Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, we identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan-Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877-1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18-0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment. In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.

Objective:To develop and validate a postoperative infection nomogram of hepatitis B-associated hepatocellular carcinoma (HCC) after hepatectomy.Methods:Clinical data of 229 patients with HCC undergoing hepatectomy at the Department of Hepatobiliary Surgery of Tianjin Third Central Hospital from January 2014 to December 2022 were retrospectively analyzed, including 174 males and 55 females, aged (58.2±11.4) years. LASSO regression analysis screened the factors associated with hepatitis B-associated HCC infection after hepatectomy, which were further incorporated into multivariate logistic regression analysis. A nomographic prediction model was established based on the results of multivariate logistic regression analysis. Concordance index (C-index), calibration curve and receiver operating characteristic (ROC) curve were used to evaluate the model, and decision curve analysis (DCA) was used to analyze the clinical applicability of the model. Internal validation of the model was performed using bootstrap method.Results:A total of nine variables were screened as factors associated with the postoperative infections using LASSO regression, including gender, smoking history, body mass index (BMI), serum level of alpha fetoprotein, resection fashion (anatomical or non-anatomical), intraoperative blood loss, surgical method (laparoscopy or open), serum level of creatinine, and postoperative biliary fistula. Multivariate logistic regression analysis showed that BMI, resection fashion, intraoperative blood loss >500 ml, and postoperative biliary fistula were risk factors for postoperative infection (all P<0.05). Based on the above risk factors, a postoperative infection nomogram of hepatitis B-associated HCC after hepatectomy was established. The C-index was 0.839 (95% CI: 0.768-0.910), and the area under ROC curve was 0.853 (95% CI: 0.795-0.912), indicating that the model had a good predictive ability. The calibration curve was basically consistent with the ideal curve. The DCA showed that the model had a good clinical applicability. Internal validation C-index was 0.829 (95% CI: 0.766-0.892). Conclusion:The nomogram based on BMI, surgical resection fashion, intraoperative blood loss >500 ml, and postoperative biliary fistula has a high predictive accuracy and can be used to predict postoperative infections after hepatectomy for HCC.

OBJECTIVE: To analyze the epidemiological characteristics of measles, mumps, and rubella (MMR) between 2014 and 2021 and identify potential strategies and measures for the prevention and control of MMR in China. METHODS: Data on MMR was obtained from China's National Notifiable Disease Reporting System for the period from 2014 to 2021. Spatiotemporal distributions were analyzed using SaTScan; temporal trends were analyzed using JoinPoint; and clusters were visualized using ArcGIS. RESULTS: A total of 1,808,067 cases of MMR were reported from 2014 to 2021 in China's mainland, most of which were children and students under the age of 20. The incidence of measles declined during 2014-2021, whereas that of mumps and rubella peaked in 2019. MMR-reported cases generally peaked from March to July; however, high numbers of mumps cases were reported from September to November in 2020-2021. Measles and rubella clusters predominantly occurred in Western China, whereas clusters of mumps were generally found in the southern region. CONCLUSION The relatively heterogeneous epidemiological characteristics of MMR have highlighted the weaknesses and gaps in surveillance and timely control of MMR transmission in China's mainland. Real-time and intelligent monitoring data should be collected for evidence-based early interventions.
China/epidemiology* ; Humans ; Measles/epidemiology* ; Child ; Mumps/epidemiology* ; Adolescent ; Child, Preschool ; Rubella/epidemiology* ; Young Adult ; Infant ; Male ; Female ; Adult ; Incidence ; Middle Aged ; Measles-Mumps-Rubella Vaccine ; Infant, Newborn

