Coronavirus-related diseases pose a significant challenge to the global health system. Given the diversity of coronaviruses and the unpredictable nature of disease outbreaks, the traditional "one bug, one drug" paradigm struggles to address the growing number of emerging crises. Therefore, there is an urgent need for therapeutic agents with broad-spectrum anti-coronavirus activity. Here, we provide evidence that ATV006, an anti-SARS-CoV-2 nucleoside analog targeting RNA-dependent RNA polymerase (RdRp), has broad antiviral activity against human and animal coronaviruses. Using mouse hepatitis virus (MHV) and human coronavirus NL63 (HCoV-NL63) as a model, we show that ATV006 has potent prophylactic and therapeutic activity against murine coronavirus infection in vivo. Remarkably, ATV006 successfully inhibits viral replication in mice even when administered 96 h after infection. Due to its oral bioavailability and potency against multiple coronaviruses, ATV006 has the potential to become a useful antiviral agent against SARS-CoV-2 and other circulating and emerging coronaviruses in humans and animals.

Autism spectrum disorder(ASD)is a neurodevelopmental disorder starting from early childhood.At present,the age of diagnosis for ASD in children is significantly delayed,typically occurring after two years of age,although behavioral signs or prodromal symptoms can emerge before the age of 12 months.These early indicators gradually evolve into the core symptoms of ASD.It has been well recognized that early screening and intervention can maximally improve its prognosis and promote optimal development of the affected children.Therefore,there has been increasing emphasis on preemptive screening and intervention for prodromal symptoms of ASD before the age of 12 months in clinical practice and research,so as to reduce the symptoms to a normal state to some extent.However,during the prodromal period of ASD,especially before the age of one,preemptive screening and intervention present many challenges.Preemptive screening faces obstacles such as significant individual differences in infant growth and development,incomplete presentation of ASD symptoms,and differing assessment content and criteria;preemptive intervention must overcome challenges like the diversity of screening tools and varying factors of parents.As a result,few research has been conducted in this field.This review mainly introduces preemptive screening tools and intervention techniques for children with ASD in the first year of life,including the intervention used in the British Autism Study of Infant Siblings-video interaction for promoting positive parenting(iBASIS-VIPP),the promoting first relationships,the environmental enrichment for infants,parenting with acceptance and commitment therapy(ENACT),and the adapted response teaching.The application of neuroimaging technology and artificial intelligence technology is also explained to provide reference for relevant research and clinical practice.

Melatonin is widely used as an over-the-counter medication to treat insomnia in children with autism spectrum disorder (ASD) and neurogenetic disorders (NGD). However, there is still a lack of research on its efficacy and safety, and clinical practice standards are to be established. In response, the International Pediatric Sleep Association (IPSA) convened an expert panel and developed a consensus statement:"Melatonin Use in Managing Insomnia in Children with Autism and Other Neurogenetic Disorders-an Assessment by the International Pediatric Sleep Association (IPSA)", which was published in Sleep Medicine, April 2024. The consensus focused on the efficacy and adverse effects of melatonin treatment for insomnia in children with ASD and NGD-including Smith-Magenis syndrome, Rett syndrome, Angelman syndrome, and tuberous sclerosis complex. It systematically reviews randomized controlled trials (RCTs) conducted between 2012 and 2022, and integrates current best clinical practices to formulate 10 consensus recommendations. Despite these contributions, the consensus has limitations: a small number of included RCTs, a lack of grading for evidence quality, and recommendation strength. Furthermore, the study population is primarily composed of children from Western countries. This article seeks to interpret the consensus to improve standardized use of melatonin for insomnia in Chinese children with ASD and NGD, and to provide a reference for the future development of localized evidence-based guidelines.

