OBJECTIVE To compare the efficacy and safety of vedolizumab （VDZ） versus infliximab （IFX） in biologic-naive（Bio-naive） patients with moderate-to-severe active ulcerative colitis （UC）， and to analyze the factors influencing efficacy. METHODS Clinical data were retrospectively collected from Bio-naive patients with moderate-to-severe active UC who received treatment in the Department of Gastroenterology at Shanxi Provincial People’s Hospital from June 2023 to June 2024. Based on the type of biologic agent administered， the patients were divided into the IFX group （41 cases） and the VDZ group （30 cases）. Patients in the two groups received IFX （5 mg/kg） or VDZ （300 mg） for induction and maintenance of remission therapy. The two groups were compared regarding modified Mayo score， serological indicators （hemoglobin， albumin， platelet count， erythrocyte sedimentation rate， C-reactive protein）， combined medication， efficacy-related indexes （clinical response rate/remission rate， and endoscopic response rate/remission rate）， and the occurrence of adverse drug reactions （ADR）. Based on Logistic regression model， univariate and multivariate analyses were conducted to identify potential factors influencing clinical remission at week 14 and endoscopic remission at week 38. RESULTS There were no statistically significant differences in clinical response rate/remission rate， or endoscopic response rate/remission rate between the two groups at weeks 14 and 38 （ P ＞0.05）. However， at week 14 of treatment， the proportion of patients using concomitant corticosteroids in VDZ group was 26.67%， significantly higher than the 7.50% in IFX group （ P ＜0.05）. There was no statistical significance in the overall incidence of ADR between the two groups （ P ＞0.05）； all ADRs in the IFX group were grade 3 and led to treatment discontinuation （6 cases）， whereas ADR in the VDZ group was grade 2 and did not interrupt therapy （1 case）. Univariate and multivariate regression analyses revealed that disease type （relapsing） was significantly associated with clinical remission at week 14 of treatment， and a history of smoking was significantly associated with endoscopic remission at week 38 of treatment （the odds ratios were 0.08 for both， with 95% confidence intervals of 0.01-0.77 and 0.01-0.91 respectively， P ＜0.05）. CONCLUSIONS For Bio-naive patients with moderate-to-severe active UC， VDZ and IFX demonstrate comparable efficacy in inducing and maintaining clinical remission and promoting mucosal healing， as well as overall safety. Although IFX can achieve faster control of inflammation in the early stage of the disease， it causes more severe ADR. Disease type （relapsing） and smoking history are identified as independent negative predictors for short-term clinical remission and long-term endoscopic remission， respectively.

Objective To understand and grasp the status quo of resistance of Culex pipiens pallens to four commonly used insecticides in Hefei City, and to provide a scientific basis for the chemical control of mosquito larvae. Methods From June to July 2023, Cx. pipiens pallens larvae were collected from 9 counties (cities and districts) in Hefei City. The LC50 of late third-instar to early fourth-instar larvae of Cx. pipiens pallens to commonly used insecticides was determined by larval immersion method (sensitive baseline method). Results Cx.pipiens pallens larvae in Hefei City exhibited different degrees of resistance to four insecticides: permethrin, beta-cypermethrin, temephos, and propoxur. The relative resistance coefficients to permethrin and beta-cypermethrin were 26.96 and 21.17, respectively, indicating the moderate resistance level. The relative resistance coefficients to propoxur were 6.70, indicating a low resistance level. The relative resistance coefficient to temephos was 2.43, indicating a sensitivity level. Culex pipiens pallens against pyrethroids such as 0.25% permethrin, 0.025% deltamethrin and 0.025% cypermethrin in 1 h knockout rate and 24 h mortality rates were 3.25% (4/123) and 46.34% (57/123), 3.60% (5/139) and 35.97% (50/139), 3.85% (6/156) and 40.38% (63/156), respectively. For 5% malathion and 0.1% propoxur, the 1 h knockdown rate and 24 h mortality rate were 97.69% (127/130) and 99.23% (129/130), 94.48% (137/145) and 100.00% (145/145), respectively. It showed resistance to 0.25% permethrin, 0.025% deltamethrin and 0.025% cypermethrin, and sensitivity to 5% malathion and 0.1% propoxur. Conclusions Culex pipiens pallens in Hefei City have developed varying degrees of resistance to parathyroid and carbamate insecticides. In the control of mosquito vectors, it is essential to strengthen the scientific and rational use of chemical control in combination with environmental and physical control measures to form an integrated control strategy. This approach will improve the control efficiency while delaying the occurrence and development of insecticide resistance.