Objective     To verify the feasibility and accuracy of the "lung surface intersegmental constant proportion landmarks", developed by our center, in identifying intersegmental planes during pulmonary segmentectomy. Methods    We prospectively enrolled the patients who planned to receive thoracoscopic segmentectomy in West China Hospital of Sichuan University and The Third People's Hospital of Chengdu from September 2021 to October 2021. We took a relatively objective and feasible method, intravenous injection of indocyanine green, in identifying intersegmental planes as standard control. We intraoperatively judged the consistency between "lung surface intersegmental constant proportion landmarks" and intravenous injection of indocyanine green in identifying intersegmental planes. We discerned main landmarks of intersegmental plane by the constant proportion segment module, which was built based on the "lung surface intersegmental constant proportion landmarks", as well as distinguished the planes with discrepant fluorescence by peripheral intravenous indocyanine green injection. When the distance between the landmarks determined by the "ung surface intersegmental constant proportion landmarks" and the segmental boundaries displayed by indocyanine green  fluorescence staining was ≤1 cm, the landmarks were judged to be consistent with the planes with discrepant fluorescence. As long as one of the landmarks was judged to be consistent, the method was considered to be feasible and accurate. Results 聽 聽 A total of 21 patients who underwent thoracoscopic segmentectomy were enrolled, with 5 male and 16 female patients. The median age was 55 years, ranging from 34 to 76 years. A total of 11 patients received left-side surgery, while 10 patients received right-side surgery. In the operations of 21 pulmonary segmentectomies, at least one intersegmental landmark determined by the "lung surface intersegmental constant proportion landmarks" was consistent with the intersegmental plane determined by indocyanine green fluorescence staining in each patient. Conclusion 聽 聽The intersegmental landmarks determined by the "lung surface intersegmental constant proportion landmarks" are consistent with that determined by indocyanine green fluorescence staining. The method of "lung surface intersegmental constant proportion landmarks" is feasible and accurate in identifying intersegmental planes during pulmonary segmentectomy.

Objective To investigate whether the effect of rabeprazole in treating gastroesophageal reflux disease is related to CYP2C19 gene polymorphisms.Methods 278 patients with gastroesophageal reflux disease confirmed by endoscopy and proton-pump inhibitor testing were enrolled in this study,including non erosive reflux disease (NERD) in 122 cases,the reflux esophagitis (RE) in 98 cases and Barrett esophagus in 58 cases.They were treated with rabeprazole for 8 weeks.GerdQ scores before and after the treatment were completed,endoscopy was performed again in patients with RE after treatment.The blood CYP2C19 genotyping was detected by matrix assisted laser desorption ionization time of flight mass spectrum(MALDI-TOF-MS).Results According to the genotype of CYP2C19,they were divided into extensive metabolizers,intermediate metabolizers and poor metabolizers,accounted for 39.57%,42.45% and 17.98%,respectively.There was no significant difference in GerdQ scores of three groups before treatment,and also had no significant difference after 8 weeks treatment,but in each subgroup GerdQ scores after treatment was decreased significantly than before treatment.The total effective rate of 98 patients with RE by endoscopy was 86.73%,but there was no significant difference in total effective rate of the three groups after treatment.Conclusion Rabeprazole is effective in the treatment of gastroesophageal reflux disease.Moreover,rabeprazole is less affected by CYP2C19 genotype and therefore its curative effect is more stable.

Objective To evaluate the safety and efifcacy of Laparoscopic partial nephrectomy (LPN) versus 1aparoscopic cryoablation (LCA) for the small renal tumors (SRMs).Methods The databases of PubMed, SCI, Ovid, the Cochrane Library, CNKI, CBM, VIP and Wangfang Data were searched to controlled clinical trial about LPN versus LCA for the treatment of small renal tumor. The retrieval time span was from inception to Apr 2016. The studies were screened according to the inclusion and exclusion criteria, the date were extracted and the quality was evaluated by 2 reviewers independently. And then the Meta-analysis was conducted using RevMan 5.3 software.Results 9 studies were included, and 748 cases were involved. The meta-analysis showed that comparing with LPN, the operation time of LCA was shorter [MD = 42.75, 95 % CI (12.19~73.31),P = 0.006], less intraoperative blood loss [MD = 190.73, 95 % CI (126.67~254.78),P = 0.000], shortening hospital stay [MD = 2.23, 95 % CI (0.17~4.28),P = 0.030], lower transfusion rate [OR^ = 3.54, 95 % CI (1.18~10.59),P = 0.020], lower rate of postoperative glomerular ifltration levels [MD = 10.30, 95 % CI (5.38~15.24),P = 0.000], less complications [OR^= 3.90, 95 % CI (1.84 ~ 8.24),P = 0.000], higher risk of local recurrence [OR^ = 0.13, 95 % CI (0.04 ~ 0.44),P =0.000], higher risk of distant metastases [OR^ = 0.16, 95 % CI (0.03 ~ 0.78),P = 0.020], but there were no signiifcant differences in postoperative creatinine rise and transfusion rate (P > 0.05).Conclusions LCA has advantage in perioperative period results and protect renal function. But LCA has a higher local recurrence and distant metastasis risk, short-term and medium-term efficacy considerably, long-term effect is not clear, therefore, in the choice of surgical cases still need to be careful.

