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 translate Amyotrophic Lateral Sclerosis Impairment Multidomain Scale(AIMS)into Chinese,and to investi-gate its reliability and validity among Amyotrophic Lateral Sclerosis(ALS)patients.Methods:A total of 161 ALS patients who were registered in the registry system of Integrated Traditional Chinese and Western Medicine Treatment Center for Motor Neuron Disease in Hubei Provincial Hospital of Traditional Chinese Medicine from August 2023 to July 2024 were enrolled as subjects,and the Chinese version of AIMS was used for investigation after translation and revision.The Rasch model was used to assess the unidimensionality,in-ternal consistency,content validity,construct validity,and criterion-related validity of the questionnaire,and the classical test theory was used for item analysis,test-retest reliability analysis,and criterion-related validity analysis.Results:Unidimensionality testing showed that all three dimensions of AIMS have good unidimensionality.For all items except item 18,information-weighted fit statis-tic mean square(Infit MNSQ)and outlier-sensitive fit statistic mean square(Outfit MNSQ)ranged from 0.5 to 1.5,and point-measure correlation(PT-Measure)ranged from 0.63 to 0.87.The threshold between adjacent options of each item was>1.4 logit.Wright maps showed that item difficulties ranged from-2.24 to 2.08 logit,and the differential item functioning analysis showed that the absolute values of differences between patients across different char-acteristic subgroups were<1 logit.The overall scale and each di-mension had a reliability of>0.9,with an individual reliability of>0.7.The dimension of respiration had a separation index of 1.56,while the overall scale and the other dimensions had a separation in-dex of>2.The item analysis showed that the correlation coefficient between the items in each dimension and their respective dimen-sions ranged from 0.622 to 0.865(P<0.01).The overall scale and the dimensions of medulla oblongata,motor,and respiration had a test-retest reliability of 0.994,0.970,0.990,and 0.972,respectively(P<0.01).The criterion-related validity analysis showed that the correlation coefficients of total score and the score of each dimension between the Chinese version of AIMS and the revised version of AIMS were 0.863,0.829,0.876,and 0.755,respectively(P<0.01).Conclusion:The Chinese version of AIMS has a good degree of fit-ting and relatively high levels of reliability and validity,with moderate item difficulty,reasonable option settings,and high overall qual-ity,and it is suitable for the functional assessment of ALS patients in China.

Objective To systematically evaluate the effects of liraglutide combined with metformin on glucose and lipid metabolism,sex hormones,reproductive function,and gastrointestinal reactions in patients with polycystic ovary syndrome(PCOS).Methods We searched databases such as PubMed,WanFang Medical Network,WanFang Database,China National Knowledge Infrastructure(CNKI),and VIP Journals to collect randomized controlled trials published from January 2011 to August 2022 on the treatment of polycystic ovary syndrome with liraglutide combined with metformin,using Revman 5.4 for the meta-analysis.Results A total of 16 case-control studies were included,involving 1436 patients.Compared to metformin alone,the combination of liraglutide and metformin significantly lowered fasting blood sugar,postprandial blood glucoseafter 2 hours,HbA1c,HOMA-IR,FINS,BMI,as well as LH,FSH,and total testosterone in patients with PCOS.It improved lipid levels,helped establish menstrual cycles,and increased the normal ovulation rate and natural conception rate in these patients.However,there was a significantly higher incidence of gastrointestinal reactions in the liraglutide plus metformin group,and the difference was statistically significant(P＜0.05).Conclusion The combination of liraglutide and metformin can improve glucose and lipid metabolism in patients with polycystic ovary syndrome(PC OS),reduce levels of LH,FSH,and total testosterone,help establish regular menstrual cycles,and increase ovulation and pregnancy rates,but it significantly increases gastrointestinal side effects.

