A 42-year-old male patient developed mild allergic symptoms after the use of cisatracurium besylate in laparoscopic left renal tumor resection,which was relieved by symptomatic treatment.When the drug was added again intraoperatively,the patient's blood pressure decreased sharply from 120/71 mmHg to 50/30 mmHg,and the airway resistance increased from 16 cmH2O to 38 cmH2O,and the patient developed typical signs of anaphylactic shock.After immediate intravenous injection of epinephrine,calcium chloride and other drugs,the patient's blood pressure rose to 95/57 mmHg,airway resistance decreased to 20 cmH2O,and vital signs tended to be stable.The Naranjo's Assessment Scale was used to evaluate and analyze the correlation of suspected drugs.The score was 9 points,indicating that the association between anaphylactic shock and cisatracurium besylate in this patient was judged to be"definitely related".This article suggests that cisatracurium besylate carries an allergic risk and should be used with caution,and the monitoring of vital signs and allergic reactions should be strengthened for early identification and timely treatment to ensure the safety of patients during the perioperative period.

Thousands of variant gene sequences of SARS-CoV-2 have been emerged since the COVID-19 epidemic broke out in Dec.2019.Alpha(B.1.1.7),Beta(B.1.351),Gamma(P.1),Delta(B.1.617.2)and Omicron(B.1.1.529)were the most representative variants.With the continuous emergence of new variants,the predomi-nant strain in the global pandemic as of Jan.2025 is the Omicron BA.2.86-derived mutant,JN.1.The effectiveness of drugs against Omicron variants remains a key research focus in the treatment of SARS-CoV-2 infections.The infectiousness and pathogenicity of the variants altered remarkably due to mutations in the genome on S protein of the mutant strains,and these emerging variants are more likely to evade immunity and were more infectious than the previous prevalent variants.During the process of combating with the constantly emerging novel variants,drugs showed various effects on treatment of diseases caused by different variants.New drugs and treatment coun-termeasures are constantly updated with the prevalence of various variants.The current status of research on pres-ent drugs for treatment of SARS-CoV-2 and the therapeutic effects on emerging variants are reviewed in the article so as to provide reference for prevention and treatment of the upcoming evolved variants.

Objective To explore the application value of quadriceps fat fraction(FF)in the early diagnosis of patellofemoral arthritis(PA).Methods A total of 98 patients were selected for conventional knee MRI examination and IDEAL-IQ sequence imaging.The FFm,FFl and FFt of quadriceps were measured.The patient group[chondromalacia patellae(CMP)(CMP group)and PA group]was compared with normal control(NC)(NC group).The receiver operating characteristic(ROC)curve was applied to assess diag-nostic efficacy.Results FFm,FFl,and FFt in the NC group were significantly lower than those in the patient group(P＜0.001).The FFm and FFl in the PA group were significantly higher than those in the CMP group(P=0.015,P=0.011).Additionally,within both CMP and PA groups,FFl was significantly higher than FFm(P＜0.01).The diagnostic efficacy of FFm was the highest for early PA diagnosis,with an optimal threshold of 8.4％.Conclusion The quadriceps FF can effectively quantify muscle fat infiltration in PA patients,especially in the lateral muscle.An increase in FF value can serve as an early quantitative biomarker for PA,providing sig-nificant reference value for clinical diagnosis and disease progression monitoring.

