OBJECTIVE To evaluate the efficacy， safety， and cost-effectiveness of posaconazole for the prevention of invasive fungal infections （IFIs）. METHODS PubMed， Embase， CNKI， Wanfang data and other Chinese and English databases were searched， as well as the official websites of related health technology assessment （HTA）. Systematic review （SR）/meta-analysis， pharmacoeconomic studies， and HTA reports of posaconazole for the prevention of IFIs were collected. The retrieval time limit was from the establishment of the database to November 1， 2025. After screening the literature， extracting the data， and evaluating the quality of the literature， the results of the included studies were descriptively analyzed. RESULTS A total of 45 studies were included， involving 17 SR/meta-analyses， 26 pharmacoeconomic studies， 1 SR/meta-analysis combined with a pharmacoeconomic study， and 1 HTA report. In terms of effectiveness， posaconazole was significantly superior to other antifungal drugs （eg.， fluconazole， itraconazole） in reducing the incidence of IFIs， the incidence of invasive aspergillosis， all-cause mortality， and IFI-related mortality （ P ＜0.05）. In terms of safety， posaconazole was significantly superior to other antifungal drugs in the incidence of total adverse reactions （ P ＜0.05）， but there was no significant difference in the incidence of serious adverse reactions， the incidence of gastrointestinal advers e reactions， drug-induced liver injury， and the withdrawal rate due to adverse drug reactions （ P ＞0.05）. In terms of cost-effectiveness， most studies have shown that posaconazole possesses more cost-effectiveness advantages. CONCLUSIONS Posaconazole demonstrates favorable efficacy， safety， and cost-effectiveness in preventing IFIs.

Objective To investigate the effects of dihydroartemisinin(DHA)on the proliferation and metastasis of prostate cancer cells via the speckle-type POZ protein(SPOP)/heterogeneous nuclear ribonucleoprotein K(HnRNPK)pathway.Methods The prostate cancer cell line DU145 was cultured in vitro and treated with different concentrations of DHA.Cells were divided into groups based on DHA concentration:blank group(0 μmol/L),low-concentration group(10 μmol/L),medium-concentration group(50 μmol/L),and high-concentration group(100 μmol/L).Colony formation assay,scratch assay,and Transwell assay were performed to observe changes in proliferation,migration,and invasion of DU145 cells under different DHA treatments.Western blotting was used to detect the expression levels of SPOP,HnRNPK,Vimentin,Neural-cadherin(N-cadherin),Epithelial-cadherin(E-cadherin),and Zonula occludens-1(ZO-1).SPOP expression was knocked down in DU145 cells(SPOP-shNC-DU145,SPOP-sh-DU145),which were then subjected to the aforementioned low,medium,and high DHA concentration interventions for rescue experiments.A xenograft mouse model was established by injecting SPOP-knockdown cells into mice,followed by oral administration of low(2.5 mg/kg),medium(5 mg/kg),and high(10 mg/kg)concentrations of DHA.Results Compared with the blank group,the proliferation,migration,and invasion of DU145 cells in the low-,medium-,and high-concentration groups were significantly inhibited(P<0.05),Intracellular expression levels of HnRNPK,Vimentin,and N-cadherin were decreased(P<0.05),while the expression levels of SPOP,E-cadherin,and ZO-1 were increased(P<0.05).Compared with SPOP-shNC DU145 cells,the inhibitory effects of DHA on SPOP-sh DU145 cells were attenuated,with increased expression levels of HnRNPK,Vimentin,and N-cadherin(P<0.05),and decreased expression levels of E-cadherin and ZO-1(P<0.05).Conclusion DHA may target and induce increased SPOP expression,thereby inhibiting the proliferation and metastasis of DU145 cells.

