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 effect of problem-solving therapy (PST) on clinical efficacy, cognitive and social function in senile patients with first episode depression.Methods:From March 2020 to August 2021, a total of 86 patients with first onset elderly depression treated in the geriatric department of Qingdao Mental Health Center were selected. According to the random number table method, totally 86 patients were randomly divided into a study group and a control group, with 43 cases in each group. The control group was treated with antidepressant drugs and basic psychiatric nursing intervention. The study group received PST treatment on the basis of the control group for 8 weeks. The Hamilton depression scale-17 items(HAMD-17), Montreal cognitive assessment scale (MoCA), and social dysfunction screening scale (SDSS) were used to assess the degree of depression, cognitive function and social function in both groups. SPSS 18.0 was used for statistical analysis. Independent sample t-test was used for comparison between groups, paired sample t-test was used for comparison before and after treatment. Results:After 8 weeks of intervention, HAMD-17 scores and SDSS scores in the two groups were both significantly decreased compared with before intervention, and the differences between pre intervention and post intervention had statistical significance( t=3.067, 22.543, both P<0.05), while MoCA scores were significantly increased, and the difference between pre intervention and post intervention had statistical significance ( t=9.623, P<0.05). Compared with the control group after 8 weeks of intervention, the HAMD-17 score ((14.44±1.97), (15.58±2.66), t=2.260, P=0.026) and SDSS score((9.44±2.24), (13.00±1.73), t=8.242, P<0.001) of the study group were lower, and the score of MoCA ((25.44±1.28), (23.84±1.56), t=5.223, P<0.001) was higher. Conclusion:In addition to conventional antidepressant therapy, PST not only reduces the severity of depression in elderly patients with first episode depression, but also significantly improves their cognitive and social function.

Objective To compare and analyze the operation time,detection rate and detection number of sentinel lymph node(SLN)who was using contrast-enhanced ultrasound(CEUS)body surface localization combined with nano carbon tracking and single dye method for sentinel lymph node biopsy(SLNB)in patients with cN0 invasive breast cancer(IBC).To explore the feasibility of CEUS body surface localization combined with nano carbon tracking for SLNB.Methods The clinicopathological data of 199 patients with cN0 IBC who were diagnosed and treated in Beijing Shunyi District Hospital from January 1st,2018 to April 30th,2023 were collected.We divided all patients into dye method group(100 cases)and combined method group(99 cases)according to SLN missing method.In dye method group,SLNB was performed with nano carbon tracer;In combined method group,SLN was marked and located by CEUS before surgery and SLNB was performed with nano carbon tracer during surgery.Results The detection rate of SLN in this study was 96.48％(192/199).In the dye method group,the detection rate of SLN was 95.00％and the average detection number of SLN was(2.79±1.228).while in the combination method group,the detection rate was 97.98％and the average detection number of SLN was(3.32± 1.469).There was no statistically significant difference in the detection rate of SLN between the two groups(P＞0.05).The average detection number in combination method group was more than that in dye method group(P＜0.05).However,there was no statistically significant difference in the distribution of SLN detection number between the two groups(P＞0.05).The duration of SLNB surgery in the combination method group was significantly shorter than that in the dye method group[(13.83±4.58)minutes vs(19.85±3.20)minutes),P＜0.05].Conclusion Combined method for SLNB can reduce surgical time and increase the detection rate and number of SLN.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the correlation between CpG island methylation levels of human placental genes and spontaneous abortion in pregnant women. Methods A total of 55 pregnant women who underwent routine prenatal examination were selected as the study subjects, including 25 cases of spontaneous abortion (abortion group) and 30 cases of normal delivery (control group). Clinical data and human placental tissue samples were collected from the enrolled pregnant women. Clinical general data of the two groups were compared. The predictive value of methylation levels of related placental genes on the outcome of spontaneous abortion in pregnant women was analyzed. Logistic regression analysis was used to analyze the influencing factors of spontaneous abortion in pregnant women. Results There were statistically significant differences in maternal age, birth weight of aborted fetuses/neonates, days of pregnancy, and gender of aborted fetuses/neonates between the two groups (P < 0.05). Methylation of MECP2-1, MECP2-4, HSD11B2, MECP2-3 and MECP2-2 genes was associated with spontaneous abortion. The methylation rates of MECP2-1, MECP2-4, HSD11B2 and MECP2-3 genes in the abortion group were higher than those in the control group, with statistically significant differences (P < 0.05). The area under the curve (AUC) of MECP2-1, MECP2-4, HSD11B2, MECP2-3 and MECP2-2 was 0.773, 0.737, 0.700, 0.663, and 0.627, respectively. Logistic regression analysis showed that MECP2-1 was an independent influencing factor for miscarriage in pregnant women (P < 0.05). Conclusion The methylation levels of MECP2-1, MECP2-4, HSD11B2, MECP2-3 and MECP2-2 genes are related to the outcome of spontaneous abortion in pregnant women. The MECP2-1 gene is an independent influencing factor for spontaneous abortion.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

【Objective】 To investigate the association of maternal medication during early pregnancy and cytochrome P450 (CYP450) genetic polymorphisms with the risk of congenital heart disease (CHD) in offspring. 【Methods】 We selected 127 pregnant women with CHD fetuses as the observation group and 132 pregnant women with non-CHD fetuses as the control group. Their characteristics and medication history were investigated, and CYP450 polymorphisms were detected. Logistic regression analysis was used to assess the association between maternal medication, CYP450 gene variations, and offspring CHD risk. 【Results】 The risk of CHD in offspring was higher in the observation group with maternal use of ovulation induction drugs, antihypertensive drugs, antibiotics, antidepressants, miscarriage prevention drugs, and traditional Chinese medicine (P<0.05). The A/T and T/T genotypes in rs1065852 and the C/G and G/G genotypes in rs16947 increased the risk of CHD in offspring compared to their respective genotypes. The risk of CHDs in offspring increased with the presence of risk genotypes (A/T or T/T) at the rs1065852 locus of the maternal CYP450 gene and early pregnancy medication use (P<0.05); the same was observed for risk genotypes (C/G or G/G) at the rs16947 locus (P<0.05). 【Conclusion】 Maternal medication during early pregnancy may be associated with offspring CHD, and the rs1065852 and rs16947 loci of CYP450 are significantly related to the risk of CHD in offspring.