Objective This study aims to observe the impact of warm moxibustion on menstrual pain in college students with primary dysmenorrhea and explore its potential mechanism.Methods College students with primary dysmenorrhea were recruited and treated with warm moxibustion at Shenque acupoint for three consecutive menstrual cycles.Healthy subjects were also recruited for comparison.Pain scale,uterine artery hemodynamics,and related inflammatory factors were assessed before and after treatment.Results ①The results of scale study showed that the severity and duration of dysmenorrhea were gradually alleviated with the prolongation of treatment time through the analysis of variance of repeated measurements of the total scores of McGill pain inquiry scale and CMSS dysmenorrhea symptom scale before and after 3 treatments.The results of variance analysis and pairwise comparison of repeated measurements of PRI,VAS and PPI of McGill pain inquiry scale before and after 3 times treatment in warm moxibustion group also showed that each index decreased gradually with the prolongation of treatment time.The comparison of the scores of each item of CMSS scale showed that the severity and duration of low back before treatment were significantly different from those in the healthy group(P<0.001),but the difference was weakened after the third treatment.The severity of vomiting,the duration of vomiting,the severity of diarrhea and the duration of diarrhea were significantly different from those in the healthy group before treatment(P<0.001),but they were still higher than those in the healthy group after the third treatment.but the difference was not statistically significant.②Prior to treatment,PD college students exhibited significantly higher S/D and PI values on both sides compared to healthy subjects,with a statistically significant difference observed for PI on the left side(P<0.001).Following treatment,all aforementioned indexes decreased significantly,particularly PI on the left side which showed a significant difference from pre-treatment levels(P<0.001).③Before treatment,the levels of serum IL-1β,TNF-α,and CRP in PD college students were significantly higher compared to those in the healthy group.The difference in IL-1β level was statistically significant(P<0.001).After treatment,there was a noticeable decrease in the levels of IL-1β,TNF-α,and CRP.Specifically,IL-1β showed a significant reduction(P<0.01),and this time the comparison with the healthy group did not reveal any significant difference in IL-1β levels.Conclusion The application of warm moxibustion at the Shenque acupoint demonstrates a significant improvement in both the dysmenorrhea pain rating index and severity among college students with primary dysmenorrhea,while also alleviating the severity and duration of associated symptoms.These positive effects may be attributed to warm moxibustion's ability to enhance uterine microcirculation in individuals with primary dysmenorrhea,and ameliorating inflammatory conditions.

A 42-year-old male patient developed mild allergic symptoms after the use of cisatracurium besylate in laparoscopic left renal tumor resection,which was relieved by symptomatic treatment.When the drug was added again intraoperatively,the patient's blood pressure decreased sharply from 120/71 mmHg to 50/30 mmHg,and the airway resistance increased from 16 cmH2O to 38 cmH2O,and the patient developed typical signs of anaphylactic shock.After immediate intravenous injection of epinephrine,calcium chloride and other drugs,the patient's blood pressure rose to 95/57 mmHg,airway resistance decreased to 20 cmH2O,and vital signs tended to be stable.The Naranjo's Assessment Scale was used to evaluate and analyze the correlation of suspected drugs.The score was 9 points,indicating that the association between anaphylactic shock and cisatracurium besylate in this patient was judged to be"definitely related".This article suggests that cisatracurium besylate carries an allergic risk and should be used with caution,and the monitoring of vital signs and allergic reactions should be strengthened for early identification and timely treatment to ensure the safety of patients during the perioperative period.

Dental impressions contaminated by Candida albicans(C.albicans)and Streptococcus mutan(S.mutans)were used to com-pare the disinfection effects of the 2 disinfection reagents.Digital technology was used to compare the effect on accuracy of the 2 reagents.After rinsing the dental impressions with 100 mg/L slightly acidic hypochlorite water(SSHW)for 2 min,the killing log values for C.albicans and S.mutan were 3.44 and 5.26,and the bactericidal rates(％)99.96 and 100,respectively,and the root mean square(RMS)of deviation before and after disinfection was(21.40±2.88)μm.After immersing the dental impressions with 0.525％sodium hypochlorite for 10 minutes,the killing log values for C.albicans and S.mutan were 5.18 and 5.26,the bactericidal rates(％)was 100％for both.The RMS of deviation before and after disinfection was(28.50±4.25)μm.The SAHW rinsing method has good disinfec-tion effect,and has less influence on the accuracy of dental impressions.