Autism spectrum disorder(ASD)is a neurodevelopmental disorder starting from early childhood.At present,the age of diagnosis for ASD in children is significantly delayed,typically occurring after two years of age,although behavioral signs or prodromal symptoms can emerge before the age of 12 months.These early indicators gradually evolve into the core symptoms of ASD.It has been well recognized that early screening and intervention can maximally improve its prognosis and promote optimal development of the affected children.Therefore,there has been increasing emphasis on preemptive screening and intervention for prodromal symptoms of ASD before the age of 12 months in clinical practice and research,so as to reduce the symptoms to a normal state to some extent.However,during the prodromal period of ASD,especially before the age of one,preemptive screening and intervention present many challenges.Preemptive screening faces obstacles such as significant individual differences in infant growth and development,incomplete presentation of ASD symptoms,and differing assessment content and criteria;preemptive intervention must overcome challenges like the diversity of screening tools and varying factors of parents.As a result,few research has been conducted in this field.This review mainly introduces preemptive screening tools and intervention techniques for children with ASD in the first year of life,including the intervention used in the British Autism Study of Infant Siblings-video interaction for promoting positive parenting(iBASIS-VIPP),the promoting first relationships,the environmental enrichment for infants,parenting with acceptance and commitment therapy(ENACT),and the adapted response teaching.The application of neuroimaging technology and artificial intelligence technology is also explained to provide reference for relevant research and clinical practice.

Melatonin is widely used as an over-the-counter medication to treat insomnia in children with autism spectrum disorder (ASD) and neurogenetic disorders (NGD). However, there is still a lack of research on its efficacy and safety, and clinical practice standards are to be established. In response, the International Pediatric Sleep Association (IPSA) convened an expert panel and developed a consensus statement:"Melatonin Use in Managing Insomnia in Children with Autism and Other Neurogenetic Disorders-an Assessment by the International Pediatric Sleep Association (IPSA)", which was published in Sleep Medicine, April 2024. The consensus focused on the efficacy and adverse effects of melatonin treatment for insomnia in children with ASD and NGD-including Smith-Magenis syndrome, Rett syndrome, Angelman syndrome, and tuberous sclerosis complex. It systematically reviews randomized controlled trials (RCTs) conducted between 2012 and 2022, and integrates current best clinical practices to formulate 10 consensus recommendations. Despite these contributions, the consensus has limitations: a small number of included RCTs, a lack of grading for evidence quality, and recommendation strength. Furthermore, the study population is primarily composed of children from Western countries. This article seeks to interpret the consensus to improve standardized use of melatonin for insomnia in Chinese children with ASD and NGD, and to provide a reference for the future development of localized evidence-based guidelines.

