Objective:To investigate the predictive value of serum neutrophil gelatinase-associated lipocalin(NGAL),calcitonin gene-related peptide(CGRP),and neutrophil-to-lymphocyte ratio(NLR)for the prognostic regression of elderly patients with stroke complicated with pulmonary infection(SCPI).Methods:This study was a retrospective single-center study,149 elderly patients with SCPI who were admitted to Inner Mongolia Baogang Hospital from June 2020 to June 2024 were selected,they were divided into poor prognosis group(n=56)and good prognosis group(n=93)according to the prognosis.Baseline data and laboratory test indicators were collected,and NLR was calculated.Serum NGAL and CGRP levels were measured by ELISA.Influencing factors of poor prognosis of elderly patients with SCPI were analyzed by Multivariate logistic regression.Predicts value was analyzed by Receiver operating characteristic(ROC)curve.Results:Compared with good prognosis group,the poor prognosis group had higher of aged ≥ 70 years,incidence of hemorrhagic stroke,serum creatinine,white blood cell count,national institute of health stroke scale(NIHSS),platelet count,C-reactive protein,NGAL,and NLR levels,longer nerosurgery intensive care unit(NICU)stay,and lower CGRP levels(P＜0.05).Higher CGRP level was an independent protective factor of poor prognosis of elderly patients with SCPI(OR＜1,P＜0.05).Age ≥ 70 years,hemorrhagic stroke,longer NICU stay,higher NIHSS score,higher NGAL level and higher NLR were independent risk factors of poor prognosis of elderly patients with SCPI(OR＞1,P＜0.05).The area under the curve(AUC)for predicting the prognostic regression of elderly patients with SCPI used NGAL,CGRP,and NLR alone or in combination was 0.777,0.771,0.786,and 0.927,respectively,with the combination of three factors showed the highest predictive power(P＜0.05).Conclusion:Age ≥70 years,hemorrhagic stroke,longer NICU stay,higher NIHSS score,higher NGAL level and higher NLR are independent risk factors of poor prognosis of elderly patients with SCPI,while higher CGRP level is an independent protective factor.The combination detection of NGAL,CGRP and NLR can improve the predictive value of prognostic regression in elderly patients with SCPI.

Objective:To investigate the predictive value of serum neutrophil gelatinase-associated lipocalin(NGAL),calcitonin gene-related peptide(CGRP),and neutrophil-to-lymphocyte ratio(NLR)for the prognostic regression of elderly patients with stroke complicated with pulmonary infection(SCPI).Methods:This study was a retrospective single-center study,149 elderly patients with SCPI who were admitted to Inner Mongolia Baogang Hospital from June 2020 to June 2024 were selected,they were divided into poor prognosis group(n=56)and good prognosis group(n=93)according to the prognosis.Baseline data and laboratory test indicators were collected,and NLR was calculated.Serum NGAL and CGRP levels were measured by ELISA.Influencing factors of poor prognosis of elderly patients with SCPI were analyzed by Multivariate logistic regression.Predicts value was analyzed by Receiver operating characteristic(ROC)curve.Results:Compared with good prognosis group,the poor prognosis group had higher of aged ≥ 70 years,incidence of hemorrhagic stroke,serum creatinine,white blood cell count,national institute of health stroke scale(NIHSS),platelet count,C-reactive protein,NGAL,and NLR levels,longer nerosurgery intensive care unit(NICU)stay,and lower CGRP levels(P＜0.05).Higher CGRP level was an independent protective factor of poor prognosis of elderly patients with SCPI(OR＜1,P＜0.05).Age ≥ 70 years,hemorrhagic stroke,longer NICU stay,higher NIHSS score,higher NGAL level and higher NLR were independent risk factors of poor prognosis of elderly patients with SCPI(OR＞1,P＜0.05).The area under the curve(AUC)for predicting the prognostic regression of elderly patients with SCPI used NGAL,CGRP,and NLR alone or in combination was 0.777,0.771,0.786,and 0.927,respectively,with the combination of three factors showed the highest predictive power(P＜0.05).Conclusion:Age ≥70 years,hemorrhagic stroke,longer NICU stay,higher NIHSS score,higher NGAL level and higher NLR are independent risk factors of poor prognosis of elderly patients with SCPI,while higher CGRP level is an independent protective factor.The combination detection of NGAL,CGRP and NLR can improve the predictive value of prognostic regression in elderly patients with SCPI.

