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:To explore the clinical application of preimplantation genetic testing for monogenic disorders (PGT-M) in an unique case with Spinal muscular atrophy (SMA) type 2+ 0.Methods:A special SMA family presented at the Third Affiliated Hospital of Guangzhou Medical University on October 19, 2020 was selected as the study subject. Multiple ligation-dependent probe amplification (MLPA) and molecular tagging linkage analysis were carried out to identify the SMN1 genotype of the couple and their fetus. Subsequently, next-generation sequencing (NGS), molecular tagging linkage analysis, and chromosomal microarray analysis were employed to determine the haplotypes and validate the result of PGT-M on the 11 embryos derived for the couple. Results:The female partner was identified as a carrier of the rare SMN1[2+ 0] variant, and prenatal diagnosis confirmed the fetus to be affected by SMA. Ultimately, PGT-M has successfully selected four embryos free from the pathogenic SMN1 variants and X chromosome deletion. Conclusion:PGT-M can effectively prevent the transmission of rare genetic variants such as the SMA 2+ 0 subtype in the families. Above finding has provided guidance for genetic counseling and family planning for the couple.

Objective To investigate the correlation between knee joint line and anterior knee pain after total knee arthroplasty (TKA).Methods From January 2008 to December 2010,76 patients with osteoarthritis underwent primary TKA in our hospital,including 11 males and 65 females,aged from 47 to 83 years (average,68.88±7.61 years).Fixed-bearing posterior stabilized TKA (PFC) was used in all patients.All patients were followed up every 12 months after TKA.According to the Figgie's method,pre-and post-operative knee joint line was measured,and the changes of pre-and post-operative knee joint line were calculated.If the knee joint line was elevated,it was defined as positive; on the contrary,it was defined as negative.The Feller's patellar score was used to assess pre-and post-operative patellar function.The correlation between joint line level and Feller's patellar score was analyzed 24 months after operation.Results The joint line level ranged from-6.8 to 10.44 mm (average,2.69±3.31 mm).With the rise of the joint line,the patient's patella score decreased.There is a negative correlation between the elevated joint line level and Feller's patellar score (r=-0.763,P=0.000).The Feller's patellar score decreased with the fall of joint line level,and there is a positive correlation between them (r=0.914,P=0.000).The Feller's patellar score was higher in patients whose joint line change was less than 4 mm than that in patients whose joint line change was greater than 4 mm (t=12.648,P=0.000; t=l 1.775,P=0.000).Conclusion The joint line change was correlated to anterior knee pain after TKA with fixedbearing posterior stabilized prosthesis.The joint line change less than 4 mm can result in a better knee joint function.

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 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.