Objective:To investigate the clinical characteristics of first-episode and recurrent acute hypertriglyceridemic pancreatitis (HTGP).Methods:The retrospective cohort study was con-ducted. The clinical data of 313 patients with HTGP admitted to 26 medical centers in China in the Chinese Acute Pancreatitis Clinical Research Group (CAPCTG)-PERFORM database from November 2020 to December 2021 were collected. There were 219 males and 94 females, aged 38(32,44)years. Of the 313 patients, 193 patients with first-episode HTGP were allocated into the first-episode group and 120 patients with recurrent HTGP were allocated into the recurrent group. Observation indica-tors: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) comparison of severity and prognosis in the course of disease within 14 days between the two groups; (3) the association between recurrent HTGP and the risk of persistent organ failure (POF); (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. The Kaplan-Meier method was used to plot the cumulative recurrence rate curve and Log-Rank test was used for survival analysis. The Logistic regression model was used for multivariate analysis, and continuous variables were converted into categorical variables according to the mean value or common criteria. Propensity score matching was performed by 1∶1 nearest neighbor matching method, with caliper value of 0.02. Paired t test or Wilcoxon rank sum test and McNemar′s test were used for comparison between matched groups. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 313 patients,208 cases were successfully matched, including 104 cases in the first-episode group and 104 cases in the recurrent group. After propensity score matching, there was no significant difference in demographic characteristics, severity of illness scores and laboratory test between the two groups ( P>0.05). The elimination of gender, acute physiology and chornic health evaluation (APACHE) Ⅱ score, computed tomography severity index score, systemic inflammatory response syndrome score, sequential organ failure assessment score, apolipoprotein E, C-reactive protein, creatinine, lactic acid dehydrogenase, procal-citonin confounding bias ensured comparability between the two groups. (2) Comparison of severity and prognosis in the course of disease within 14 days between the two groups. There were signifi-cant differences in POF and local complications between the first-episode group and the recurrent group ( P<0.05). (3) The association between recurrent HTGP and the risk of POF. Results of uncor-rected univariate analysis showed that there was no association between recurrent HTGP and the risk of POF ( odds ratio=0.78, 95% confidence interval as 0.46-1.30, P>0.05). Results of multivariate analysis after adjusting for covariates such as gender, age, APACHE Ⅱ score, C-reactive protein, triglyceride and total cholesterol showed that compared with first-episode HTGP, recurrent HTGP was associated with a higher risk of POF ( odds ratio=2.22, 95% confidence interval as 1.05-4.71, P<0.05). Results of subgroup analysis showed that age<40 years was associated with an increased risk of POF ( odds ratio=3.31, 95% confidence interval as 1.09-10.08, P<0.05). (4) Follow-up. Twelve of the 313 patients died during hospitalization, including 9 cases in the first-episode group and 3 cases in the recurrent group. The rest of 301 surviving patients, including 184 cases in the first-episode group and 117 cases in the recurrent group, were followed up for 19.2(15.5, 21.9)months. Results of follow-up showed that for 184 survived patients of the first-episode group, 164 cases were followed up and 24 cases experienced recurrence, for 117 survived patients of the recurrent group,29 cases experienced recurrence, showing a significant difference between the two groups ( χ2=4.67, P<0.05). Conclusion:Compared with first-episode HTGP, patients with recurrent HTGP are more prone to POF and local complications, and are more prone to recurrence after discharge. The risk of POF in recurrent HTGP patients is 2.22 times that of those with first-episode, and the risk is higher in patients with age <40 years.

Objective:To understand the current status of knowledge, attitude and practice of exercise rehabilitation nursing of clinical nurses in ClassⅢ Grade A hospitals in China.Methods:The convenient sampling method was adopted to conduct an online survey of 9 091 nurses from 31 Class Ⅲ Grade A hospitals in 31 provinces, municipalities and autonomous regions by using a self-designed questionnaire on Nurses' Knowledge, Attitude and Practice of Exercise Rehabilitation from May to July 2019. There were 34 items in the questionnaire, which mainly included the basic information of the survey objects, the knowledge and skills of sports rehabilitation nursing that nurses needed to master, the willingness of nurses to provide sports rehabilitation guidance and the current status of clinical implementation. A total of 9 091 questionnaires were distributed in this study, and the effective response rate was 100%.Results:Among the 9 091 nurses, 3 728 nurses (41.0%, 3 728/9 091) and 3 749 nurses (41.2%, 3 749/9 091) respectively indicated that they had not received relevant courses or skills training in school. 8 565 nurses (94.2%, 8 565/9 091) thought it was important to provide sports rehabilitation guidance, but they lacked the corresponding guidance ability, motivation and energy. In practice, 8 493 nurses (93.4%, 8 493/9 091) would provide suggestions and guidance related to sports rehabilitation to patients, mainly based on departmental nursing routine, relevant training, personal experience and literature.Conclusions:Clinical nurses in ClassⅢ Grade A hospitals in China have a positive attitude to participate in the exercise rehabilitation guidance of patients, but the level of knowledge and skills is low, and the behavior of rehabilitation guidance needs to be standardized. In the future, it should be further strengthened in terms of professional training, personnel training and related guidelines and standard construction.

In the practice of building its humanistic environment of a research hospital,Nanjing Drum Tower hospital adheres to such humanistic characteristics of the hospital as humanistic concept,planning, environment,management,service,and quality.Furthermore,the hospital upholds such keys as learning, innovation, cooperation, undertaking, competition and development. High focus, high starting point planning,persistence,and down-to-earth efforts,effectively promoting hospital development.