Background and objective Pembrolizumab(PEM)has been shown to be effective in clinical trials for the treatment of advanced non-small cell lung cancer(NSCLC),but clinical trials were based on cohorts of patients selected on specific criteria,and whether the findings are consistent with real-world patients is debatable.The aim of this study is to evaluate the efficacy and safety of PEM in the treatment of advanced NSCLC based on real-world data.Methods A retro-spective collection of real-world data from patients with advanced NSCLC receiving PEM was conducted.Propensity score matching was used to eliminate inter-group differences and assess the efficacy and safety of PEM compared to chemotherapy.Results Among 450 matched patients,the incidence rates of any-grade adverse events were 79.87％in the PEM group and86.71％inthe chemotherapy group,while the incidence rates of grade＞3 adverse events were 4.03％and 7.31％,respectively.The objective response rates were 48.63％for PEM and 36.00％for chemotherapy(P=0.011).The median progression-free survival was 15.5 months for PEM and 8.8 months for chemotherapy(P＜0.001),and the median overall survival was not reached for PEM and 26.2 months for chemotherapy(P＜0.001).Conclusion PEM treatment for advanced NSCLC demonstrates favorable survival outcomes and acceptable safety in real-world clinical practice.

Migraine is a common neurological disease,and its pathogenesis is complex.So far,it has not been fully elucidated,nor has it obtained clinically accepted serum biomarkers.Accumulating evidence shows that microRNAs(miRNA),as a class of non-coding regulatory RNAs,not only participate in the pathophysiological mechanism of migraine but also are expected to be a potential biomarker of migraine and play an important role in the pathogenesis of migraine.This article reviews the research on migraine and miRNA,and provides new research ideas for further elucidating the pathogenesis of headache,marker screening,treatment response prediction,and future development of new prevention and treatment drugs.

Hepatolithiasis is one of the most difficult benign diseases in hepatobiliary surgery due to its diverse causes, complex pathogenesis, and high difficulty in therapy. The authors discuss controversial issues in epidemiology, etiology, pathogenesis, and surgical treatment of hepatolithiasis, aiming to explore the research progress and controversial issues, and improve the understanding, diagnosis, and therapy of hepatolithiasis among clinical physicians.

A 57-year-old female patient was treated with secukinumab injection for psoriasis.After the eighth administration,large area of reticular streaks with hyperemia and erosion appeared on the dorsum of the tongue and left buccal mucosa,which improved after three weeks of corticosteroids treatment.The symptoms worsened after re-administration and a diagnosis of an oral lichenoid drug reaction(OLDR)was made,which improved after eight weeks of corticosteroids treatment.There was no recurrence four months after secukinumab injection withdrawal.By correlation analysis,the causal relationship between OLDR and Secukinumab injection was evaluated as"be sure",which had not been reported in China.The clinical manifestations of oral lichenoid drug reactions were unilateral buccal mucosa with hyperemia and erosion.Discontinuation of suspected drugs and topical application of corticosteroids were the most effective treatments.

Migraine is a common type of primary headache worldwide,and its high morbidity and disability rates have brought heavy burden to individuals and society,thereby requiring preventive and acute treatment.Previous thera-peutic strategies for migraine include traditional analgesics and triptans,which are mainly used to relieve pain and reduce accompanying symptoms,but long-term administration of such drugs may lead to medication overuse headache.In recent years,new drugs targeting calcitonin gene-related peptide(CGRP)and its receptors have shown a promising future in the preventive treatment of migraine and the treatment of migraine in the acute stage,such as monoclonal antibodies and small-molecular receptor antagonists,and in addition,they also can be used in patients who have no response to various pharma-cotherapies.This article reviews the recent advances in CGRP drugs in the treatment of migraine.

Objective:To construct the nursing sensitive quality index system for interventional treatment of trigeminal neuralgia, so as to provide reference for the nursing quality evaluation and management of interventional treatment of trigeminal neuralgia.Methods:From June to December 2022, using the "Structure-Process-Results" quality evaluation model as the theoretical framework, an expert inquiry questionnaire was developed based on literature review. The indicator system was established using the Delphi method, and the weights of the indicators were determined using the analytic hierarchy process.Results:The recovery rates of the two rounds of expert correspondence questionnaires were 92.6% (25/27) and 100.0% (25/25), the expert authority coefficients were 0.860 and 0.888, the Kendall's coordination coefficients were 0.073 and 0.058 ( P<0.05), and the coefficient of variation were 0-0.330 and 0-0.191, respectively. Finally, the nursing sensitive quality index system for interventional treatment of trigeminal neuralgia was formed, which included three primary indexes, 14 secondary indexes and 54 tertiary indexes. Conclusions:The index system has strong scientific and clinical applicability, which can provide reference for nursing quality evaluation and management of interventional treatment of trigeminal neuralgia.

Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.