Objective:To evaluate the efficacy and safety of intrasaccular flow disruptor in wide-necked intracranial aneurysms.Methods:One hundred and seventeen patients with wide-necked intracranial aneurysms treated with intrasaccular flow disruptor were collected from Department of Neurointervention (First Affiliated Hospital of Zhengzhou University), Department of Neurosurgery (Beijing Tiantan Hospital, Capital Medical University), Department of Cerebrovascular Surgery, Neurosurgery Center (Zhujiang Hospital, Southern Medical University), and Department of Neurosurgery (First Affiliated Hospital of Harbin Medical University) from August 2022 to March 2024. Raymond-Roy Occlusion Classification (RROC) was employed to evaluate aneurysm embolization immediately after procedure; cranial CT or MRI within 48 hours of embolization were performed to identify any new intracranial hemorrhage, subarachnoid hemorrhage, or new symptomatic cerebral infarction related to the intracranial aneurysms. Modified Rankin Scale (mRS) was used to assess the neurological function at discharge. Imaging follow-up and outpatient follow-up were performed at 6 months after embolization to evaluate the aneurysm occlusion degree and complications.Results:A total of 117 intrasaccular flow disruptors were implanted in 117 patients, with a technical success rate of 100%; 115 patients (98.3%) enjoyed successful one-time release of their disruptors, and 2 patients (1.7%) required retrieval and redirection of the disruptors before second successful attempt. Flow disruptor plus stent was performed in 13 patients (11.1%). Immediately after procedure, RROC grading I was noted in 3 patients, grading II in 51 patients and grading III in 63 patients. Cranial CT or MRI within 48 hours of embolization indicated no new intracranial hemorrhage, subarachnoid hemorrhage, or symptomatic cerebral infarction related to the intracranial aneurysms. All patients had mRS score of 0 at discharge. Eighty-three patients completed a 6-month follow-up (RROC grading I in 41 patients, grading II in 33 patients and grading III in 9 patients), without ischemic or hemorrhagic adverse events.Conclusion:The results of this study preliminarily suggest that intrasaccular flow disruptor is effective and safe in wide-necked intracranial aneurysms.

Dental impressions contaminated by Candida albicans(C.albicans)and Streptococcus mutan(S.mutans)were used to com-pare the disinfection effects of the 2 disinfection reagents.Digital technology was used to compare the effect on accuracy of the 2 reagents.After rinsing the dental impressions with 100 mg/L slightly acidic hypochlorite water(SSHW)for 2 min,the killing log values for C.albicans and S.mutan were 3.44 and 5.26,and the bactericidal rates(％)99.96 and 100,respectively,and the root mean square(RMS)of deviation before and after disinfection was(21.40±2.88)μm.After immersing the dental impressions with 0.525％sodium hypochlorite for 10 minutes,the killing log values for C.albicans and S.mutan were 5.18 and 5.26,the bactericidal rates(％)was 100％for both.The RMS of deviation before and after disinfection was(28.50±4.25)μm.The SAHW rinsing method has good disinfec-tion effect,and has less influence on the accuracy of dental impressions.

