Diabetic retinopathy(DR)remains the leading cause of vision loss in patients with diabetes. Current anti-vascular endothelial growth factor(VEGF)therapies are limited by inadequate response in some patients and the necessity for repeated intravitreal injections, underscoring the urgent need for novel therapeutic targets. Angiopoietin-like protein 4(ANGPTL4), a multifunctional secreted protein, has emerged as a critical regulator in the pathogenesis and progression of DR, positioning it as a promising interventional target. This review systematically elaborates the biological characteristics of ANGPTL4, with a focus on its expression dynamics, molecular mechanisms, and regulatory networks rolesin the development of DR. Furthermore, the prospects of ANGPTL4-targeted therapeutic strategies are discussed, aiming to offer new insights and directions for understanding DR pathogenesis, advancing multi-target drug development, and improving clinical management.

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 understand the present situation of symptom burden in patients with spastic dysfunction after stroke and to analyze its influencing factors.Methods:This was a cross-sectional study. Patients with spastic dysfunction after stroke who were treated in the Department of Neurology, Shaoxing Hospital of Traditional Chinese Medicine, from September 2021 to September 2023 were enrolled. General clinical data on the patients was obtained via questionnaire surveys. The corresponding scales were used to evaluate both the symptom burden experienced by the patients (which included 6 dimensions: physiological function, cognitive function, psychological function, pain manifestation, motor abnormalities and speech ability) and their severity of spasms. Pearson correlation analysis was used to assess the correlation between the symptom burden of patients and the severity of spasms. The associated factors of symptom burden in patients with spastic dysfunction following a stroke were analyzed using a multiple linear regression model.Results:A total of 147 patients with spastic dysfunction after stroke were included with an average age of (65.15±7.15) years old. There were 78 males (53.06%). The overall symptom burden of the enrolled patients was high ((38.42±5.78) points), with the burden of physiological function being the highest, followed by the burden of psychological function. The clinical spasticity index score of the enrolled patients was (12.26±3.14) points. Pearson correlation analysis showed that the symptom burden score of patients with spastic dysfunction after stroke was positively correlated with the clinical spasm index score ( r=0.438, P<0.001). The results of multiple linear regression analysis showed that age, disease duration, monthly family income, and the score of the Mental Health Inventory-5 (MHI-5) were independent associated factors for symptom burden in patients with spastic dysfunction after stroke (all P<0.05). Conclusions:Patients with spastic dysfunction after stroke have a high symptom, especially in physiological and psychological functions. Age, disease duration, economic status, and mental health status are independent associated factors for the symptom burden in such patients.

Objective To establish the reference intervals of serum β-human chorionic gonadotropin(β-HCG)in adult non-pregnant women in Shanghai,and to explore its relationship with age.Methods A total of 854 non-pregnant women in the hospital from March 2021 to December 2023 were selected as the research ob-jects,and 800 women who met the criteria were finally included.All serum β-HCG levels were detected by magnetic particle enzyme immunoassay.The results of serum β-HCG in different age groups were statistically analyzed,and the reference intervals of each age group was calculated by one-sided 95%reference interval method.Results The distribution of serum β-HCG in non-pregnant women was not normal.Spearman corre-lation analysis showed that the median level of β-HCG was correlated with age(correlation coefficient was 0.859,P<0.05).The reference intervals established by percentile method were 0.00-3.03 mIU/mL 18-<41 years old.41-55 years old 0.00-4.61 mIU/mL,>55 years old 0.00-6.80 mIU/mL,respectively,the difference of serum β-HCG level between different age groups was statistically significant(P<0.05).Accord-ing to the literature review,the reference intervals of serum β-HCG in different laboratories were different.In this study,the appropriate reference intervals were established and verified according to the actual situation.Conclusion The reference intervals of serum β-HCG in adult non-pregnant women should be established ac-cording to their age,so as to provide scientific basis for clinical diagnosis and treatment.

