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.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective:To explore the effect of amiodarone combined with rivaroxaban on the plasma concentration of rivaroxaban in patients with non-valvular atrial fibrillation.Methods:This study was designed as the prospective cohort study. The subjects were selected from patients with atrial fibrillation who were hospitalized in the Department of Cardiology of Beijing Hospital from January to October 2019 and treated with rivaroxaban (≥3 days). The enrolled patients were divided into the with amiodarone combination group and the without amiodarone combination group. The trough concentration and peak concentration of rivaroxaban were detected by chromogenic substrate method with anti-Xa assay kit. Taking the plasma concentration of patients with a daily dose of 20 mg of rivaroxaban as the standard, plasma concentrations in patients with various daily doses of rivaroxaban were standardized. The measured plasma concentrations, standardized plasma concentrations, and plasma concentrations in patients at daily dose of 20 mg of rivaroxaban were respectively compared between the 2 groups.Results:A total of 65 patients were entered in the study, including 12 patients in the with amiodarone combination group (the daily dose of rivaroxaban was 20 mg) and 53 patients in the without amiodarone combination group (the daily doses of rivaroxaban were 20, 15, and 10 mg in 42, 9, and 2 patients, respectively). The differences in gender, age, weight, body mass index, smoking history, CHA 2DS 2-VASc score, HAS-BLED score, daily dose of rivaroxaban, liver and kidney function, and platelet count of patients between the 2 groups were not statistically significant ( P>0.05 for all). The trough and peak plasma concentrations of rivaroxaban in the with amiodarone combination group were higher than those in the without combination amiodarone group, but the differences were not statistically significant [(43±30) ng/ml vs. (38±26) ng/ml, t=0.569, P=0.571; (294±114) ng/ml vs. (251±87) ng/ml, t=1.473, P=0.146]. The differences in standardized trough and peak plasma concentrations of rivaroxaban [(41±28) ng/ml, (273±108) ng/ml]in patients between the 2 groups, and the trough and peak plasma concentration [(40±27) ng/ml,(249±75) ng/ml]of patients at daily dose of 20 mg of rivaroxaban were not statistically significant ( P>0.05 for all). Conclusion:Amiodarone has no significant effects on the plasma concentration of rivaroxaban in patients with atrial fibrillation, however, it is still necessary to strengthen the patient monitoring in those with combination use of the 2 drugs.

Objective:To explore the effect of amiodarone combined with rivaroxaban on the plasma concentration of rivaroxaban in patients with non-valvular atrial fibrillation.Methods:This study was designed as the prospective cohort study. The subjects were selected from patients with atrial fibrillation who were hospitalized in the Department of Cardiology of Beijing Hospital from January to October 2019 and treated with rivaroxaban (≥3 days). The enrolled patients were divided into the with amiodarone combination group and the without amiodarone combination group. The trough concentration and peak concentration of rivaroxaban were detected by chromogenic substrate method with anti-Xa assay kit. Taking the plasma concentration of patients with a daily dose of 20 mg of rivaroxaban as the standard, plasma concentrations in patients with various daily doses of rivaroxaban were standardized. The measured plasma concentrations, standardized plasma concentrations, and plasma concentrations in patients at daily dose of 20 mg of rivaroxaban were respectively compared between the 2 groups.Results:A total of 65 patients were entered in the study, including 12 patients in the with amiodarone combination group (the daily dose of rivaroxaban was 20 mg) and 53 patients in the without amiodarone combination group (the daily doses of rivaroxaban were 20, 15, and 10 mg in 42, 9, and 2 patients, respectively). The differences in gender, age, weight, body mass index, smoking history, CHA 2DS 2-VASc score, HAS-BLED score, daily dose of rivaroxaban, liver and kidney function, and platelet count of patients between the 2 groups were not statistically significant ( P>0.05 for all). The trough and peak plasma concentrations of rivaroxaban in the with amiodarone combination group were higher than those in the without combination amiodarone group, but the differences were not statistically significant [(43±30) ng/ml vs. (38±26) ng/ml, t=0.569, P=0.571; (294±114) ng/ml vs. (251±87) ng/ml, t=1.473, P=0.146]. The differences in standardized trough and peak plasma concentrations of rivaroxaban [(41±28) ng/ml, (273±108) ng/ml]in patients between the 2 groups, and the trough and peak plasma concentration [(40±27) ng/ml,(249±75) ng/ml]of patients at daily dose of 20 mg of rivaroxaban were not statistically significant ( P>0.05 for all). Conclusion:Amiodarone has no significant effects on the plasma concentration of rivaroxaban in patients with atrial fibrillation, however, it is still necessary to strengthen the patient monitoring in those with combination use of the 2 drugs.