Objective:To explore the effectiveness of systematic nursing based on health empowerment theory in patients with decompensated liver cirrhosis.Methods:Convenience sampling was used to select 200 patients with decompensated liver cirrhosis in Shanxi Provincial People's Hospital from March 2024 to September 2024 for the study. The patients were divided into control group ( n=100) and observation group ( n=100) by randomized numerical table method. Control group implemented conventional nursing, and observation group was treated with systematic nursing based on health empowerment theory on the basis of control group. Patients were assessed using the Exercise of Self-Care Agency Scale (ESCA), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Generic Quality of Life Inventory-74 (GQOLI-74), and a self-designed satisfaction rating scale. Results:After intervention, the ESCA scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the SDS and SAS scores of observation group were lower than those of control group, and the differences were statistically significant ( P<0.05). After intervention, the GQOLI-74 scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the overall satisfaction of observation group and control group was 92.00% (92/100) and 82.00% (82/100), respectively, with a statistically significant difference ( P<0.05) . Conclusions:The systematic nursing based on health empowerment theory for patients with decompensated liver cirrhosis can improve patients' self-care ability and quality of life, effectively alleviate depression and anxiety, and enhance patients' overall satisfaction with nursing services, which is worthy of clinical practice.

Objective:To explore the effectiveness of systematic nursing based on health empowerment theory in patients with decompensated liver cirrhosis.Methods:Convenience sampling was used to select 200 patients with decompensated liver cirrhosis in Shanxi Provincial People's Hospital from March 2024 to September 2024 for the study. The patients were divided into control group ( n=100) and observation group ( n=100) by randomized numerical table method. Control group implemented conventional nursing, and observation group was treated with systematic nursing based on health empowerment theory on the basis of control group. Patients were assessed using the Exercise of Self-Care Agency Scale (ESCA), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Generic Quality of Life Inventory-74 (GQOLI-74), and a self-designed satisfaction rating scale. Results:After intervention, the ESCA scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the SDS and SAS scores of observation group were lower than those of control group, and the differences were statistically significant ( P<0.05). After intervention, the GQOLI-74 scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the overall satisfaction of observation group and control group was 92.00% (92/100) and 82.00% (82/100), respectively, with a statistically significant difference ( P<0.05) . Conclusions:The systematic nursing based on health empowerment theory for patients with decompensated liver cirrhosis can improve patients' self-care ability and quality of life, effectively alleviate depression and anxiety, and enhance patients' overall satisfaction with nursing services, which is worthy of clinical practice.

Purpose/Significance To analyze the multidimensional interaction between the characteristics of traditional Chinese and western medicine in patients with type 2 diabetes mellitus and its influence on traditional Chinese medicine(TCM)syndrome differentia-tion.Method/Process Based on the real-world electronic medical record(EMR)data,the traditional association rule algorithm is im-proved,and the important TCM syndromes are screened out as dependent variables by increasing the respect index,and the logistic regres-sion algorithm is used to explore the influence of traditional Chinese and western medicine indexes on TCM syndromes.Result/Conclusion Based on 688 patients,112 association rules are obtained,of which 12 includes TCM syndromes.The respect of association rules between middle-earth stagnation syndrome and overweight/obesity is the highest,moreover,overweight/obesity patients have a higher prevalence rate of middle-earth stagnation syndrome.There is a strong correlation between middle-earth stagnation syndrome,peripheral neuropathy or hypertension and overweight/obesity.Patients with diabetic nephropathy are more likely to have qi and yin deficiency syndrome.