Objective:To explore the mediating effect of sense of coherence (SOC) on the utilization of chronic disease resources and symptom distress in liver cancer patients after transarterial chemoembolization (TACE), so as to provide a basis for comprehensive management strategies from a new perspective.Methods:A convenience sampling method was used to select 260 inpatients who underwent TACE in Xinxiang Central Hospital and Henan Provincial People's Hospital from September 2023 to October 2024 as the research objects. The Basic Information Questionnaire, Sense of Coherence Scale-13 (SOC-13), Chronic Illness Resource Survey (CIRS), and the Rotterdam Symptom Checklist (RSCL) were used to investigate the patients. Pearson correlation was used to analyze the relationships among SOC, chronic disease resource utilization, and symptom distress in patients after TACE. Structural equation modeling was established using AMOS 21.0 software to verify the mediating effect.Results:A total of 260 questionnaires were distributed, and 249 valid questionnaires were recovered, with a valid recovery rate of 95.77% (249/260). The SOC-13 score of 249 patients after TACE was (44.30±7.64), the CIRS score was (46.84±7.02), and the RSCL score was (93.61±8.85). The SOC-13 score was positively correlated with the CIRS score ( P<0.01) and negatively correlated with the RSCL score ( P<0.01). The CIRS score was negatively correlated with the RSCL score ( P<0.01). SOC had a direct negative effect on symptom distress (β'=-0.382, P<0.01), chronic disease resource utilization had a direct negative effect on symptom distress (β'=-0.176, P<0.01), and SOC played a partial mediating role between chronic disease resource utilization and symptom distress (β'=-0.148, P<0.01), with the mediating effect accounting for 45.68% of the total effect. Conclusions:There are certain deficiencies in the sense of coherence and chronic disease resource utilization in patients after TACE, and the phenomenon of symptom distress is obvious. SOC plays a partial mediating role between chronic disease resource utilization and symptom distress.

Objective:To evaluate the effects of a reduced-positioning restrictions nursing program on postoperative recovery, sleep quality, self-care ability, and hip joint function in patients undergoing total hip arthroplasty (THA), providing a reference for postoperative positioning management.Methods:A randomized controlled trial was conducted, and 140 THA patients admitted to Zhejiang Provincial People′s Hospital from January 2022 to June 2023 were selected using convenience sampling. They were divided into a control group (70 cases) and an observation group (70 cases) using a random number table. The control group received conventional rehabilitation care, while the observation group received a reduced-positioning restrictions nursing program in addition to the conventional care. The incidence of dislocation at 3 months postoperatively, the activities of daily living, the hip joint function recovery at 1 month and 3 months postoperatively, the sleep quality at 1 month postoperatively were compared between the two groups.Results:Finally 63 cases in the control group and 64 cases in the observation group completed the study. The control group included 25 males and 38 females, with an average age of (65.44 ± 10.97) years, while the observation group included 28 males and 36 females, with an average age of (65.13 ± 12.18) years. At 3 months postoperatively, there was no significant difference in the dislocation rate between the control group and the observation group ( P>0.05). At 1 month and 3 months postoperatively, the scores of activities of daily living in the observation group were (77.89 ± 6.71) and (93.52 ± 6.59) points respectively, which were higher than those in the control group [(69.68 ± 5.53) and (87.38 ± 7.72) points], the differences were statistically significant ( t=5.38, 6.96, both P<0.05), the time, interaction and inter-group effects were all statistically significant ( F=33.93, 10.81, 876.91, all P<0.05). At 1 month postoperatively, the excellent and good rate of hip joint function score grade in the observation group was 73.44% (47/64), which was higher than 41.27% (26/63) in the control group, the difference was statistically significant ( Z=-3.67, P<0.05), there was no statistically significant difference between the two groups at 3 months postoperatively ( P>0.05). At 1 month after the operation, the excellent and good rate of sleep quality score grades in the observation group was 81.25% (52/64), which was higher than 57.14% (36/63) in the control group, and the difference was statistically significant ( Z=-3.00, P<0.05). Conclusions:Incorporating a reduced-positioning restrictions nursing program into the perioperative management of THA does not increase the risk of prosthesis dislocation. This approach enhances patient comfort, improves sleep quality, increases self-care ability, and supports the recovery of hip joint function.