Objective To analyze the burden and trend of musculoskeletal diseases(including gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis)in China from 1990 to 2021,and to provide reference for formulating and adjusting prevention strategies for musculoskeletal diseases.Methods The Global Burden of Disease(GBD)in 2021 database was used to analyze the status and trend of the incidence and disability-adjusted life years(DALYs)rate of musculoskeletal diseases in China.Annual percentage change(EAPC)was used to comprehensively evaluate the trend of the burden of musculoskeletal diseases from 1990 to 2021.Gender and age-specific incidence and DALYs rate of musculoskeletal diseases were analyzed.Results In 2021,the number of cases of gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis in China was 3,079,836,43,374,995,10,292,099,11,652,721,and 247,307,respectively.Among the 5 major musculoskeletal conditions,low back pain had the greatest incidence and DALYs rate.From 1990 to 2021,the age-standardized incidence of gout,osteoarthritis,and rheumatoid arthritis showed an upward trend,that of neck pain remained relatively stable,and that of low back pain showed a downward trend.The age-standardized DALYs rates of gout and osteoarthritis showed an increasing trend,that of neck pain and rheumatoid arthritis remained relatively stable,and that of low back pain showed a decreasing trend.The results of the stratified analysis by gender and age indicated that,the age-standardized incidence rate and age-standardized DALYs rate of gout were higher in men than in women,while the age-standardized incidence rate and age-standardized DALYs rate of low back pain,neck pain,osteoarthritis,and rheumatoid arthritis were higher in women than in men.The age groups with the burden of the five major musculoskeletal diseases were relatively consistent,mainly in the 40-75 years old.Conclusion From 1990 to 2021,the disease burden of gout,osteoarthritis,and rheumatoid arthritis increased significantly in China,while the disease burden of neck pain remained relatively stable,while the disease burden of low back pain showed a certain improvement.In addition,the burden of musculoskeletal diseases in China varies greatly by gender and age.Targeted intervention measures should be implemented as soon as possible based on the stratification results by gender and age,and health education and basic healthcare should be improved to effectively reduce the burden of musculoskeletal diseases.

Objective To analyze the burden and trend of musculoskeletal diseases(including gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis)in China from 1990 to 2021,and to provide reference for formulating and adjusting prevention strategies for musculoskeletal diseases.Methods The Global Burden of Disease(GBD)in 2021 database was used to analyze the status and trend of the incidence and disability-adjusted life years(DALYs)rate of musculoskeletal diseases in China.Annual percentage change(EAPC)was used to comprehensively evaluate the trend of the burden of musculoskeletal diseases from 1990 to 2021.Gender and age-specific incidence and DALYs rate of musculoskeletal diseases were analyzed.Results In 2021,the number of cases of gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis in China was 3,079,836,43,374,995,10,292,099,11,652,721,and 247,307,respectively.Among the 5 major musculoskeletal conditions,low back pain had the greatest incidence and DALYs rate.From 1990 to 2021,the age-standardized incidence of gout,osteoarthritis,and rheumatoid arthritis showed an upward trend,that of neck pain remained relatively stable,and that of low back pain showed a downward trend.The age-standardized DALYs rates of gout and osteoarthritis showed an increasing trend,that of neck pain and rheumatoid arthritis remained relatively stable,and that of low back pain showed a decreasing trend.The results of the stratified analysis by gender and age indicated that,the age-standardized incidence rate and age-standardized DALYs rate of gout were higher in men than in women,while the age-standardized incidence rate and age-standardized DALYs rate of low back pain,neck pain,osteoarthritis,and rheumatoid arthritis were higher in women than in men.The age groups with the burden of the five major musculoskeletal diseases were relatively consistent,mainly in the 40-75 years old.Conclusion From 1990 to 2021,the disease burden of gout,osteoarthritis,and rheumatoid arthritis increased significantly in China,while the disease burden of neck pain remained relatively stable,while the disease burden of low back pain showed a certain improvement.In addition,the burden of musculoskeletal diseases in China varies greatly by gender and age.Targeted intervention measures should be implemented as soon as possible based on the stratification results by gender and age,and health education and basic healthcare should be improved to effectively reduce the burden of musculoskeletal diseases.

Purpose/Significance To use artificial intelligence(AI)technology to quickly screen negative comments from a large num-ber of reviews,so as to understand the needs and grievances of patients,and promote the sustainable development of telemedicine.Meth-od/Process Taking comments from Haodf.com as an example,the paper first uses bidirectional encoder representations from transformers(BERT)to generate word embeddings,which are then fed into a convolutional neural network(CNN)and a bidirectional long short-term memory(BiLSTM)network in a dual-channel manner.Finally,a feature fusion strategy is employed to obtain textual sentiment informa-tion to achieve a binary classification task.Result/Conclusion The proposed dual-channel model based on BERT can better integrate the advantages of CNN and BiLSTM.It achieves the highest classification accuracy and macro F1-score compared to other 9 models,including BERT,BERT_BiLSTM,BERT_CNN,etc.,which is effective in sentiment classification tasks for online medical reviews.

