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 provide reference for clinical rational drug use and the prevention and treatment of drug-resistance bacteria.METHODS:A total of 148 patients with oral infection after orthodontic treatment were selected from a hospital during Jul.2011-Jul.2016.The distribution of pathogenic bacteria and drug resistance were analyzed retrospectively.RESULTS:Among 148 patients with oral infection,275 clinical specimens were detected,including 209 positive specimens with positive rate of 76.00％.A total of 332 pathogenic bacteria were detected,including 85 Gram-positive bacteria (25.60％) and 247 Gram-negative bacteria (74.40％).Top 7 isolated bacteria in the list of quantity were Actinobacillus pleuropneumoniae (54 strains,16.27％),Porphyromonas gingivalis (41 strains,12.35 ％),Tannerella forsythia (37 strains,11.14 ％),Streptococcus oralis (33 strains,9.94％),Klebsiella pneumoniae (30 strains,9.04％),Staphylococcus aureus (26 strains,7.83％) and Pseudomonas aeruginosa (25 strains,7.53％).Resistance rates of S.aureus to penicillin G,gentamicin,ciprofloxacin,oxacillin and tetracycline were all in high level (resistance rate＞50％),but it was sensitive to vancomycin and teicoplanin (resistance rate of 0).Enterococcus faecalis showed high resistance to penicillin G,erythromycin and oxacillin (resistant rate＞50％),but was sensitive to vancomycin and rifampicin (resistant rate of 0).K.Pneumoniae showed high resistance to gentamicin,ciprofloxacin,levofloxacin and cefazolin (resistant rate＞ 50％),but was sensitive to imipenem,ceftazidime,cefepime,ampicillin sodium and sulbactarn sodium,amoxicillin and clavulanate potassium (resistant rate＜ 10 ％).Resistant rates of P aeruginosa to gentamicin and levofloxacin were ≥ 80 ％,but it was sensitive to aztreonam (resistant rate of 8.00 ％).Resistant rate of Escherichia coli to piperacillin was 84.21％,but it was sensitive to imipenem and ampicillin sodium and sulbactam sodium (resistance rate of 5.26％).CONCLUSIONS:After orthodontic treatment,the pathogens of oral infection are various,mainly Gram-negative bacteria,and their drug resistance is not optimistic.The drugs with high sensitivity to the main pathogens include vancomycin,imipenem and enzyme inhibitor complex preparations,etc.Clinical attention should be paid to the cultivation of pathogenic bacteria and drag sensitivity test;according to the results of drug sensitivity test,targeted antibiotics should be selected to improve the antibacterial effect and delay the emergence of drug-resistant bacteria.

Objective To observe the effects of serum with drug Penthorum chinense Pursh extractum on transforming growth factor (TGF)-β1 and collagen I secretions of activated hepatic stellate cells. Methods Twenty male SD rats were divided into 2 groups, and were administered with 0.9% sodium chloride solution and Penthorum chinense Pursh extraetum via gastrogavage for 3 days respectively and then sacrificed. Serum samples of these rats were collected. HSC-T6 cells were divided into the normal group and the treatment group. The cells of the normal group were incubated in Dulbecco's modified eagle medium (DMEM)with sera of normal rats, while those of the treatment group were incubated in DMEM with sera from Penthorum chinense Pursh extractum treated rats. The HSC-T6 viability was observed by AlamarBlue assay, while the toxicity of Penthorum ehinense Pursh extractum was measured by 3-(4, 5-Dimethyhhiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. The expression of collagen I and TGF-β1 mRNA were determined by real timepolymerase chain reaction (real time PCR). The protein expressions of collagen I and TGF-β1 were analyzed by Western blotting. The data were analyzed by single factor analysis of variance and pairwise comparison was done by q test. Results Different concentrations of sera from Penthorum chinense Pursh extractum treated rats could all inhibit HSC-T6 proliferation, especially when the sera concentration were 10% and the HSC-T6 cells were incubated for 24 h (P＜0.01 ). MTT assay indicated that sera from Penthorum chinense Pursh extractum treated rats showed no obvious toxicity to HSC-T6 compared with those from normal rats (P ＞0.05). After 24 h incubation, 10% sera from Penthorum chinense Pursh extractum treated rats could significantly down-regulate mRNA expression of TGF-β1 and collagen I compared with normal group (TGF-β1 2.790±0.174 vs 9. 827 ± 1.429, P＜0.01 ; collagen I 1.213 ± 0.099 vs 4.053 ± 1.005, P＜0.01 ). Mcanwhile, the protein expressions of TGF-β1 and collagen I were also obviously inhibited in drug treated group compared with normal group (P＜0.01). Conclusions Serum from Penthorum chinense Pursh extractum treated rats can significantly decrease TGF-β1 and collagen I secretions of activated hepatic stellate cells, which provides the experimental evidence for liver fibrosis treatment.