Objective:To evaluate the effects of a reduced-positioning restrictions nursing program on postoperative recovery, sleep quality, self-care ability, and hip joint function in patients undergoing total hip arthroplasty (THA), providing a reference for postoperative positioning management.Methods:A randomized controlled trial was conducted, and 140 THA patients admitted to Zhejiang Provincial People′s Hospital from January 2022 to June 2023 were selected using convenience sampling. They were divided into a control group (70 cases) and an observation group (70 cases) using a random number table. The control group received conventional rehabilitation care, while the observation group received a reduced-positioning restrictions nursing program in addition to the conventional care. The incidence of dislocation at 3 months postoperatively, the activities of daily living, the hip joint function recovery at 1 month and 3 months postoperatively, the sleep quality at 1 month postoperatively were compared between the two groups.Results:Finally 63 cases in the control group and 64 cases in the observation group completed the study. The control group included 25 males and 38 females, with an average age of (65.44 ± 10.97) years, while the observation group included 28 males and 36 females, with an average age of (65.13 ± 12.18) years. At 3 months postoperatively, there was no significant difference in the dislocation rate between the control group and the observation group ( P>0.05). At 1 month and 3 months postoperatively, the scores of activities of daily living in the observation group were (77.89 ± 6.71) and (93.52 ± 6.59) points respectively, which were higher than those in the control group [(69.68 ± 5.53) and (87.38 ± 7.72) points], the differences were statistically significant ( t=5.38, 6.96, both P<0.05), the time, interaction and inter-group effects were all statistically significant ( F=33.93, 10.81, 876.91, all P<0.05). At 1 month postoperatively, the excellent and good rate of hip joint function score grade in the observation group was 73.44% (47/64), which was higher than 41.27% (26/63) in the control group, the difference was statistically significant ( Z=-3.67, P<0.05), there was no statistically significant difference between the two groups at 3 months postoperatively ( P>0.05). At 1 month after the operation, the excellent and good rate of sleep quality score grades in the observation group was 81.25% (52/64), which was higher than 57.14% (36/63) in the control group, and the difference was statistically significant ( Z=-3.00, P<0.05). Conclusions:Incorporating a reduced-positioning restrictions nursing program into the perioperative management of THA does not increase the risk of prosthesis dislocation. This approach enhances patient comfort, improves sleep quality, increases self-care ability, and supports the recovery of hip joint function.

Objective:To explore the mediating effect of sense of coherence (SOC) on the utilization of chronic disease resources and symptom distress in liver cancer patients after transarterial chemoembolization (TACE), so as to provide a basis for comprehensive management strategies from a new perspective.Methods:A convenience sampling method was used to select 260 inpatients who underwent TACE in Xinxiang Central Hospital and Henan Provincial People's Hospital from September 2023 to October 2024 as the research objects. The Basic Information Questionnaire, Sense of Coherence Scale-13 (SOC-13), Chronic Illness Resource Survey (CIRS), and the Rotterdam Symptom Checklist (RSCL) were used to investigate the patients. Pearson correlation was used to analyze the relationships among SOC, chronic disease resource utilization, and symptom distress in patients after TACE. Structural equation modeling was established using AMOS 21.0 software to verify the mediating effect.Results:A total of 260 questionnaires were distributed, and 249 valid questionnaires were recovered, with a valid recovery rate of 95.77% (249/260). The SOC-13 score of 249 patients after TACE was (44.30±7.64), the CIRS score was (46.84±7.02), and the RSCL score was (93.61±8.85). The SOC-13 score was positively correlated with the CIRS score ( P<0.01) and negatively correlated with the RSCL score ( P<0.01). The CIRS score was negatively correlated with the RSCL score ( P<0.01). SOC had a direct negative effect on symptom distress (β'=-0.382, P<0.01), chronic disease resource utilization had a direct negative effect on symptom distress (β'=-0.176, P<0.01), and SOC played a partial mediating role between chronic disease resource utilization and symptom distress (β'=-0.148, P<0.01), with the mediating effect accounting for 45.68% of the total effect. Conclusions:There are certain deficiencies in the sense of coherence and chronic disease resource utilization in patients after TACE, and the phenomenon of symptom distress is obvious. SOC plays a partial mediating role between chronic disease resource utilization and symptom distress.