Objective:To analyze the 3D changes of pharyngeal airway in patients with skeletal Class Ⅲ malocclusion after rapid maxillary expansion(RME)and maxillary protraction.Methods:53 patients underwent orthodontic treatment with Hyrax palatal ex-panders and maxillary protraction.Cone-Beam computed tomography(CBCT)scan was taken before treatment(T0),after 1 6 d RME (T1 )and after about 5 month maxillary protraction(T2).Data were reconstructed into 3D model,sagittal and transversal measure-ments,cross sectional areas,volumes of the pharyngeal airway were computed.Results:After RME,the transversal measurements, cross sectional areas,volumes of nasal passage were increased(P <0.05).After maxillary protraction,the 4 nasopharyngeal measure-ments were increased(P <0.05).Conclusion:RME and maxillary protraction may increase pharyngonasal airway.

Objective To investigate the phenotypic and genetic characteristics of the lysostaphin‐resistant Staphylococcus aureus variants induced by recombinant lysostaphin in vitro .Methods Three clinical isolates of S . aureus ,including two resistant to methicillin (MRSA ) and one susceptible to methicillin (MSSA ) were induced by treatment with sub‐MIC of recombinant lysostaphin via one‐step selection in vitro .Susceptibility of the variants to antibiotics were determined and compared with their parental strains .The full length of femABX genes was amplified by polymerase chain reaction and sequenced to identify the potential mutation sites in these genes .The growth‐curve in liquid medium and virulence in a mouse systemic infection model of both parental and variant strains were observed . Results The frequency of lysostaphin resistance in S . aureus was between 10-4 to 10-8 following induction by lysostaphin . Resistance to lysostaphin was associated with a significant decrease in growth rate in vitro and virulence in vivo ,as well as increased susceptibility toβ‐lactams evidenced by the M IC of β‐lactams against the variants as low as 1/4 000 to 1/2 of the M IC against their parental strains . Sequencing of f emA BX genes showed mutation in femA gene in both variants ,which resulted in a premature termination codon .Conclusions Resistance of S . aureus to lysostaphin may develop following induction by recombinant lysostaphin in vitro . The lysostaphin‐resistant S . aureus variants are characteristic of lower growth rate , decreased virulence ,and higher susceptibility to β‐lactams .

Objectives To evaluate the naso-maxillary complex width and pharyngeal airway volume changes after rapid maxillary expansion(RME).Methods Thirty-five patients were selected(18 males,17 females,mean age,12.1 ± 1.1 years).All patients underwent orthodontic treatment with Hyrax palatal expanders.Cone-beam CT(CBCT) scan was taken before treatment(T0),16 days(T1) and three months (T3) after RME.Naso-maxillary complex width and pharyngeal airway volume were measured.Results After treatment the width of piriform aperture and maxillary width were significantly increased compared with that before treatment(P＜0.05).Three months after RME,no statistical difference was found in maxillary width compared with that before treatment.The nasopharyngeal volume significantly increased by 29.9％ compared with that before treatment(P＜0.05),and the volume remained relatively stable after three months.Conclusions RME resulted in a significant increase in the naso-maxillary complex width and nasopharyngeal volume.

Objective To investigate the association of interleukin-6 (IL-6) with depression using meta analysis. Methods A systematic literature search was conducted to examine depression and interleukin-6 in Chinese patients us-ing“depression”and“interleukin-6”in Databases including PubMed, CBM, VIP, CNKI and WanFang Data. A me-ta-analysis was performed to analyze correlation between depression and interleukin-6 using RevMan 5.2.8 software. Results A total of 9 studies were recruited, involving 432 depression patients and 277 healthy controls. The results of meta-analysis showed that concentration of IL-6 was higher in depression patients than in healthy controls(SMD=1.48, 95%CI:0.78~2.18,P<0.05). Subgroup analysis in the first-episode subgroup and the non first-episode subgroup showed that concentration of interleukin-6 was higher in depression patients than that in controls [the first-episode subgroup (SMD=1.94,95%CI:0.07~3.81,P<0.05), the non first-episode subgroup (SMD=1.26,95%CI:0.60~1.93,P<0.05)]. Conclusion There is a good correlation between depression and the serum IL-6 concentration. Due to the small number of studies and heterogeneity in different studies, the present meta-analysis has not yet confirmed the quantitative correla-tion between IL-6 and depression.