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 investigate the predictive value for major adverse cardiovascular events (MACE) occurring within 1 year in patients with old myocardial infarction(OMI) using characteristics of myocardial scar derive from dual-energy CT (DECT) post-processing technique.Methods:OMI patients who received coronary CT angiography following dual-energy CT with late iodine enhancement (LIE-DECT) in the Second Affiliated Hospital of Nantong University from November 2019 to October 2022 were continuously included, and the images of all enrolled patients were reconstructed using 40 keV monoenergetic plus (Mono+) map, LIE (representing myocardial scar) was quantified on left ventricular short-axis images, including the LIE segments, the LIE score, and the LIE degree. All enrolled patients were followed up for MACE, defined as hospitalization for heart failure, malignant arrhythmia, and cardiac death. Regression analysis was used to investigate the relationship between the quantified value of myocardial scar and the occurrence of MACE, and receiver operating characteristic curve (ROC) was used to evaluate the efficacy of quantified value of myocardial scar in predicting MACE. The area under the curve (AUC) was compared using the DeLong test.Results:Finally, 231 patients with OMI were included, and MACE occurred in 37 cases (16.0%) within 1 year after LIE-DECT examination. The LIE segments 5 (4, 7), the LIE score 27 (13, 49) and the LIE degree 9.4%(7.5%, 15.5%) in the MACE group were higher than those in the non-MACE group 3 (2, 5), 9 (6, 15) and 6.7%(6.3%, 7.9%) (all P<0.001). Multivariable logistic regression analysis showed that after adjusting for confounders, the LIE segments ( OR=2.118, P<0.001), the LIE score ( OR=3.168, P<0.001), and the LIE degree ( OR=3.092, P<0.001) remained risk factors for the development of MACE. On ROC analysis, AUC of LIE segments, LIE score and LIE degree were 0.715, 0.822 and 0.806 (all P<0.001), with sensitivities of 81.1%, 86.5%, and 91.9%, and specificities of 53.6%, 69.6%, and 60.8%, respectively. DeLong′s test showed that the predictive efficacy of LIE score and LIE degree was higher than that of LIE segments ( Z=2.63, P=0.008; Z=1.96, P=0.049), and there were no significant differences in the predictive efficacy of LIE score and LIE degree ( Z=0.60, P=0.551). Conclusion:The LIE segments, the LIE score and the LIE degree detected by LIE-DECT 40 keV Mono+maps are risk factors for the occurrence of MACE in patients with OMI and have good efficacy in predicting the occurrence of MACE, which can be used as important indicators for assessing the clinical prognosis of OMI.

Tumor radiotherapy is established on the basis of clinical oncology, radio-physics and radiobiology, and has become one of the three major therapeutic methods for malignant tumors. With the pace of socialist construction in China, the subject of radiotherapy in Shanxi province has developed from scratch and from small to large for more than 60 years. Remarkable achievements have been made in the establishment of departments, the updating of technical equipment, the increase of employees and clinical scientific research. This article reviews and summarizes the development history of tumor radiotherapy in Shanxi province.

OBJECTIVETo screen a new strain which can transform panaxadiol saponins into the rare ginsenoside compound K.

METHODThe total saponins in stems and leaves of Panax notoginseng was used as a substrate in the liquid state fermentation process, and the results were detected by TLC and HPLC-ELSD to screen a strain from twelve plant pathogenic fungi which can produce ginsenoside compound K.

RESULTFusarium moniliforme was found to transform the total saponins to ginsenoside compound K efficiently in the all twelve fungal strains. In the fermentation process, ginsenoside Rb1 was transformed almost completely, and the content of ginsenoside Rd was decreasing evidently.

CONCLUSIONF. moniliforme is selected as a new high-yield strain. It is expected to be used to produce the high activity infrequent ginsenoside compound K and to improve the content of active principles in medicinal plants.

Objective To summarize the curative effect of ERCP and EST before laparoseopic cholecystec-tomy for treatment of patients with cbolelithiasts concurrent with choledoeholithiasis. Methods A retrospec-tive analysis was carried out for 43 cases of cholelithiasis concurrent with choledocholithiasis from January 2006 to December 2008. Results The procedures were successfully accomplished in 40 patients, the suc-cess rate was 93%. The successful clearance rate of common bile duct stone was 95.2%. Complication oc-curred in 2 cases, including 1 case of papilla bleeding and 1 case of hyperamylesemia. All complications were cured with non-operating treatment. Conclusions ERCP and EST before laparoseopic cholecystectomy is the best treatment and diagnosis method in gallbladder stone with common bile dust stone. It is very impor-tant to improve the success rate of LC, decrease complication and occurrence of the open operation of com-mon bile duct stone.