Objective:To understand the present situation of symptom burden in patients with spastic dysfunction after stroke and to analyze its influencing factors.Methods:This was a cross-sectional study. Patients with spastic dysfunction after stroke who were treated in the Department of Neurology, Shaoxing Hospital of Traditional Chinese Medicine, from September 2021 to September 2023 were enrolled. General clinical data on the patients was obtained via questionnaire surveys. The corresponding scales were used to evaluate both the symptom burden experienced by the patients (which included 6 dimensions: physiological function, cognitive function, psychological function, pain manifestation, motor abnormalities and speech ability) and their severity of spasms. Pearson correlation analysis was used to assess the correlation between the symptom burden of patients and the severity of spasms. The associated factors of symptom burden in patients with spastic dysfunction following a stroke were analyzed using a multiple linear regression model.Results:A total of 147 patients with spastic dysfunction after stroke were included with an average age of (65.15±7.15) years old. There were 78 males (53.06%). The overall symptom burden of the enrolled patients was high ((38.42±5.78) points), with the burden of physiological function being the highest, followed by the burden of psychological function. The clinical spasticity index score of the enrolled patients was (12.26±3.14) points. Pearson correlation analysis showed that the symptom burden score of patients with spastic dysfunction after stroke was positively correlated with the clinical spasm index score ( r=0.438, P<0.001). The results of multiple linear regression analysis showed that age, disease duration, monthly family income, and the score of the Mental Health Inventory-5 (MHI-5) were independent associated factors for symptom burden in patients with spastic dysfunction after stroke (all P<0.05). Conclusions:Patients with spastic dysfunction after stroke have a high symptom, especially in physiological and psychological functions. Age, disease duration, economic status, and mental health status are independent associated factors for the symptom burden in such patients.

Objectives:To investigate the association between normal-weight central obesity with new-onset cardiovascular disease and all-cause mortality risk. Methods:A prospective cohort study was conducted,selecting a total of 93885 participants from the Kailuan Study who had their first physical examination in 2006-2007.According to waist circumference (central obesity:male waist circumference ≥90 cm,female waist circumference ≥85 cm;no central obesity:male waist circumference<90 cm,female waist circumference<85 cm) and body mass index (BMI,normal weight:18.5 kg/m2≤BMI<24.0 kg/m2;overweight/obesity:BMI ≥24.0 kg/m2),the participants were divided into 4 groups:normal weight no central obesity group (G1 group),normal weight central obesity group (G2 group),overweight/obesity no central obesity group (G3 group) and overweight/central obesity group (G4 group);Using the Kaplan-Meier method,the cumulative incidence of new-onset cardiovascular diseases (including hemorrhagic stroke,ischemic stroke and myocardial infarction) and all-cause mortality in different groups was calculated,and the Log-rank test was used for intergroup comparisons.Furthermore,the associations between the different groups and the risk of new-onset cardiovascular diseases and all-cause mortality were analyzed using the multivariate Cox proportional hazard regression model. Results:After a median follow-up of 14.97 (14.55,15.17) years,the cumulative incidence of new-onset cardiovascular diseases in G1 group,G2 group,G3 group and G4 group was 7.62％,10.84％,8.67％,12.91％ respectively (log-rank P<0.05) and the cumulative incidence of all-cause mortality was 12.83％,19.72％,10.65％,16.33％ respectively (log-rank P<0.01).After adjusting for confounding factors,Cox regression analysis showed that the HR (95％CI) of new-onset cardiovascular diseases in G2 group,G3 group and G4 group were 1.14 (1.04-1.25),1.07 (1.01-1.14),1.27 (1.21-1.34),respectively compared with G1 group (all P<0.05).The HR (95％CI) of all-cause mortality were 1.06 (1.00-1.14),0.90 (0.85-0.95),0.97 (0.93-1.01) compared with G1 group,and P values were 0.07,<0.01,0.15,respectively.The results of sensitivity analysis were consistent with the above major studies after excluding overweight/obesity and cancer participants during follow-up. Conclusions:Normal-weight central obesity increases the risk of new-onset cardiovascular diseases and all-cause mortality.