ObjectiveTo investigate the epidemiological and clinical characteristics of human bocavirus (HBoV) in hospitalized children with acute lower respiratory tract infection (ALRTI) at a single-center children’s hospital in Shanghai, thereby providing evidence for the diagnosis, treatment, and prevention of HBoV infection. MethodsA retrospective study was conducted on 19 537 hospitalized children with ALRTI at Shanghai Children’s Hospital from January 2021 to December 2023. Multiplex polymerase chain reaction (PCR) combined with capillary electrophoresis was used to detect HBoV and 12 other common respiratory viruses /atypical pathogens. The positive detection rate, demographic characteristics (sex, age), temporal distribution (year, season) of HBoV, as well as the clinical characteristics of severe and non-severe pneumonia were analyzed. ResultsThe overall HBoV-positive rate was 2.57% (503/19 537), with 59.44% (299/503) being single infections and 40.56% (204/503) being co-infections. The positive detection rate was significantly higher in boys than that in girls (2.78% vs 2.33%, χ²=3.88, P=0.049). The highest infection rate was observed in toddlers, followed by infants (χ²=379.57, P<0.001). The positive rate peaked in 2021 and reached its lowest point in 2023 (χ²=45.49, P<0.001), with epidemics mainly prevalent in summer and autumn. The main clinical symptoms were cough (90.06%, 453/503), fever (75.94%, 382/503), and wheezing (39.96%, 201/503). Children with severe pneumonia showed a higher incidence of wheezing compared with the non-severe group (P<0.001), while underlying diseases and co-infections had no significant association with disease severity (P>0.05). ConclusionHBoV was an important pathogen of ALRTI in children, predominantly affecting infants and toddlers, with higher susceptibility in boys and seasonal peaks in autumn and summer. The main clinical manifestations included cough, fever, and wheezing, with wheezing being more prevalent in children with severe pneumonia.

Seven novel acylphloroglucinol-sesquiterpenoid adducts, designated as dryatraols J-P (1-7), were isolated from the rhizomes of Dryopteris atrata (Wall. ex Kunze) Ching. The structures, including absolute configurations, were elucidated using comprehensive spectroscopic data, calculated ¹³C Nuclear Magnetic Resonance-Diastereotopic Probability Assignment Plus (¹³C NMR-DP4+) probability analysis, and ECD calculations. These structures represent a rare subclass of carbon skeleton of acylphloroglucinol-sesquiterpenoid adducts with a furan ring connecting the acylphloroglucinol and sesquiterpenoid moieties. Notably, compounds 1-6 are the first reported examples of acylphloroglucinol-sesquiterpenoid adducts with dimeric acylphloroglucinol incorporated into the aristolane- or rulepidanol-type sesquiterpene, while compound 7 features a hydroxylated monomeric acylphloroglucinol motif. A preliminary evaluation of their antiviral activities revealed that compounds 1-6 exhibited more potent activities against respiratory syncytial virus (RSV) with IC₅₀ values ranging from 0.75 to 3.12 μmol·L^-1 compared to the positive control (ribavirin).
