Objective To rapidly evaluate the efficacy,safety,and cost-effectiveness of venetoclax(Ven)in non-M3 acute myeloid leukemia(AML),and to provide an evidence-based basis for rational clinical treatment.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data databases,and relevant health technology assessment(HTA)websites were searched to collect relevant literature and reports on Ven treatment for non-M3 AML,with a search timeframe from the establishment of the database/website to November 1st,2024.Two researchers independently screened literature,extracted data,and assessed quality,and then qualitatively described and analyzed the results.Results A total of 11 pieces of literature were included,including 5 systematic reviews/Meta-analysis,4 pharmacoeconomic studies,and 2 HTA reports.In terms of efficacy,compared with the control group,non-M3 AML patients receiving Ven treatment had a higher clinical remission rate(P<0.05),a longer event-free survival(EFS)(P<0.05)and a similar or longer overall survival(OS)(P<0.05).Regarding safety,compared to Azacitidine(Aza)monotherapy,Ven+Aza resulted in a higher likelihood of febrile neutropenia in non-M3 AML patients(P<0.05).Non-M3 AML patients receiving Ven+low-dose cytarabine(LDAC)had a higher risk of developing thrombocytopenia compared with LDAC monotherapy(P<0.05).However,the early 30-day mortality rate was lower in the Ven+chemotherapy group than that in the chemotherapy alone group(P<0.05),presenting an acceptable security profile overall.In terms of cost-effectiveness,Ven was cost-effective in non-M3 AML patients compared with the control group.Conclusion Ven has manifested remarkable efficacy and acceptable security profile among patients with non-M3 AML,thus proving to be a medium to long-term cost-effective treatment modality.

Objective:To explore the distribution characteristics and drug resistance of pathogenic bacteria in neonatal infectious diseases in Meizhou city from 2019 to 2023, and to guide the use of clinical antibacterial drugs.Methods:A retrospective analysis was conducted on the bacterial culture and drug sensitivity results of neonates with bacterial infectious diseases diagnosed and treated in Meizhou People's Hospital from January 2019 to December 2023. The distribution characteristics of pathogenic bacteria were observed, and the resistance of common pathogenic bacteria to antibacterial drugs was analyzed.Results:A total of 660 strains of pathogenic bacteria were collected, of which 434 isonates (65.76%) came from sputum, 111 isonates (16.82%) came from blood and 73 isonates (11.06%)came from umbilical secretions or other secretions.Gram-negative bacteria accounted for 55.45%(366/660), mainly Escherichia coli and Klebsiella pneumoniae. Gram-positive bacteria accounted for 42.42%(280/660), mainly Staphylococcus aureus and Streptococcus agalactiae. A total of 216 strains of multidrug-resistant bacteria were found, and the top three were extended spectrum beta-lactamases (ESBLs)-producing Escherichia coli, methicillin-resistant Staphylococcus aureus and ESBLs-producing Klebsiella pneumoniae.The resistance rates of Escherichia coli and Klebsiella pneumoniae to cefuroxime and cefotaxime were higher, and the resistance rates to ceftazidime, piperacillin-tazobactam and carbapenems were lower. The resistance rate of Staphylococcus aureus to penicillin was 91.61%. Streptococcus agalactiae was sensitive to penicillin, and both of them were sensitive to linezolid and vancomycin. Conclusions:The main pathogens of neonatal bacterial infection are Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus agalactiae. The proportion of multidrug-resistant bacteria is high, mainly producing ESBLs bacteria. Antibiotics should be rationally selected according to the distribution and drug resistance of pathogens.