Objective This study aims to observe the impact of warm moxibustion on menstrual pain in college students with primary dysmenorrhea and explore its potential mechanism.Methods College students with primary dysmenorrhea were recruited and treated with warm moxibustion at Shenque acupoint for three consecutive menstrual cycles.Healthy subjects were also recruited for comparison.Pain scale,uterine artery hemodynamics,and related inflammatory factors were assessed before and after treatment.Results ①The results of scale study showed that the severity and duration of dysmenorrhea were gradually alleviated with the prolongation of treatment time through the analysis of variance of repeated measurements of the total scores of McGill pain inquiry scale and CMSS dysmenorrhea symptom scale before and after 3 treatments.The results of variance analysis and pairwise comparison of repeated measurements of PRI,VAS and PPI of McGill pain inquiry scale before and after 3 times treatment in warm moxibustion group also showed that each index decreased gradually with the prolongation of treatment time.The comparison of the scores of each item of CMSS scale showed that the severity and duration of low back before treatment were significantly different from those in the healthy group(P<0.001),but the difference was weakened after the third treatment.The severity of vomiting,the duration of vomiting,the severity of diarrhea and the duration of diarrhea were significantly different from those in the healthy group before treatment(P<0.001),but they were still higher than those in the healthy group after the third treatment.but the difference was not statistically significant.②Prior to treatment,PD college students exhibited significantly higher S/D and PI values on both sides compared to healthy subjects,with a statistically significant difference observed for PI on the left side(P<0.001).Following treatment,all aforementioned indexes decreased significantly,particularly PI on the left side which showed a significant difference from pre-treatment levels(P<0.001).③Before treatment,the levels of serum IL-1β,TNF-α,and CRP in PD college students were significantly higher compared to those in the healthy group.The difference in IL-1β level was statistically significant(P<0.001).After treatment,there was a noticeable decrease in the levels of IL-1β,TNF-α,and CRP.Specifically,IL-1β showed a significant reduction(P<0.01),and this time the comparison with the healthy group did not reveal any significant difference in IL-1β levels.Conclusion The application of warm moxibustion at the Shenque acupoint demonstrates a significant improvement in both the dysmenorrhea pain rating index and severity among college students with primary dysmenorrhea,while also alleviating the severity and duration of associated symptoms.These positive effects may be attributed to warm moxibustion's ability to enhance uterine microcirculation in individuals with primary dysmenorrhea,and ameliorating inflammatory conditions.

Objective To construct a prediction model for in-hospital mortality in the elderly(≥65 years)patients undergoing unsynchronous cardioversion in ICU and to evaluate its effectiveness.Methods A retrospective study was conducted on 276 elderly eligible patients in the ICU of the Ninth and the First Medical Centers of Chinese PLA General Hospital between June 2022 and August 2024.According to their clinical outcomes,they were divided into a non-in-hospital dead group(111 cases)and an in-hospital dead group(165 cases).Clinical data were collected,and pre-dictive factors for in-hospital mortality were screened.And then a nomogram prediction model was developed based on the obtained predictive factors,which was evaluated with ROC curve and deci-sion curve analyses.Results When compared to the non-in-hospital dead group,the in-hospital dead group had significantly higher heart rate,ratio of hemodialysis,and levels of alanine amin-otransferase,aspartate aminotransferase,lactate dehydrogenase,alkaline phosphatase,serum cre-atinine,blood glucose,lactate,low base excess,sequential organ failure assessment(SOFA)score,model for end-stage liver disease score,and larger proportions of ventricular fibrillation/flutter and structural heart disease induced by pulseless ventricular tachycardia,and had significantly lower Glasgow Coma Scale(GCS)(P＜0.05).Multivariate logistic regression analysis identified body temperature＞37℃(OR=0.426,95％CI:0.198-0.915,P=0.029),chronic obstructive pulmonary disease(OR=2.333,95％CI:1.217-4.473,P=0.011),GCS score(OR=0.622,95％CI:0.410-0.944,P=0.026),hemoglobin(OR=0.817,95％CI:0.715-0.934,P=0.003),lactate(OR=1.365,95％CI:1.174-1.587,P=0.000),heart rate＞100 bpm(OR=2.757,95％CI:1.397-5.441,P=0.003),and SOFA score(OR=1.112,95％CI:1.032-1.198,P=0.005)as pre-dictors of in-hospital mortality.ROC curve analysis showed an AUC value of above indicators combined together in the prediction was 0.797,with a sensitivity of 76.97％and a specificity of 65.77％.Calibration curve analysis demonstrated good consistency between predicted and observed outcomes.Decision curve analysis indicated favorable clinical utility of the model.Conclusion This study identifies independent risk factors for in-hospital mortality among elderly patients in the ICU who underwent asynchronous cardioversion.Based on these factors,a nomo-gram model is established,demonstrating good discrimination,calibration,and model fit,with high clinical applicability.