Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, we identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan-Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877-1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18-0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment. In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.

Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40–80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40–50 keV showed increased CNR and SNR breast lesion compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR breast lesion: 40 keV, 21.01; 50 keV, 16.28; vs.PEI, 10.77; p< 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.

Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40–80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40–50 keV showed increased CNR and SNR breast lesion compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR breast lesion: 40 keV, 21.01; 50 keV, 16.28; vs.PEI, 10.77; p< 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.

Objective To assess the technical feasibility and effectiveness of X-ray-guided implantation of inverted Y-type metal airway stent under local anesthesia by using a modified technique of exchanging guide wire in order to shorten operation time.Methods The clinical data of a total of 16 patients,who received inverted Y-type metal airway stent implantation under local anesthesia,were retrospectively analyzed.Routine gradual guide wire exchange method with a harder one was used in 6 patients (routine group),while in 10 patients (modification group) a modified technique of exchanging guide wire,i.e.inserting two hard wires at one time,was employed.Technical success rate and operation time were used as the main observation indexes.Results Under local anesthesia,the implantation of inverted Y-type metal airway stent was successfully accomplished in all 16 patients.The mean operation time of the routine group and the modification group was 15.6 minutes and 11.1 minutes respectively,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the performance of implantation of inverted Ytype metal airway stent under local anesthesia to treat malignant carina stenosis,the use of modified technique of guide wire insertion,i.e.inserting two hard wires at one time,can effectively shorten the operation time.

Objective To evaluate the value of 320 row CT upper abdominal computed tomography angiography (CTA) in the follow up of transjugular intrahepatic portosystemic shunt(TIPSS) .Methods 21 cases after TIPSS therapy underwent upper ab-dominal CTA .Post-processing images ,including MPR ,VR ,MIP ,and CPR ,were used to determine the position and patency of the stent .The best images of the portal veins were obtained .Results Among the 21 cases ,CPR image clearly demonstrated endovascu-lar stent thrombosis in 3 cases(14 .29% ) with stent occlusion and 1 case(4 .76% ) with stent stenosis ;there were no stent stenosis or occlusion in 17 cases(80 .95% ) ,their CPR image showed the contrast agent was filled completely in the stent and no low-density thrombosis was found .The best phase of the portal vein was 45 s .Conclusion 320 row CT upper abdominal CTA can clearly dis-play the stent position and patency situation in patients ,therefore ,should be regarded as the first choice for the follow-up of patients after TIPSS therapy .

Objective To evaluate the clinical effect of recombinant human epidermal growth factor (rhEGF) on the treatment of chronic tympanic membrane perforation and the function of inner ear. Methods From 2005 to 2008, the outpatients were randomly divided into three groups (A:control group, B:kangfuxin group, C:rhEGF group) . The patients were also divided into three groups (small, medium and large) . The hearing level and the function of inner ear in three groups were compared. Results The hearing level of rhEGF group was 4.5, which was significantly than that of other groups (7.3 and 9.4 respectively, <0.05) . There was no significant difference in the function of inner ear among the three groups ( >0.05) . Conclusion rhEGF can decrease the healing time significantly and increase the healing rates in the treatment of chronic tympanic membrane perforation, and it has no obvious adverse effects on the inner ear.

OBJECTIVE: To retrospectively evaluate the feasibility and effectiveness of three-tube insertion for the treatment of postoperative gastroesophageal anastomotic leakage (GEAL). MATERIALS AND METHODS: From January 2007 to January 2011, 28 cases of postoperative GEAL after an esophagectomy with intrathoracic esophagogastric anastomotic procedures for esophageal and cardiac carcinoma were treated by the insertion of three tubes under fluoroscopic guidance. The three tubes consisted of a drainage tube through the leak, a nasogastric decompression tube, and a nasojejunum feeding tube. The study population consisted of 28 patients (18 males, 10 females) ranging in their ages from 36 to 72 years (mean: 59 years). We evaluated the feasibility of three-tube insertion to facilitate leakage site closure, and the patients' nutritional benefit by checking their serum albumin levels between pre- and post-enteral feeding via the feeding tube. RESULTS: The three tubes were successfully placed under fluoroscopic guidance in all twenty-eight patients (100%). The procedure times for the three tube insertion ranged from 30 to 70 minutes (mean time: 45 minutes). In 27 of 28 patients (96%), leakage site closure after three-tube insertion was achieved, while it was not attained in one patient who received stent implantation as a substitute. All patients showed good tolerance of the three-tube insertion in the nasal cavity. The mean time needed for leakage treatment was 21 +/- 3.5 days. The serum albumin level change was significant, increasing from pre-enteral feeding (2.5 +/- 0.40 g/dL) to post-enteral feeding (3.7 +/- 0.51 g/dL) via the feeding tube (p < 0.001). The duration of follow-up ranged from 7 to 60 months (mean: 28 months). CONCLUSION: Based on the results of this study, the insertion of three tubes under fluoroscopic guidance is safe, and also provides effective relief from postesophagectomy GEAL. Moreover, our findings suggest that three-tube insertion may be used as the primary procedure to treat postoperative GEAL.
Adult ; Aged ; Anastomosis, Surgical ; Anastomotic Leak/radiography/*therapy ; Decompression, Surgical/instrumentation ; Drainage/instrumentation ; Enteral Nutrition/instrumentation ; Esophageal Neoplasms/*surgery ; Esophagectomy ; Female ; Fluoroscopy ; Humans ; Intubation, Gastrointestinal/*methods ; Male ; Middle Aged ; Postoperative Complications/*radiography/*therapy ; Radiography, Interventional/*methods ; Retrospective Studies ; Stomach Neoplasms/*surgery

This study sought to detect the effect of Fascin-1 expression on the cytoskeleton and immigration of laryngeal squamous carcinoma cell. In the experiment, Fascin-1 expression in Hep-2 cells was inhibited by small interfering RNA. The cytoskeleton of Hep-2 cells was observed with the use of laser scanning confocal fluorescence microscope. Millicell insert was applied to detect the immigration of Hep-2 cells in vitro. The results showed that the integrity of cytoskeleton in Hep-2 cells was broken with the down-regulation of Fascin-1 expression and the immigration ability was decreased significantly (P < 0.05). The inhibiting ratio of cell immigration was 44.6 +/- 6.3%. In conclusion, inhibition of Fascin-1 expression in Hep-2 cells could break the integrity of cytoskeleton and decrease the ability of cellular immigration.
Carcinoma, Squamous Cell ; metabolism ; ultrastructure ; Carrier Proteins ; genetics ; metabolism ; Cell Line, Tumor ; Cell Movement ; Cytoskeleton ; metabolism ; ultrastructure ; Down-Regulation ; Humans ; Laryngeal Neoplasms ; metabolism ; ultrastructure ; Microfilament Proteins ; genetics ; metabolism ; RNA, Small Interfering ; genetics

Objective To establish a method of GS-MS for determination of polychlorinated biphenyls (PCBs) in human cerumen. Methods The PCBs in cerumen samples was separated by n-hexane extraction, liquid-liquid extraction separation and column chromatography purification, then was analyzed quantitatively by gas chromatography and affirmed qualitatively by mass spectroscopy. Results The detection limit, average recovery rate and precision of this method were 0.15 ?g/g fat, 92.1% and 3.0%-4.6% (n=12) respectively. The contents of PCBs in 90 cerumen samples collected in polluted and control areas were detected. The levels(0.00-18.42 ?g/g fat) of PCBs in cerumen collected in polluted area were significantly higher than that in the control area(P