Objective:To explore the impact of previous cytomegalovirus (CMV), herpes simplex virus (HSV), and rubella virus (RV) infection on pregnancy outcomes in infertile women undergoing the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) treatment. Methods:A retrospective cohort study was conducted to analyze the clinical data of women who underwent IVF/ICSI-ET for the first time at the Reproductive Medicine Center, the First Affiliated Hospital of Zhengzhou University from December 2017 to December 2022. The patients were divided into CMV-IgG (+) group ( n=154), RV-IgG (+) group ( n=86), HSV-IgG (+) group ( n=93) and IgG all-negative group ( n=172). The pregnancy outcomes of the patients in the virus-only infection group and the IgG all-negative group were compared. Patients who were previously co-infected with CMV and HSV were classified as the CMV+HSV-IgG (+) group ( n=344), and the pregnancy outcomes of patients with previous CMV and HSV co-infection and those with infection alone were further compared. Results:The two pronuclei (2PN) fertilization rate [63.90% (1 195/1 870)], the clinical pregnancy rate [51.30% (79/154)], and the live birth rate [45.45% (70/154)] of the CMV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.001; 61.05% (105/172), P=0.005]. The 2PN fertilization rate [61.62% (729/1 183)], the clinical pregnancy rate [50.54% (47/93)], and the live birth rate [43.01% (40/93)] of the HSV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.004; 61.05% (105/172), P=0.005]. There were no statistical differences in the 2PN fertilization rate, the clinical pregnancy rate, and the live birth rate between the RV-IgG (+) group and the IgG completely negative group (all P>0.05). Compared with the IgG completely negative group, there were no significant differences in the risk of complications such as gestational diabetes, hypertensive disorders of pregnancy and neonatal outcomes in the CMV-IgG (+) group, RV-IgG (+) group, and HSV-IgG (+) group (all P>0.05). Multivariate logistic regression analysis showed that CMV-IgG (+) ( OR=0.453, 95% CI: 0.280-0.734, P=0.001; OR=0.515, 95% CI: 0.321-0.825, P=0.006), HSV-IgG (+) ( OR=0.425, 95% CI: 0.245-0.738, P=0.002; OR=0.447, 95% CI: 0.259-0.771, P=0.004) and CMV+HSV-IgG (+) ( OR=0.491, 95% CI: 0.329-0.733, P=0.001; OR=0.528, 95% CI: 0.357-0.780, P=0.001) were all independent influencing factors of patients' clinical pregnancy and live birth. There were no statistical differences in the clinical outcomes between the previous CMV and HSV co-infection group and the single infection group ( P>0.05). Conclusion:Previous CMV or HSV infection alone reduced the fertilization rate, the clinical pregnancy rate and the live birth rate of patients undergoing IVF/ICSI-ET treatment, but had no significant impact on pregnancy complications and neonatal outcomes. Pregnancy outcomes of patients with previous CMV and HSV co-infection were similar to those with infection alone.

Objective:To analyze the exercise rehabilitation preference of stroke patients, and provide reference for clinical medical staff to formulate personalized exercise rehabilitation scheme, construct precise rehabilitation decision support system, and develop exercise rehabilitation intelligent service platform.Methods:A convenience sampling approach was employed to select the stroke patients in Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University from June to December 2024, a face to face cross-sectional survey was conducted using the questionnaire on exercise rehabilitation preferences of stroke patients based on the method of discrete choice experiments. The obtained data were analyzed using conditional Logit model.Results:Finally, 242 stroke patients were included, including 152 males and 90 females, aged 64 (56, 69) years. The six attributes included in this study: rehabilitation goal, rehabilitation setting, exercise intensity, exercise duration, exercise supervision method, and payment method. The relative importance of each attribute was ranked as follows: payment method (37.1%), exercise duration (15.5%), supervision method (14.3%), rehabilitation setting (14.1%), exercise intensity (11.4%), and rehabilitation goal (7.6%). The most preferred combination was identified as a rehabilitation goal of ≥70% recovery, professional institution/hospital as the setting, supervision by wearable device combined with professional guidance, low-intensity exercise, a duration of 30-60 minutes per session, and a self-payment rate of <30%. Under this combination, the probability of patients choosing the rehabilitation program was 75.4%.Conclusions:Stroke patients' preferences for exercise rehabilitation are influenced by multiple factors, with substantial heterogeneity observed across individuals. Rehabilitation programs should be tailored according to patients' preferences regarding goals, settings, duration, and other key attributes to enhance adherence and optimize rehabilitation outcomes.

