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.

Objective To investigate the role of preoperative 3D printing simulation technology in the interventional endovascular exclusion of Stanford B aortic dissection.Methods A retrospective study protocol was used to select 76 patients with Stanford B-type aortic dissection who underwent endovascular isolation surgery in our hospital from January 2019 to January 2021 in the study.Among them,40 patients underwent simulated surgery with preoperative 3D printing simulation technology(simulation group)and another 36 patients received conventional endovascular isolation surgery(control group).The two groups were compared in terms of the.cardiac ultrasound indicators,the true and false lumen diameters,and the complication rates of the proximal aortic rupture plane,stent end plane,and abdominal trunk artery plane at different times before and after surgery.Results As com-pared to the control group,the simulation group showed significantly longer surgical time,extracorporeal circulation time,aortic occlusion time,and ICU stay time(all P<0.05).After the operation,the true lumen diameter of the proximal aortic rupture plane,stent end plane,and abdominal trunk artery plane were significantly increased in two groups at months 1,3,and 6(P<0.05),but the false lumen diameter of the proximal aortic rupture plane,stent end plane,and abdominal trunk artery plane were significantly decreased(P<0.05)compared to preoperative levels.The LVEF and FS of the two groups were significantly increased 6 months after surgery(P<0.05).Conclusion The preoperative 3D printing simulation technology in the interventional endovascular isolation of Stanford B aortic dissection can ensure the surgical effect.It can achieve the same surgical effect as the traditional procedures and importantly it can reduce the difficulty of operation and shorten the operation time.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

OBJECTIVE: To investigate the effect of electroacupuncture on osteoarthritis in rats and explore the possible mechanism. METHODS: Thirty SD rats were randomly divided into osteoarthritis model group, electro-acupuncture group and control group (n=10), and in the former two groups, early osteoarthritis was induced using a modified DMM surgical modeling method. After successful modeling, the rats in the electro-acupuncture group were treated with electro-acupuncture at bilateral "Housanli" and "Anterior knee point". Behavioral tests of the rats were performed and scored using the LequesneMG scale. Subchondral bone degeneration was observed in each group, and serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP were measured using ELISA. The mRNA and protein expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7, and MMP-3 in the cartilage tissue of the knee joints were detected using RT-PCR and Western blotting. RESULTS: In behavioral tests, the rats in the model and electroacupuncture groups had significantly higher LequesneMG scores after modeling than those in the control group (P < 0.05). After 20 days of treatment, LequesneMG scores were significantly lowered in rats in the electroacupuncture as compared with the model rats (P < 0.05). Imaging examination revealed obvious subchondral bone damage in both the electroacupuncture group and the model group, but the damages were significantly milder with former group. Compared with the model rats, the rats receiving electroacupuncture had significantly lower serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP (P < 0.05) with also lower expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7 and MMP-3 in the cartilage tissues at both the mRNA and protein levels (P < 0.05). CONCLUSION Electroacupuncture can alleviate joint pain and improve subchondral bone damage in rats with osteoarthritis by reducing IL-1β levels in the joint cartilage tissue and serum to alleviate joint inflammation and by reducing such cytokines as ADAMTS-7 and MMP-3 via regulating the Wnt-7B/β-catenin signaling pathway.
Rats ; Animals ; Electroacupuncture ; Matrix Metalloproteinase 3/metabolism* ; Rats, Sprague-Dawley ; beta Catenin/metabolism* ; Osteoarthritis/metabolism* ; Wnt Signaling Pathway ; Cartilage, Articular ; Inflammation/metabolism*