The motor nervous system transmits motion control information through nervous oscillations, which causes the synchronous oscillatory activity of the corresponding muscle to reflect the motion response information and give the cerebral cortex feedback, so that it can sense the state of the limbs. This synchronous oscillatory activity can reflect connectivity information of electroencephalography-electromyography (EEG-EMG) functional coupling. The strength of the coupling is determined by various factors including the strength of muscle contraction, attention, motion intention etc. It is very significant to study motor functional evaluation and control methods to analyze the changes of EEG-EMG synchronous coupling caused by different factors. This article mainly introduces and compares coherence and Granger causality of linear methods, the mutual information and transfer entropy of nonlinear methods in EEG-EMG synchronous coupling, and summarizes the application of each method, so that researchers in related fields can understand the current research progress on analysis methods of EEG-EMG synchronous systematically.
Electroencephalography ; Electromyography ; Humans ; Motor Cortex ; physiology ; Muscle, Skeletal ; physiology ; Research

Background and purpose:New treatment methods should be explored for non-small cell lung cancer (NSCLC) patients with acquired resistance to epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). This study compared the curative effect of pemetrexed with geiftinib or pemetrexed alone in advanced NSCLC with acquired resistance to EGFR-TKI.Methods:This study included 62 NSCLC patients with advanced EGFRgene mutation and acquired resistance to EGFR-TKI. Among those, 32 patients were treated with pemetrexed and geiftinib, and 30 patients treated with geiftinib alone. The differences in outcomes between the two strategies were assessed.Results:Objective response rate (ORR) was 46.9% for those treated with pemetrexed and geiftinib and 20%for those treated with pemetrexed alone(χ2=4.933,P<0.05). There was no signiifcant differences between the two groups on disease control rate (DCR) (P>0.05). The median progression-free survival (PFS) was 8.0 months on pemetrexed and gefitinib group and 6.3 months on pemetrexed alone (χ2=8.063,P<0.05). There was no significant differences between the two groups on overall survival (OS) (P>0.05). Higher occurrence of leukocytopenia and rash was observed in the pemetrexed and geiftinib group than in the pemetrexed group (P<0.05). There was no signiifcant differences be-tween the two groups on grade 3-4 toxicities (P>0.05).Conclusion:This study was to demonstrate that continuation of EGFR-TKI with pemetrexed in patients with acquired resistance improves outcomes compared with pemetrexed alone. An improved response rate and PFS were observed in this study. A larger prospective clinical trial is needed to further evaluate this promising strategy.

Insertional mutagenesis is a widely used method to determine the function(s) of a gene. To study the function(s) of the gene nsdAmgh in Streptomyces roseoflavus, a homologous recombination vector pSRNA2500 was structured in this paper. The recombination donor vector was then transformed into Strempomyces roseoflavus strain Men-myco-93-63 by conjugative transfer. The transformants were subjected to selection under the pressure of high temperature and appropriate antibiotics. As a result, several disrupted mutants of nsdAmgh gene, with a phenotype of Am(s)Km(r), were isolated and verified using PCR and Dot-blotting and Southern blotting hybridization methods. Functional analysis showed that the disrupted mutants of nsdAmgh had a two-fold higher inhibition against Verticillium dahlia Kleb than that of the wild strain Men-myco-93-63, which all will provide a new study route for future research about positive and negative regulator in Men-myco-93-63.
Genes, Bacterial ; Genetic Vectors ; Mutagenesis, Insertional ; Polymerase Chain Reaction ; Streptomyces ; genetics