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

BACKGROUND: Preclinical studies have indicated that Angong Niuhuang Pills (ANP) reduce cerebral infarct and edema volumes. This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in patients with moderate to severe acute ischemic stroke. METHODS: This randomized, double-blind, placebo-controlled pilot trial included patients with acute ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores ranging from 10 to 20 in 17 centers in China between April 2021 and July 2022. Patients were allocated within 36 h after onset via block randomization to receive ANP or placebo (3 g/day for 5 days). The primary outcomes were changes in cerebral infarct and edema volumes after 14 days of treatment. The primary safety outcome was severe adverse events (SAEs) for 90 days. RESULTS: There were 57 and 60 patients finally included in the ANP and placebo groups, respectively for modified intention-to-treat analysis. The median age was 66.0 years, and the median NIHSS score at baseline was 12.0. The changes in cerebral infarct volume at day 14 were 0.3 mL and 0.4 mL in the ANP and placebo groups, respectively (median difference: -7.1 mL; interquartile range [IQR]: -18.3 to 2.3 mL, P = 0.30). The changes in cerebral edema volume of the ANP and placebo groups on day 14 were 11.4 mL and 4.0 mL, respectively ( median difference: 3.0 mL, IQR: -1.3 to 9.9 mL, P = 0.15). The rates of SAE within 90 days were similar in the ANP (3/57, 5%) and placebo (7/60, 12%) groups ( P = 0.36). Changes in serum mercury and arsenic concentrations were comparable. In patients with large artery atherosclerosis, ANP reduced the cerebral infarct volume at 14 days (median difference: -12.3 mL; IQR: -27.7 to -0.3 mL, P = 0.03). CONCLUSIONS: ANP showed a similar safety profile to placebo and non-significant tendency to reduce cerebral infarct volume in patients with moderate-to-severe stroke. Further studies are warranted to assess the efficacy of ANP in reducing cerebral infarcts and improving clinical prognosis. TRAIL REGISTRATION Clinicaltrials.gov , No. NCT04475328.
Aged ; Female ; Humans ; Male ; Middle Aged ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Ischemic Stroke/drug therapy* ; Pilot Projects ; Stroke/drug therapy* ; Treatment Outcome

Objective:To explore the correlation between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and the risk of hypertension in elderly physical examination populations.Methods:This study was a cross-sectional study. A total of 1 028 patients aged≥60 years who underwent physical examinations at the Health Management Center of Fuwai Central China Cardiovascular Hospital from September 2023 to February 2024 were included in this study. The general demographic data, past medical history, physical examination and laboratory examination indicators of the physical examiners were collected, and according to whether they had hypertension or not, they were divided into hypertension group (390 cases) and non-hypertension group (638 cases), and all UHR values were arranged from small to large, and the UHR was divided into three groups by tertiles of UHR, and the general data and blood biochemical indexes between the groups were compared. Spearman rank correlation was used to analyze the correlation between UHR level and body mass index, total cholesterol, triglyceride and other indexes in the elderly population. Logistic regression was used to explore the relationship between UHR level and hypertension in the elderly population, and the stratification analysis of the physical examination population was carried out according to diabetes, coronary heart disease and dyslipidemia, and the interaction test between groups was carried out.Results:Among the 1 028 geriatric physical examination cases, 580 (56.4%) were males and 448 (43.6%) were females, aged (66.7±5.8) years. UHR levels were higher in the hypertensive group compared to the non-hypertensive group [248.88 (191.19, 322.25) vs 213.52 (165.94, 275.29); Z=-5.445, P<0.05]. With the increase of UHR level, the detection rate of hypertension in the elderly population increased (accounted for 27.8%, 38.2% and 47.8%, respectively; χ2=29.211, P<0.05). Spearman rank correlation analysis showed that UHR was positively correlated with body mass index, triglycerides, serum uric acid, serum creatinine and fasting blood glucose ( r=0.318, 0.334, 0.774, 0.474, 0.080; all P<0.05), and negatively correlated with total cholesterol, glomerular filtration rate and low-density lipoprotein cholesterol ( r=-0.239, -0.303, -0.154; all P<0.05). When the confounding factors were not adjusted (model 1), the risk of hypertension in high UHR group was 2.382 times higher than that in low UHR group and 1.607 times higher than that in medium UHR group; after adjusting for all confounding factors such as age, gender, body mass index, systolic blood pressure, diastolic blood pressure, junior high school education or below, smoking, alcohol consumption, glomerular filtration rate, etc., the risk of hypertension in the high-level UHR group was 1.732 times higher than that in the low-level UHR group (95% CI: 1.139-2.635) ( P<0.05). The elderly physical examination population was further stratified according to whether there was diabetes, dyslipidemia and coronary heart disease, and it was found that there was no interaction between UHR and diabetes, dyslipidemia and coronary heart disease on the prevalence of hypertension (all P>0.05). Conclusions:Hypertension detection rate increases with higher UHR levels. UHR is closely related to the incidence of hypertension in the elderly population.