Objective:To retrieve, evaluate, and integrate the evidence from both domestic and international sources on the management of artificial airways in children.Methods:All evidence on the management of artificial airways in children, including clinical decisions, evidence-based guidelines, expert consensus, best clinical practice manuals, evidence summaries, systematic reviews and so on was retrieved through computer on UpToDate, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-based Healthcare Center Database in Australia, Guidelines International Network, National Guideline Clearinghouse, American Association for Respiratory Care, PubMed, Medline, CINAHL, China Biomedical Medline Disc, China National Knowledge Infrastructure, WanFang Data, Medlive, and other databases and websites. The search period was from database establishment to April 30, 2022. We evaluated the quality of the included literature, extracted and integrated evidence, determined the level of evidence recommendation.Results:A total of 24 articles were included, including four clinical decisions, six evidence-based guidelines, one systematic review, six expert consensus, one evidence summary, one industry standard, four best clinical practice manuals, and one original study. Finally, 36 recommendations were summarized from five aspects, including artificial airway establishment, airbag management, airway humidification, endotracheal suction and prevention of complication.Conclusions:Artificial airway management in children is crucial for the treatment of critically ill children. The summary of the best evidence can provide a theoretical basis for the standardized management of artificial airways in children.

The incidence of valvular heart disease (VHD) increases with age, and its principal therapy is valve replacement. However, in recent years, the emergence of transcatheter interventions has changed the traditional therapy, making high-risk patients of surgery see dawn of hope. 3D printing technology has developed rapidly since it was applied to the medical field in 1990. Moreover, it has been widely applied in many surgical majors via refined reduction technology. However, the application of 3D printing technology in cardiovascular surgery is still in the preliminary stage, especially in the field of VHD. This article aims to review basic principles of 3D printing technology, its advantages in the therapy of VHD, and its current status of clinical application. Furthermore, this article elaborates current problems and looks forward to the future development direction.

Objective:To investigate the risk factors for nosocomial infection in older adult inpatients in some psychiatric hospitals in Ningbo of Zhejiang Province.Methods:The clinical data of 832 inpatients who received treatment in Ningbo Kangning Hospital and the Third Branch of Healthcare Group of Xiangshan Hospital of Traditional Chinese Medicine were retrospectively analyzed. These patients were divided into one infection group ( n = 45) and one non-infection group ( n = 787). The risk factors for nosocomial infection were analyzed. Results:Univariate analysis results showed that there were significant differences in age, disease type, primary pulmonary infection, time of antibiotics use, length of hospital stay, suffering from mental diseases, and use of urinary catheters ( χ2 = 10.721, 18.127, 12.183, 67.127, 56.326, 65.114, 27.153, all P < 0.001). Multivariate analysis showed that age ≥ 75 years, disease type, primary pulmonary infection, time of antibiotics use, length of hospital stay, suffering from mental diseases, and use of urinary catheter were independent risk factors for nosocomial infection in older adult inpatients ( OR = 3.360, 3.777, 5.238, 3.364, 3.939, 4.428, all P < 0.001). Conclusion:Age ≥ 75 years, disease type, primary pulmonary infection, time of antibiotics use, length of hospital stay, suffering from mental diseases, and use of urinary catheters are independent risk factors for nosocomial infection in older adult inpatients in some psychiatric hospitals in Ningbo of Zhejiang Province.