Estrogen impacts neural development; meanwhile, it has a protective effect on the brain. Bisphenols, primarily bisphenol A (BPA), can exert estrogen-like or estrogen-interfering effects by binding with estrogen receptors. Extensive studies have suggested that neurobehavioral problems, such as anxiety and depression, can be caused by exposure to BPA during neural development. Increasing attention has been paid to the effects on learning and memory of BPA exposure at different developmental stages and in adulthood. Further research is required to elucidate whether BPA increases the risk of neurodegenerative diseases and the underlying mechanisms, as well as to assess whether BPA analogs, such as bisphenol S and bisphenol F, influence the nervous system.
Receptors, Estrogen/metabolism* ; Estrogens ; Benzhydryl Compounds/pharmacology* ; Nervous System/metabolism*

Many efforts have been made to understand excitotoxicity and develop neuroprotectants for the therapy of ischemic stroke. The narrow treatment time window is still to be solved. Given that the ischemic core expanded over days, treatment with an extended time window is anticipated. Bestrophin 1 (BEST1) belongs to a bestrophin family of calcium-activated chloride channels. We revealed an increase in neuronal BEST1 expression and function within the peri-infarct from 8 to 48 h after ischemic stroke in mice. Interfering the protein expression or inhibiting the channel function of BEST1 by genetic manipulation displayed neuroprotective effects and improved motor functional deficits. Using electrophysiological recordings, we demonstrated that extrasynaptic glutamate release through BEST1 channel resulted in delayed excitotoxicity. Finally, we confirmed the therapeutic efficacy of pharmacological inhibition of BEST1 during 6-72 h post-ischemia in rodents. This delayed treatment prevented the expansion of infarct volume and the exacerbation of neurological functions. Our study identifies the glutamate-releasing BEST1 channel as a potential therapeutic target against ischemic stroke with a wide time window.

Objective:To investigate the predictive role of dynamic changes of plasma biomarkers in patients with viral and mycoplasma community-acquired pneumonia (CAP).Methods:From January 2020 to June 2020, 141 patients with viral and mycoplasma CAP in People's Hospital of Ningxia Hui Autonomous Region were enrolled. Pneumonia severity index (PSI) scores [grade Ⅰ-Ⅱ(PSI score ≤ 70), grade Ⅲ (PSI score 71-90) and grade Ⅳ-Ⅴ(PSI score ≥ 91)], serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) on the 1 day after admission were compared between the different pathogens (viral and mycoplasma) or different disease severity. The change in level of SAA, hs-CRP on the third day (Δ 3 d = 1 d-3 d) were compared among different disease outcome groups (patients were divided into improved group, stable group and exacerbation group based on PSI scores or lung CT images on the third day). The change in the level of SAA, hs-CRP on the seventh day (Δ 7 d = 1 d-7 d) were compared among different disease prognosis groups (patients were divided into survival group and death group based on 28-day survival data). The receiver operating characteristic curve (ROC) were drawn to evaluate the value of SAA in the evaluation of disease and prediction prognosis. Results:The level of SAA in mycoplasma group (43 cases) was significantly higher than that in virus group (98 cases) on the 1 day after admission. There were no significant differences in other plasma biomarkers between the two groups. The more severe the illness, the higher the SAA level on the 1 day after admission. The trends of other plasma biomarkers in the two groups were consistent with SAA. The levels of SAA in the patients with exacerbation of the virus group and mycoplasma group (12 cases, 9 cases) were significantly higher than those of the improved group (57 cases, 26 cases) and the stable group (29 cases, 8 cases). SAA increased gradually in the exacerbation group, decreased gradually in the improved group, and slightly increased in the stable group. ΔSAA 3 d were differences among three groups. The change trend of hs-CPR was consistent with SAA. The level of SAA in the death group was higher than that in the survival group on the seventh day. SAA increased in the death group and decreased in survival group with time from hospital admission. There were differences according to ΔSAA 7 d between death group and survival group. The change trend of hs-CPR was consistent with SAA. ROC curve showed that the value of SAA was better than hs-CRP in assessing the severity of patients on admission day, and the area under ROC curve (AUC) was respectively 0.777 [95% confidence interval (95% CI) was 0.669-0.886], 0.729 (95% CI was 0.628-0.830). The value of ΔSAA 3 d was better than SAA on the third day predicting disease trends, and AUC was respectively 0.979 (95% CI was 0.921-1.000), 0.850 (95% CI was 0.660-1.000). hs-CRP on the third day and Δhs-CRP 3 d had no predictive value. Both SAA on the seventh day and ΔSAA 7 d have predictive value for prognosis. AUC was respectively 0.954 (95% CI was 0.898-0.993) and 0.890 (95% CI was 0.689-1.000). SAA on the seventh day and ΔSAA 7 d were better than hs-CRP on the seventh day. Δhs-CRP 7 d have no predictive value. Conclusions:SAA is a sensitive and valuable indicator for CAP patients with viruses and mycoplasma. Dynamic monitoring of SAA can evaluate the patient's progression, prognosis, and assist diagnosis and treatment.