Objective Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections(CRKP-BSI).Methods Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020,to indentify the risk factors of death and treatment effects of different antibiotic regimens.Results In 81 CRKP-BSI cases,the majority source were from abdominal and respiratory,accounting for 56.79%(46 cases)and 22.22%(18 cases),respectively.The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32%(44 cases)and 65.43%(53 cases).Multivariate regression analysis suggested that biliary tract disease before admission(P=0.026)and increased SOFA score at the onset of BSI(P=0.006)were independent risk factors for 28-day mortality.There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline(44 cases)and polymyxin B(26 cases)[56.82%(25/44)vs.57.69%(15/26),P=0.943].Patients were evaluated based on their age(≤65 years vs.>65 years),gender,body mass index(≤25 kg/m2 vs.>25 kg/m2),and APACHEⅡ score(≤20 vs.>20),the use of renal replacement therapy and mechanical ventilation,there was no difference in the mortality among each subgroup.Conclusions Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality.There was no significant difference outcomes between tigecycline-and polymyxin B-based therapy.

Objective:To explore the clinical characteristics of tumor necrosis factor-α (TNF-α) inhibitors-related optic neuritis.Methods:The database at home and abroad (as of November 2022) were searched and the case reports on optic neuritis induced by TNF-α inhibitors were collected. Clinical data including gender, age, use of TNF-α inhibitors, combination drugs, time to onset of optic neuritis, clinical manifestations, results of ancillary examinations, treatment and outcome were extracted and analyzed descriptively.Results:A total of 37 patients were enrolled in the study, including 16 males and 21 females, with an average age of 44 years; 11 patients were treated with adalimumab, 16 with infliximab, 8 with etanercept, 1 with golimumab, and 1 with peselizumab. Among them, 5 patients had previously been treated with other TNF-α inhibitors. The primary disease was rheumatoid arthritis in 15 patients, Crohn′s disease and ulcerative colitis disease in 8 patients, psoriatic arthritis in 3 patients, anterior uveitis in 2 aptients, and other rheumatic and inflammatory diseases in 9 patients. Of them, 4 patients were complicated with other diseases. The median time from TNF-α inhibitors use to optic neuritis occurrence was 4.5 months (3 days to 2 years). The most common clinical manifestations were decreased vision and ocular movement pain. Of the 37 patients, cerebrospinal fluid (CSF) analysis was performed in 8 patients, and 6 were abnormal. CSF oligoclonal bands were detected in 7 patients, and 4 were positive. Magnetic resonance imaging of the brain or orbit was performed in 32 patients, 11 patients showed optic nerve enhancement, 14 patients had brain lesions, and 5 patients had cervical or spinal cord lesions. Visual acuity was examined in 30 patients, 29 of which showed decreased vision. Of the 37 patients, 24 patients stopped the suspected drugs and were treated with glucocorticoid (GC), 6 patients only stopped medication but not treated with GC, and it was not described in 7 patients, 5 of whom were treated with GC. Of the 37 patients, 30 patients recovered partially or completely after discontinuation of the drugs and/or treated with GC, 6 patients were not improved and 1 patient was deteriorated.Conclusions:TNF-α inhibitors-related optic neuritis mostly occurs within the first 6 months of treatment, and more common clinical manifestation is visual acuity loss, with or without brain MRI lesions. Early detection and intervention usually lead to a better prognosis.