OBJECTIVE To establish and optimize the detection of highly pathogenic influenza virus H5N1 subtype by RT-Multiplex (RT-M) PCR method. METHODS The viral RNA was reversely transcripted with universal primer,and the cDNA was sequenced and analyzed. According to the cleavage site of H5 and the conservative sequence of N1,designed two pairs of specificity primer,RT-M PCR was developed by these primers. Then verified the sensitivity of method and its specificity by detecting comparing with NDV,IBV and IBDV. RESULTS The results of H5N1 gene sequence showed the high homology with the Anhui H5N1 strain [avian influenza A/Anhui/1/2005 (H5N1)] after comparing in the GenBank. Two fragments of 302 bp and 567 bp were amplified by RT-M PCR. The method could detect 0.500 pg virus RNA at least,and own high specificity. CONCLUSIONS This method can be used for highly pathogenic avian influenza.

Objective To evaluate the role of CT in diagnosis of the gastrointestinal tract rupture after blunt abdominal trauma . Methods Twenty preoperative CT scans and clini cal data were obtained in 20 patients who subsequently had bowel ruptures verifi ed surgically. CT findings were analyzed retrospectively in these patients. Retr ospective interpretation was made by consensus of at least two radiologists. Results Twenty cases of CT scan showed intraper itoneal fluid (18 cases), pneumoperitoneum (18 cases), extravasations of gastro intestinal tract contents (2 cases), bowel wall findings (14 cases) and mesenter ic injury (15 cases). Conclusion CT is fast, sensitive and noninvasi ve in diagnosis of the gastrointestinal tract rupture after blunt abdominal tra uma.

Objective To evaluate the feasibility of increasing the perfraction dose in treatment of neoplasms by 3DCRT (three- dimention confornial radiation therapy). Methods From May 1998 to June 2002, the radiation therapy plans of 300 out- cranial neoplasms patients were analysed retrospectively, including 143 patients with chest neoplasms and 157 patients with abdomen neoplasms. The PTV was 7.0 ~ 1 478 cm3, major PTV was encircled by 90 % isodose curve, minor 95 % PTV were encircled by 80 % isodose curve. Prescription dose was 90 % reference point dose, perfraction dose was 5 ~ 10 Gy, a majority of dose was 6 ~ 8 Gy, period of treatment was 5 ~ 15 days with an interval of 0 ~ 1 day. The general dose was given to radical cure dose or appeasement dose. The biological effect increased 10 % ~ 30 %. Results All treatment plans were accomplished and there were not complication which reduced patients' QOL. Conclusions 1.Owing to the f factor, increasing dose of perfraction, shortening general period of treatment and improving radiative biological effect were possible during the 3DCRT. 2. It was suggested that the larger out- cranial neoplasms should be treated by 3DCRT firstly, but precise plan, precise design and precise treatment can not intensely be pursued because of the limit of knowledge. 3. During the 3DCRT for out- cranial neoplasms, 2 ~ 3 times routine radiation therapy dose was secure, credible and effective according to different purpose.

Objective To study the application of complex surgical therapy of severe hepatic trauma and the flow line reasonable.Method To study the methods and reasonable process of complex surgical treatment of severe hepatic trauma pre-hospital or hospital treatment of 46 patients during the past 15 years.Results The time of sending to hospital was delayed.Patient has severe hepatic trauma or associated injuries.Patient can not be diagnosed definitely against time.Linear correlation was demonstrated between the three upon and shock (r=0.55,t=3.38,P

AIM: To evaluate the role of human angiotensin Ⅱ(AngⅡ) type Ⅰ receptor (AT1R) antisense cDNA (ahAT1) on migration of cultured artery smooth muscle cells (VSMCs). METHODS: Two recombinant adenoviral vectors, Ad/CMV. ahAT1 containing full length antisense cDNA targeting to human AT1R mRNA, and Ad/CMV.LacZ containing LacZ called report gene, were constructed by orientation clone technology and homologous recombination, and then were used to transfect VSMCs in vitro. AT1R expression detected by RT-PCR and immunohistochemistry, and migration of VSMCs measured by Boyden's Chamer methods, were compared between transfected and non- transfected VSMCs. RESULTS: Forty-eight hours after Ad/CMV. ahAT1 transfection, the level of AT1R mRNA decreased markedly (50% of control group), and AT1R protein expression was significantly less (P