Objective To rapidly evaluate the efficacy,safety,and cost-effectiveness of venetoclax(Ven)in non-M3 acute myeloid leukemia(AML),and to provide an evidence-based basis for rational clinical treatment.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data databases,and relevant health technology assessment(HTA)websites were searched to collect relevant literature and reports on Ven treatment for non-M3 AML,with a search timeframe from the establishment of the database/website to November 1st,2024.Two researchers independently screened literature,extracted data,and assessed quality,and then qualitatively described and analyzed the results.Results A total of 11 pieces of literature were included,including 5 systematic reviews/Meta-analysis,4 pharmacoeconomic studies,and 2 HTA reports.In terms of efficacy,compared with the control group,non-M3 AML patients receiving Ven treatment had a higher clinical remission rate(P<0.05),a longer event-free survival(EFS)(P<0.05)and a similar or longer overall survival(OS)(P<0.05).Regarding safety,compared to Azacitidine(Aza)monotherapy,Ven+Aza resulted in a higher likelihood of febrile neutropenia in non-M3 AML patients(P<0.05).Non-M3 AML patients receiving Ven+low-dose cytarabine(LDAC)had a higher risk of developing thrombocytopenia compared with LDAC monotherapy(P<0.05).However,the early 30-day mortality rate was lower in the Ven+chemotherapy group than that in the chemotherapy alone group(P<0.05),presenting an acceptable security profile overall.In terms of cost-effectiveness,Ven was cost-effective in non-M3 AML patients compared with the control group.Conclusion Ven has manifested remarkable efficacy and acceptable security profile among patients with non-M3 AML,thus proving to be a medium to long-term cost-effective treatment modality.