Antiviral Agents/isolation & purification* ; Phloroglucinol/isolation & purification* ; Sesquiterpenes/isolation & purification* ; Molecular Structure ; Dryopteris/chemistry* ; Respiratory Syncytial Viruses/drug effects* ; Humans ; Rhizome/chemistry* ; Drugs, Chinese Herbal/pharmacology*

Objective:To observe the effect of different exercise methods on the prevention and treatment of senile sarcopenia.Methods:A cross-sectional investigation was carried out to select the elderly who visited the First Affiliated Hospital of Zhejiang University School of Medicine and Tongxiang Hospital of Traditional Chinese Medicine from October 2016 to December 2023 for medical check-ups at the geriatrics department and physical examination center.General information was collected, and the Hologic Discovery-Wi bone density scanner(Hologic, USA)was used to measure appendicular lean mass(ALM).Walking speed over 6 meters and grip strength were measured, and the appendicular skeletal muscle index(ASMI=limb muscle mass/height 2)was calculated.The subjects were divided into three groups aged 60-69, 70-79, and 80-89 years and the relevant information was obtained through standard questionnaires.Based on the exercise methods and time, each age group was categorized into three groups: non-exercise, aerobic exercise, and resistance exercise.Differences in related indicators of sarcopenia among the elderly in different age groups with different exercise methods were analyzed. Results:In all three age groups, the ASMI of the resistance exercise group was higher compared to the aerobic exercise and non-exercise groups: In the 60-69 years old group, (7.50±0.31)kg/m 2vs.(6.93±0.37)kg/m 2 and (6.81±0.27)kg/m 2, F=38.146, P<0.001; In the 70-79 years old group, (7.26±0.30)kg/m 2vs.(6.82±0.38)kg/m 2 and (6.50±0.36)kg/m 2, F=35.784, P<0.001; In the 80-89 years old group, (7.00±0.59)kg/m 2vs.(6.53±0.63)kg/m 2 and (5.89±0.66)kg/m 2, F=23.380, P<0.001.The resistance exercise group also had higher grip strength than the aerobic and non-exercise groups: In the 60-69 years old group, (39.23±1.78) kg vs.(26.21±4.79) kg and (24.68±3.55) kg, F=127.806, P<0.001; In the 70-79 years old group, (37.78±2.50) kg vs.(27.21±5.47) kg and (24.43±3.49) kg, F=75.265, P<0.001; In the 80-89 years old group, (28.75±4.71) kg vs.(21.37±5.57) kg and (17.08±4.50) kg, F=33.148, P<0.001; Both the resistance and aerobic exercise groups had a faster walking speed compared to the non-exercise group: 60-69 years old group (1.30±0.14) m/s and (1.31±0.15) m/s compared to (1.20±0.14) m/s, F=5.905, P=0.003; 70-79 years old group (1.26±0.13) m/s and (1.24±0.17) m/s compared to (1.16±0.16) m/s, F=4.931, P=0.009; and (1.00±0.20) m/s and (1.02±0.27) m/s over (0.84±0.24) m/s in the group of 80-89 years old, F=6.913, P=0.001.The results of two-by-two comparisons showed that among the older adults in the 70-79 and 80-89 age groups, ASMI was higher in the aerobic exercise group than in the non-exercise group ( t=0.070, 0.048, both P<0.001), and grip strength was higher in the aerobic exercise group than in the non-exercise group ( t=0.885, 0.976, P=0.002, <0.001); however, there was no difference in step speed between the resistance exercise group and the aerobic exercise group among older adults in the three age groups ( t=0.031, 0.035, 0.701, P=0.605, 0.593, 0.841). Conclusions:Compared with non-exercise and aerobic exercise, resistance exercise has a clear effect on the prevention and treatment of sarcopenia in the elderly.As age increases, aerobic exercise can also prevent and treat sarcopenia in the elderly aged 70-89 years.Both resistance exercise and aerobic exercise have obvious effect on maintaining the pace of the elderly.