Multidrug resistance (MDR) is the main cause of clinical treatment failure and poor prognosis in cancer. Targeting P-glycoprotein (P-gp) has been regarded as an effective strategy to overcome MDR. In this work, we reported our preclinical studies of the triazolo[1,5-a]pyrimidine-based compound WS-716 as a highly potent, specific, and orally active P-gp inhibitor. Through direct binding to P-gp, WS-716 inhibited efflux function of P-gp and specifically reversed P-gp-mediated MDR to paclitaxel (PTX) in multiple resistant cell lines, without changing its expression or subcellular localization. WS-716 and PTX synergistically inhibited formation of colony and 3D spheroid, induced apoptosis and cell cycle arrest at G2/M phase in resistant SW620/Ad300 cells. In addition, WS-716 displayed minimal effect on the drug-metabolizing enzyme cytochrome P4503A4 (CYP3A4). Importantly, WS-716 increased sensitivity of both pre-clinically and clinically derived MDR tumors to PTX in vivo with the T/C value of 29.7% in patient-derived xenograft (PDX) models. Relative to PTX treatment alone, combination of WS-716 and PTX caused no obvious adverse reactions. Taken together, our preclinical studies revealed therapeutic promise of WS-716 against MDR cancer, the promising data warrant its further development for cancer therapy.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with COVID-19, we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. FDA approved drug library, we identified an anticoagulation agent dipyridamole (DIP) , which suppressed SARS-CoV-2 replication . In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers ( < 0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.

Objectives: To compare the short-term and mid-term outcomes of elderly patients (>60 years old) with valvular heart disease (VHD) underwent bioprosthetic or mechanical valve replacement. Methods: Between January 2007 and December 2010, 559 elderly patients underwent valve replacement in Fuwai Hospital, clinical data of these patients were analyzed retrospectively (319 cases with bioprostheses vs 240 cases with mechanical prostheses). After matching, data from 192 cases in each group were compared. Results: The mortality within 30 postoperative days were similar (2.1% in both groups). All-cause death during follow up was also similar between the two groups (13.6% vs 13.7%, P=0.98). There was no statistically significant difference on the hospital readmission rate between the two groups (25.5% vs 35.9%, P=0.17). No significant difference was found on thromboembolic and hemorrhagic events free survival between the two groups (144 cases vs 138 cases, P=0.78). Conclusions: Short-term and mid-term survival and readmission rate are similar for the elderly VHD patients receiving bioprosthetic or mechanical valve replacement.

OBJECTIVETo analyze the molecular epidemiological characteristics of HIV-1 subtype CRF01_AE strains being prevailed among HIV/AIDS in Zhejiang province in 2009.

METHODSA total of 303 subjects were identified by stratified random sampling among HIV infected individuals in Zhejiang province in 2009. Gag fragments of the HIV-1 strains were amplified by nested polymerase chain reaction from the DNA extracted from whole blood of HIV-1 infected individuals. PCR products were sequenced and analyzed by phylogenetic method.

RESULTSA total of 132 HIV-1 subtype CRF01_AE sequences were identified from the 225 samples that sequenced successfully, accounting for 58.67% (132/225). A total of 90.91% (120/132) CRF01_AE strains infected HIV/AIDS were transmitted mainly by sexual contacts. A total of 65.91% (87/132) of the cases infected by heterosexual route and 25.00% (33/132) by homosexual route. There were three main clusters in the phylogenetic tree. Pairwise DNA distance within three groups was 0.037 ± 0.011, 0.034 ± 0.008 and 0.047 ± 0.010, which has statistical significance (P < 0.05). Distribution of the sequence of homosexual behavior infected individuals was relatively concentrated in clusters one (96.97%, 32/33), and crossed with heterosexual behavior infectors, and presented the close relations with strains from Jiangsu province, Zhengzhou of Henan province, Liaoning province, Shijiazhuang of Hebei province.

CONCLUSIONThe CRF01_AE strains were the dominant subtypes among HIV infected individuals. The majority of the CRF01_AE infected cases had high risk sexual behavior. The heterosexual infected cases were more than homosexual cases. The circulating status of CRF01_AE strains in homosexual population was relatively independent, but also had evidence of transmission from man who have sex with man to heterosexual population.

Acquired Immunodeficiency Syndrome ; epidemiology ; virology ; Adolescent ; Adult ; China ; epidemiology ; Female ; Genetic Variation ; HIV-1 ; classification ; genetics ; Humans ; Male ; Middle Aged ; Molecular Epidemiology ; Phylogeny ; Young Adult