To compare Vecchietti′s and Davydov′s laparoscopic techniques for vagino-plasty in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Methods From January 2010 to December 2013, 13 patients underwent the Vecchietti′s laparoscopic procedure (Vecchietti group), and 15 patients underwent the Davydov′s laparoscopic procedure (Davydov group). Intraoperative parameters and postoperative results were compared. Results Both of the two groups were successfully treated. The neovagina in both groups were wide with good elasticity, softness and smoothness. The operation time [(39± 7) versus (73 ± 11) minutes], the intraoperative blood loss [(21 ± 6) versus (63 ± 10) ml], the anal exsufflation time after surgery [(19 ± 5) versus (28 ± 6) hours] and the recovery period of body temperature after surgery [(35 ± 10) versus (46 ± 10) hours] of the Vecchietti group were less than those of the Davydov group (all P<0.05). But the neovagina length [(8.8±0.5) versus (9.6±0.5) cm] was shorter and the Female Sexual Function Index scale score [26.8 ± 2.0 versus 28.5 ± 1.7] was lower in the Vecchietti group than those in the Davydov group (all P<0.05). The postoperation hospital duration didn′t reached statistical difference between the two groups [(7.5 ± 0.9) versus (7.1 ± 0.7) days, P>0.05]. No intraoperative complication occurred. After surgery, 2 patients were found vaginal polyps and 8 patients were suffered from pain in the Davydov group, while all patients were suffered from pain in the Vecchietti group. Conclusions Both Vecchietti′s and Davydov′s laparoscopic techniques are simple, safe and effective surgical methods for vaginal reconstruction. In contrast, the Vecchietti′s procedure is more time efficient and minimally invasive, while the Davydov′s procedure can get less pain, longer vagina and higher sexual satisfaction.

Adolescent ; Adult ; Aged ; Carcinoma in Situ ; surgery ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Vulvar Neoplasms ; surgery

Objective To determine the levels of serum FSH and E 2 in the patients with uterus preserved or hysterectomy so as to guide the selection of operative modality for the patients with hysteromyoma and hormone replacement therapy for the patients with hysterectomy. Methods Radioimmunoassay (RIA) was used to detect the levels of serum FSH and E 2 in the patients with uterius preserved or after hysterectomy and control group. There were 60 subjects in each group. Results Before operation, there was no significant difference in the levels of serum FSH and E 2 among myomectomy group, hysterectomy group and control group. The level was higher of serum FSH and lower of serum E 2 in the hysterectomy group 7 days after operation than those in the myomectomy group and the hysterectomy group before operation (P

Objective To investigate the influence of genital tract cytomegalovirus and chlamydia infection on the incidence of tubal pregnancy. Methods Ninety five women with tubal pregnancy (study group) and 42 women with ovarian cysts (control group) were selected for this study. Serum cytomegalovirus (CMV) IgM was identified by enzyme link immunosorbent assay (ELISA). Cervical secretions, endometrium, and salpinx tissue were tested for CMV gH gene and chlamydia heat shock protein (HSP) gene by nest polymerase chain reaction (PCR) and PCR respectively. Results CMV IgM was positive in 14 (15%) women with tubal pregnancy, and 1 (2%) in the control group. CMV gH gene was detected in 18 women (19%) and chlamydia HSP gene in 25 (26%) of the tubal pregnancy group, and 2 (5%) and 2 (5%) in the control group respectively. There were significant differences between the study and the control group ( P