OBJECTIVETo explore the impact of plasma homocysteinemia(Hcy) on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients.

METHODSConsecutive 684 ACS patients undergoing first PCI in our department between January 2013 and December 2014 were prospectively enrolled.Patients were divided into 2 groups according to the pre-procedural plasma Hcy level: high-Hcy group (Hcy≥10 μmol/L, n=404) and control group (Hcy<10 μmol/L, n=280). The CIN was defined as serum creatinine ≥ 44.2 μmol/L or 25% increase compared to baseline within 48-72 h after PCI.The baseline clinical data and the ratio of CIN were compared between the 2 groups.Multivariate logistic regression analysis was used to define the independent risk factors for CIN.

RESULTSCIN occurred in 133(19.4%) out of 684 enrolled patients, and the incidence of CIN was significantly higher in high Hcy group than in the control group (22.0%(89/404)vs. 15.7%(44/280), P=0.040). After adjusting the confounding factors, including age, acute myocardial infarction, co-morbidities(hypertension, diabetes mellitus, and old myocardial infarction), laboratory examination (level of cystatin C and uric acid), glomerular filtration rate, left ventricular ejection fraction, angiographic and procedural characteristics (3 diseased vessels, multiple stent implantation), treatment at admission (spironolactone, digoxin), multivariate logistic regression analysis showed that high Hcy was independently associated with the development of CIN (OR=1.70, 95%CI 1.60-2.64, P=0.021).

CONCLUSIONElevated Hcy prior PCI is an independent risk factor of CIN in ACS patients undergoing first PCI.

Acute Coronary Syndrome ; Diabetes Mellitus ; Glomerular Filtration Rate ; Humans ; Hyperhomocysteinemia ; Incidence ; Kidney Diseases ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Risk Factors ; Ventricular Function, Left

OBJECTIVETo evaluate stress changes of intervertebral space and adjacent intervertebral space after artificial disc replacement with angles.

METHODSArtificial disc replacement with angles were designed according to existing data. Axial pressure, flexion/extension, lateral bending and torsion loading were applied on finite element models of normal cervical discs on C4,5 segments, C4,5 segments with 0 degrees artificial cervical discs and C4,5 segments with 10 degrees artificial cervical discs, then stress changes of C4,5 space was observed. The same loadings were applied on finite element models of normal cervical discs on C4-C6 segments, C4,5 segments with 0 degrees, C4,5 segments with 10 degrees, then stress changes of replaced segments space and adjacent segment space were observed.

RESULTSFor C4,5 segments, 80 MPa/0 degrees artificial discs and 80 MPa/10 degrees artificial discs had the similar equivalent shear stress (Se), and were both larger than that of normal discs, when lateral bending were performed, 80 MPa/0 degrees artificial discs were closed to normal discs when axial pressure and flexion/extension were carried out, while 80 MPa/10 degrees artificial discs had a larger Se than that of normal ones,when torsion loading were applied, Szx/Szy stress of 80 MPa/0 degrees and 80 MPa/10 degrees artificial discs were closed to normal ones. For C4-C6 segments, the axial pressure, flexion/extension and lateral bending of C5,6 were all lower than normal discs after C4,5 discs were replaced by 80 MPa/10 degrees artificial discs, while Szx/Szy of torsion loading were closed to normal ones.

CONCLUSIONArtificial discs with 10 degrees have less influences on stress of adjacent intervertebral space and closer to mechanical property after being implanted into intervertebral space.

Cervical Vertebrae ; surgery ; Humans ; Stress, Mechanical ; Total Disc Replacement ; methods

Objective:To study possibility of traditional Chinese drug preparation of controlled drug delivered to the colonic region. Methods: After the herbs was extracted and refined, micropills was produced with pectin selected as coating material and thallium monochloride was as internal standard substance. Results: The preparation was testified to attain schedule colon target. Conclusions: This research provided a way for traditional Chinese drug preparation of colon targeting.