Objective:To explore the clinical characteristics of tumor necrosis factor-α (TNF-α) inhibitors-related optic neuritis.Methods:The database at home and abroad (as of November 2022) were searched and the case reports on optic neuritis induced by TNF-α inhibitors were collected. Clinical data including gender, age, use of TNF-α inhibitors, combination drugs, time to onset of optic neuritis, clinical manifestations, results of ancillary examinations, treatment and outcome were extracted and analyzed descriptively.Results:A total of 37 patients were enrolled in the study, including 16 males and 21 females, with an average age of 44 years; 11 patients were treated with adalimumab, 16 with infliximab, 8 with etanercept, 1 with golimumab, and 1 with peselizumab. Among them, 5 patients had previously been treated with other TNF-α inhibitors. The primary disease was rheumatoid arthritis in 15 patients, Crohn′s disease and ulcerative colitis disease in 8 patients, psoriatic arthritis in 3 patients, anterior uveitis in 2 aptients, and other rheumatic and inflammatory diseases in 9 patients. Of them, 4 patients were complicated with other diseases. The median time from TNF-α inhibitors use to optic neuritis occurrence was 4.5 months (3 days to 2 years). The most common clinical manifestations were decreased vision and ocular movement pain. Of the 37 patients, cerebrospinal fluid (CSF) analysis was performed in 8 patients, and 6 were abnormal. CSF oligoclonal bands were detected in 7 patients, and 4 were positive. Magnetic resonance imaging of the brain or orbit was performed in 32 patients, 11 patients showed optic nerve enhancement, 14 patients had brain lesions, and 5 patients had cervical or spinal cord lesions. Visual acuity was examined in 30 patients, 29 of which showed decreased vision. Of the 37 patients, 24 patients stopped the suspected drugs and were treated with glucocorticoid (GC), 6 patients only stopped medication but not treated with GC, and it was not described in 7 patients, 5 of whom were treated with GC. Of the 37 patients, 30 patients recovered partially or completely after discontinuation of the drugs and/or treated with GC, 6 patients were not improved and 1 patient was deteriorated.Conclusions:TNF-α inhibitors-related optic neuritis mostly occurs within the first 6 months of treatment, and more common clinical manifestation is visual acuity loss, with or without brain MRI lesions. Early detection and intervention usually lead to a better prognosis.

It is an urgent demand worldwide to control the coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The 3-chymotrypsin-like protease (3CL^pro) and papain-like protease (PL^pro) are key targets to discover SARS-CoV-2 inhibitors. After screening 12 Chinese herbal medicines and 125 compounds from licorice, we found that a popular natural product schaftoside inhibited 3CL^pro and PL^pro with IC₅₀ values of 1.73 ± 0.22 and 3.91 ± 0.19 μmol/L, respectively, and inhibited SARS-CoV-2 virus in Vero E6 cells with EC₅₀ of 11.83 ± 3.23 μmol/L. Hydrogen-deuterium exchange mass spectrometry analysis, quantum mechanics/molecular mechanics calculations, together with site-directed mutagenesis indicated the antiviral activities of schaftoside were related with non-covalent interactions with H41, G143 and R188 of 3CL^pro, and K157, E167 and A246 of PL^pro. Moreover, proteomics analysis and cytokine assay revealed that schaftoside also regulated immune response and inflammation of the host cells. The anti-inflammatory activities of schaftoside were confirmed on lipopolysaccharide-induced acute lung injury mice. Schaftoside showed good safety and pharmacokinetic property, and could be a promising drug candidate for the prevention and treatment of COVID-19.

Objective To analyze the changes of CD4⁺ T cell numbers at different periods of antiviral therapy in HIV-infected and AIDS patients (HIV/AIDS) in Yichang City. Methods The relevant information was retrieved from the National AIDS Comprehensive Prevention Information System-Antiretroviral Treatment Management Database. Changes in the number of CD4⁺ T cells were analyzed in HIV/AIDS patients who started receiving highly active antiretroviral therapy (HAART) and continued the treatment for 3 years from January 1, 2003 to December 31, 2017 in Yichang. Results The number of CD4⁺T lymphocytes in 550 HIV/AIDS cases increased significantly at various time points within 3 years after treatment, and increased with the increase of treatment time（F=100.20，P<0.001）. The CD4+T cell counts of different baseline level groups were statistically different before and after treatment（F=8.57，P<0.01）. The CD4+ T cell counts of patients who started treatment at age of 15-30 years old increased faster than those who started treatment at age of over 30 years old（F=1.27，P<0.05）. Conclusion HAART has a significant effect on the increase of CD4+T cells, and the early treatment is more effective. Early detection, diagnosis and treatment should be promoted, and anti-viral treatment should be actively carried out.