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To observe the effect of different exercise methods on the prevention and treatment of senile sarcopenia.Methods:A cross-sectional investigation was carried out to select the elderly who visited the First Affiliated Hospital of Zhejiang University School of Medicine and Tongxiang Hospital of Traditional Chinese Medicine from October 2016 to December 2023 for medical check-ups at the geriatrics department and physical examination center.General information was collected, and the Hologic Discovery-Wi bone density scanner(Hologic, USA)was used to measure appendicular lean mass(ALM).Walking speed over 6 meters and grip strength were measured, and the appendicular skeletal muscle index(ASMI=limb muscle mass/height 2)was calculated.The subjects were divided into three groups aged 60-69, 70-79, and 80-89 years and the relevant information was obtained through standard questionnaires.Based on the exercise methods and time, each age group was categorized into three groups: non-exercise, aerobic exercise, and resistance exercise.Differences in related indicators of sarcopenia among the elderly in different age groups with different exercise methods were analyzed. Results:In all three age groups, the ASMI of the resistance exercise group was higher compared to the aerobic exercise and non-exercise groups: In the 60-69 years old group, (7.50±0.31)kg/m 2vs.(6.93±0.37)kg/m 2 and (6.81±0.27)kg/m 2, F=38.146, P<0.001; In the 70-79 years old group, (7.26±0.30)kg/m 2vs.(6.82±0.38)kg/m 2 and (6.50±0.36)kg/m 2, F=35.784, P<0.001; In the 80-89 years old group, (7.00±0.59)kg/m 2vs.(6.53±0.63)kg/m 2 and (5.89±0.66)kg/m 2, F=23.380, P<0.001.The resistance exercise group also had higher grip strength than the aerobic and non-exercise groups: In the 60-69 years old group, (39.23±1.78) kg vs.(26.21±4.79) kg and (24.68±3.55) kg, F=127.806, P<0.001; In the 70-79 years old group, (37.78±2.50) kg vs.(27.21±5.47) kg and (24.43±3.49) kg, F=75.265, P<0.001; In the 80-89 years old group, (28.75±4.71) kg vs.(21.37±5.57) kg and (17.08±4.50) kg, F=33.148, P<0.001; Both the resistance and aerobic exercise groups had a faster walking speed compared to the non-exercise group: 60-69 years old group (1.30±0.14) m/s and (1.31±0.15) m/s compared to (1.20±0.14) m/s, F=5.905, P=0.003; 70-79 years old group (1.26±0.13) m/s and (1.24±0.17) m/s compared to (1.16±0.16) m/s, F=4.931, P=0.009; and (1.00±0.20) m/s and (1.02±0.27) m/s over (0.84±0.24) m/s in the group of 80-89 years old, F=6.913, P=0.001.The results of two-by-two comparisons showed that among the older adults in the 70-79 and 80-89 age groups, ASMI was higher in the aerobic exercise group than in the non-exercise group ( t=0.070, 0.048, both P<0.001), and grip strength was higher in the aerobic exercise group than in the non-exercise group ( t=0.885, 0.976, P=0.002, <0.001); however, there was no difference in step speed between the resistance exercise group and the aerobic exercise group among older adults in the three age groups ( t=0.031, 0.035, 0.701, P=0.605, 0.593, 0.841). Conclusions:Compared with non-exercise and aerobic exercise, resistance exercise has a clear effect on the prevention and treatment of sarcopenia in the elderly.As age increases, aerobic exercise can also prevent and treat sarcopenia in the elderly aged 70-89 years.Both resistance exercise and aerobic exercise have obvious effect on maintaining the pace of the elderly.

Bedridden patients mostly use the back cushion object,raise the bedside position,and other methods to obtain the semi-decumbent position.However,the existing methods have shortcomings such as insufficient execution,wrong angle estimation,weak consciousness,forgetting,decreased comfort,easy to cause pressure sore and aspiration pneumonia.To solve the shortcomings of the existing eating position placement method,the department of geriatric medicine team of Tongxiang City Hospital of Traditional Chinese Medicine designed a bed-rest pillow for bed patients to eat or other requirements of semi-lying position,and obtained the National Utility Model Patent of China(patent number:ZL 202122859891.4).This device places the pillow on a flat bed,with the back of the pillow next to the head of the bed for support and to prevent sliding.The patient was placed in a retainer slot,head in the first retainer slot,shoulder and back in the second retainer slot,waist and abdomen in the third retainer slot,and hands on the armrests on both sides of the pillow.The use of pillows for bedridden patients is simple and easy to learn,convenient,economical and practical,time-saving and labor-saving,and convenient supervision and inspection,which can reduce complications such as aspiration and pressure ulcers,thereby reducing the economic burden of the patient,improving the quality of life,and improving the satisfaction of patients and their families,and is worthy of clinical promotion and use.