Objective:To discuss how to make the surgical strategy for tibial tubercle fracture associated with bicondylar tibial plateau fracture.Methods:Data of thirty-five patients of tibial tubercle fractures associated with bicondylar tibial plateau fractures who were treated from October 2014 to May 2018 were retrospectively analyzed. There were 26 males and 9 females with an average age of 37.6 years (range, 21-68 years). According to Schatzker classification in tibial plateau fracture, 16 cases were type V and 19 cases were type VI. According to the integrity of tibial tubercle fracture and cortical bone of the proximal tibia in bicondylar tibial plateau fracture, they were divided into four types: type A, tibial tubercle fracture fragment and cortical bone of the proximal tibia are both complete; type B, tibial tubercle fracture fragment is complete but cortical bone of the proximal tibia is comminuted; type C, tibial tubercle fracture fragment is comminuted but cortical bone of the proximal tibia is complete; type D, both of them are comminuted. The surgical approaches and fixation methods of all the tibial tubercle fractures were according to the four different types. There were 22 cases with type A and B that were treated via an anterolateral and a medial incision, 13 cases with type C and D were treated via an anterior midline and a medial incision. There were 4 cases belonging to type A fixed with lag screws singly, 18 cases with type B fixed with 1/4 tubular plates, 7 cases with type C and 6 cases with type D fixed by 1/4 tubular plates combined with lag screws.Results:Thirty-five patients were followed up for 16.8 months (range, 12-24 months). All fractures healed with an average time of 4.7 months (range, 3-6 months). Loss of reduction didn’t occur in 34 cases except one. According to Rasmussen radiographic evaluation, the average score was 14.1 (range, 10-18) and clinical outcomes were rated with excellent in 11 cases, good in 19, fair in 5. The excellent and good rate was 85.7% (30/35) . The mean Hospital for Special Surgery (HSS) scores of all cases were 86.8 (range, 64-98) and the functional scores were excellent in 22 cases, good in 10 cases and fair in 3 cases with the excellent and good rate of 91.4% (32/35) . Surgical complications included fat liquefaction in 2 cases, superficial wound infection in 1, loosening of implant in 1and traumatic arthritis in 1.Conclusion:This kind of tibial tubercle fracture associated with bicondylar tibial plateau fracture is rare and special. Therefore, the preoperative plan should be made by considering the morphological features of the tibial tubercle fragments and the cortical bone of the proximal tibia. The middle longitude approach is the best way to expose tibial tubercle fragments which should be fixed with 1/4 tubularplate and/or lag screws.

Objective To investigate the antidepressant effect of DS-1226, a hydrolysate of ginsenosides, on a mouse model of depression induced by chronic sleep interruption, and provide scientific evidence for the research and de?velopment of antidepressant drugs. Methods 72 male ICR mice were divided into control group, model group, positive control group (paroxetine hydrochloride, 10 mg/kg) and 3 treatment groups (20 mg/kg, 40 mg/kg, 80 mg/kg of DS?1226). Except the control group, the other mice were put into a rotary roller (parameter settings:1 min/rev;rest 2 min af?ter 1 rev) for 3 days of drum adaptation, 3 h/d. Then making model for 14 days in the roller( parameter settings:1 min/rev;rest 2 min after 1 rev) . The antidepressant effects of DS?1226 were evaluated by weight monitoring, open?field test, tail suspension test, and forced swimming test. Results After 14 d sleep disturbance, compared with the control group,the body weight, immobility time in tail suspension test and forced swimming test were significantly decreased in the model group. Compared with the model group, DS?1226(40 mg/kg)significantly reversed the weight loss caused by sleep disturb?ance. Paroxetine significantly reduced the immobility time of tail suspension test. DS?1226 (40 mg/kg, 80 mg/kg)signifi?cantly decreased the immobility time of tail suspension test, and DS?1226 (80 mg/kg) significantly decreased the immobil?ity time of forced swimming test. Conclusion The hydrolysate of ginsenosides DS?1226 shows antidepressant effect on mouse model of depression induced by chronic sleep interruption.

This study was aimed to quickly identify Chinese medicine Olibanum.Thermal analysis method was used on the quality analysis of Chinese materia medica (CMM).A total of 25 batches of Olibanum on the market were collected.This study examined three important factors of temperature range,heating rate,powder mesh on the TGA and DTA thermal analysis experiments.And a method of rapid authentication of medicinal materials using TGA and DTA feature maps was built.Methods of the first-order points,connection on thermogravimetric analysis and heat enthalpy calculation were adopted in the quantitative analysis of Olibanum.The results showed that the best condition of TGA and DTA experiment on Olibanum was confirmed.The temperature range is 50-750℃.The heating rate is 20℃· min-1.The powder mesh is 100 mesh.Under these conditions,good quality goods of Olibanum,counterfeit Olibanum and adulterants of Olibanum could be distinguished through the characteristic peak (T1=447 ± 5℃,T2=549 ± 5℃,T3=350 ± 5℃),thermogravimetric analysis (TV-max,△W2+△W3) and thermal enthalpy analysis (△H).It was concluded that the TGA-DTA technology was simple.It was thought to be a rapid,accurate and simple new method for Olibanum identification and quality analysis.