Objective:To explore the impact of previous cytomegalovirus (CMV), herpes simplex virus (HSV), and rubella virus (RV) infection on pregnancy outcomes in infertile women undergoing the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) treatment. Methods:A retrospective cohort study was conducted to analyze the clinical data of women who underwent IVF/ICSI-ET for the first time at the Reproductive Medicine Center, the First Affiliated Hospital of Zhengzhou University from December 2017 to December 2022. The patients were divided into CMV-IgG (+) group ( n=154), RV-IgG (+) group ( n=86), HSV-IgG (+) group ( n=93) and IgG all-negative group ( n=172). The pregnancy outcomes of the patients in the virus-only infection group and the IgG all-negative group were compared. Patients who were previously co-infected with CMV and HSV were classified as the CMV+HSV-IgG (+) group ( n=344), and the pregnancy outcomes of patients with previous CMV and HSV co-infection and those with infection alone were further compared. Results:The two pronuclei (2PN) fertilization rate [63.90% (1 195/1 870)], the clinical pregnancy rate [51.30% (79/154)], and the live birth rate [45.45% (70/154)] of the CMV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.001; 61.05% (105/172), P=0.005]. The 2PN fertilization rate [61.62% (729/1 183)], the clinical pregnancy rate [50.54% (47/93)], and the live birth rate [43.01% (40/93)] of the HSV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.004; 61.05% (105/172), P=0.005]. There were no statistical differences in the 2PN fertilization rate, the clinical pregnancy rate, and the live birth rate between the RV-IgG (+) group and the IgG completely negative group (all P>0.05). Compared with the IgG completely negative group, there were no significant differences in the risk of complications such as gestational diabetes, hypertensive disorders of pregnancy and neonatal outcomes in the CMV-IgG (+) group, RV-IgG (+) group, and HSV-IgG (+) group (all P>0.05). Multivariate logistic regression analysis showed that CMV-IgG (+) ( OR=0.453, 95% CI: 0.280-0.734, P=0.001; OR=0.515, 95% CI: 0.321-0.825, P=0.006), HSV-IgG (+) ( OR=0.425, 95% CI: 0.245-0.738, P=0.002; OR=0.447, 95% CI: 0.259-0.771, P=0.004) and CMV+HSV-IgG (+) ( OR=0.491, 95% CI: 0.329-0.733, P=0.001; OR=0.528, 95% CI: 0.357-0.780, P=0.001) were all independent influencing factors of patients' clinical pregnancy and live birth. There were no statistical differences in the clinical outcomes between the previous CMV and HSV co-infection group and the single infection group ( P>0.05). Conclusion:Previous CMV or HSV infection alone reduced the fertilization rate, the clinical pregnancy rate and the live birth rate of patients undergoing IVF/ICSI-ET treatment, but had no significant impact on pregnancy complications and neonatal outcomes. Pregnancy outcomes of patients with previous CMV and HSV co-infection were similar to those with infection alone.

Objective:To explore the distribution characteristics and drug resistance of pathogenic bacteria in neonatal infectious diseases in Meizhou city from 2019 to 2023, and to guide the use of clinical antibacterial drugs.Methods:A retrospective analysis was conducted on the bacterial culture and drug sensitivity results of neonates with bacterial infectious diseases diagnosed and treated in Meizhou People's Hospital from January 2019 to December 2023. The distribution characteristics of pathogenic bacteria were observed, and the resistance of common pathogenic bacteria to antibacterial drugs was analyzed.Results:A total of 660 strains of pathogenic bacteria were collected, of which 434 isonates (65.76%) came from sputum, 111 isonates (16.82%) came from blood and 73 isonates (11.06%)came from umbilical secretions or other secretions.Gram-negative bacteria accounted for 55.45%(366/660), mainly Escherichia coli and Klebsiella pneumoniae. Gram-positive bacteria accounted for 42.42%(280/660), mainly Staphylococcus aureus and Streptococcus agalactiae. A total of 216 strains of multidrug-resistant bacteria were found, and the top three were extended spectrum beta-lactamases (ESBLs)-producing Escherichia coli, methicillin-resistant Staphylococcus aureus and ESBLs-producing Klebsiella pneumoniae.The resistance rates of Escherichia coli and Klebsiella pneumoniae to cefuroxime and cefotaxime were higher, and the resistance rates to ceftazidime, piperacillin-tazobactam and carbapenems were lower. The resistance rate of Staphylococcus aureus to penicillin was 91.61%. Streptococcus agalactiae was sensitive to penicillin, and both of them were sensitive to linezolid and vancomycin. Conclusions:The main pathogens of neonatal bacterial infection are Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus agalactiae. The proportion of multidrug-resistant bacteria is high, mainly producing ESBLs bacteria. Antibiotics should be rationally selected according to the distribution and drug resistance of pathogens.