Objective:This study aimed to explore the clinical value of myostatin(MST) and follistatin(FST) as biological biomarkers in evaluating sarcopenia in elderly women.Methods:This was a retrospective cross-sectional study that enrolled 350 females aged 20-89 years who underwent physical examinations in Shanghai Huadong Hospital in 2021. Demographic characteristics, muscle mass, fat mass, bone mineral density, hand grip strength, gait speed, and serum indices of MST and FST were collected.Results:The serum levels of MST did not change significantly with age. However, the serum levels of FST increased with age. In women aged≥60 years, MST was positively correlated with total lean mass and appendicular skeletal muscle index(ASMI; r=0.236, P=0.041; r=0.289, P=0.014), while FST was negatively correlated with ASMI( r=-0.265, P=0.030). In multivariate stepwise regression analysis, after adjusting for age, body mass index, hip bone mineral density, and total fat mass, only FST was independently correlated with ASMI( β=-0.238, P=0.006), while MST was not correlated with ASMI. The receiver operating characteristic curve was plotted using muscle mass reduction as the state variable and serum FST level as the test variable. The area under the curve was 0.753. And when the FST cutoff value was 17.49 ng/mL, the maximum Jordan index was 0.46, with a sensitivity of 77.3% and a specificity of 68.7%. Women aged ≥60 years were divided into three groups based on serum FST levels. Compared to the upper third of the serum FST level group, the low third of the FST level group had a significantly reduced risk of suffering from sarcopenia( OR=0.098, P =0.036). Conclusions:Serum FST lever has a better correlation with muscle mass among elderly women, making it a promising biomarker for evaluating muscle mass.

Objective:To explore the effect of small dose of low molecular weight heparin on the prognosis of elderly patients with severe pneumonia using systematic evaluation method.Methods:Databases including Wanfang data, VIP, CNKI, SinoMed, PubMed, Embase and Cochrane Library were searched for randomized controlled trial (RCT) studies about the comparison of conventional therapy and low molecular weight heparin on prognosis of elderly patients with severe pneumonia from the time of database establishment to August 2019. The patients in conventional treatment group were treated by improving ventilation, anti-infection, eliminating phlegm, relieving asthma and maintaining homeostasis while those in low molecular weight heparin group were subcutaneously injected with low molecular weight heparin of 4 000 U, once a day for 7 days. The patients' main outcomes included the oxygenation index (PaO 2/FiO 2) after 7 days of treatment, duration of mechanical ventilation, mortality in hospital, and secondary outcomes included acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and coagulation function after 7 days of treatment, the length of intensive care unit (ICU) stay, and incidence of bleeding. Data extraction and quality evaluation were conducted. The Meta-analysis of included studies that met the quality standards was performed using RevMan 5.3 software. Funnel diagram analysis was used to analyze the parameters with no less than 10 studies enrolled. Results:A total of 14 RCT studies were enrolled involving 1 173 elderly patients with severe pneumonia, among whom 590 received low molecular weight heparin while the other 583 received conventional therapy. All the included studies were well designed and of high quality. The results of Meta-analysis showed that compared with conventional therapy, small dose of low molecular weight heparin significantly elevated PaO 2/FiO 2 after 7 days of treatment [mean difference ( MD) = 19.25, 95% confidence interval (95% CI) was 16.88 to 21.61, P < 0.000 01], shortened the duration of mechanical ventilation ( MD = -48.88, 95% CI was -67.42 to -30.33, P < 0.000 01), and decreased mortality in hospital [odds ratio ( OR) = 0.40, 95% CI was 0.22 to 0.73, P = 0.003] and APACHEⅡ score after 7 days of treatment ( MD = -3.38, 95% CI was -3.94 to -2.83, P < 0.000 01), and shortened the length of ICU stay ( MD = -4.51, 95% CI was -5.75 to -3.27, P < 0.000 01). There was no significant difference in the changes of coagulation parameters after 7 days of treatment or the incidence of bleeding between low molecular weight heparin group and conventional therapy group [7-day thrombin time (TT): MD = 0.57, 95% CI was -0.15 to 1.28, P = 0.12; 7-day prothrombin time (PT): MD = 0.32, 95% CI was -0.35 to 0.98, P = 0.35; 7-day fibrinogen (FIB): MD = -0.17, 95% CI was -0.45 to 0.10, P = 0.22; incidence of bleeding: OR = 0.86, 95% CI was 0.36 to 2.07, P = 0.74]. The funnel diagram showed that there was publication bias of included 10 studies about APACHEⅡ score after 7 days of treatment. Conclusion:Small dose of low molecular weight heparin can improve the prognosis of elderly patients with severe pneumonia and it has no obvious side-effect on coagulation function.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.