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 association of serum/body fluid heparin-binding protein (HBP) and blood lactate levels with disease severity and their impact on prognosis in intensive care unit (ICU) patients with sepsis.Methods:Clinical data from 100 sepsis patients admitted to Ma'anshan Shiqiye Hospital ICU (January 2023-September 2024) were retrospectively analyzed. According to Sepsis-3.0 criteria, patients were divided into: uncomplicated sepsis (general group, n=28), sepsis with organ failure/hypotension (severe group, n=61), and septic shock (shock group, n=11). Comparisons included serum/body fluid HBP, lactate, APACHE Ⅱ scores, and mortality across severity groups and laboratory parameters between survivors and non-survivors. Logistic regression was used to identify prognostic predictors. Non-normally distributed data were presented as M(Q1,Q3), comparison between groups were completed by Kruskal-Wallis H test and Mann-Whitney U tests. Spearman correlation was used to analyze relationships between biomarkers and APACHE Ⅱ scores. Categorical data were presented as n(%), and comparison between groups were completed by χ2 test or Fisher's exact tests. ROC curves was used to evaluate predictive value. Results:Shock group demonstrated significantly higher serum HBP [13.3 (12.6-16.4) μg/L], infection-site HBP [230.3 (226.3-241.1) μg/L], lactate [5.4 (4.9-5.6) mmol/L], and APACHE Ⅱ[22.0 (21.0-24.0)] than severe group [9.6 (8.9-10.5) μg/L; 208.9 (200.5-216.1) μg/L; 2.7 (2.6-2.8) mmol/L; 18.0 (17.0-19.0)] and general group [7.4 (6.3-8.1) μg/L; 190.6 (180.5-202.1) μg/L; 1.5 (1.4-1.7) mmol/L; 13.0 (12.0-14.0)] (all P<0.001). There was statistically significant difference in the mortality rate during hospita lization among three groups of patients ( χ2=30.49, P<0.001). Mortality was higher in shock group than severe group than general group [72.7% (8/11) vs. 11.5% (7/61) vs. 3.6% (1/28), all P<0.001]. Non-survivors exhibited elevated lactate [4.8 (2.7-5.5) vs. 2.6 (1.7-2.8) mmol/L, Z=-4.13, P=0.001], serum HBP [12.2 (9.2-13.3) vs. 9.3 (7.8-10.4) μg/L, Z=-3.12, P=0.002], and infection-site HBP [226.8 (209.9-237.6) vs. 203.6 (194.0-212.8) μg/L, Z=-4.32, P<0.001] vs. survivors. Serum HBP ( r=0.74), infection-site HBP ( r=0.64), and lactate ( r=0.86) were all positively correlated with APACHE Ⅱ (all P<0.001). After adjusting for age and APACHE Ⅱ, elevated serum HBP ( OR=3.743, 95% CI:1.834-7.640), infection-site HBP ( OR=3.540, 95% CI:1.932-6.486), and lactate ( OR=5.155, 95% CI:1.868-14.229) independently predicted mortality (all P<0.001). Combined biomarker detection showed superior predictive value (AUC=0.909) versus individual markers (serum HBP:0.747, infection-site HBP:0.842, lactate:0.827, all P<0.001). Conclusion:Elevated blood lactate and serum/infection-site HBP levels correlate with sepsis severity and independently predict mortality. The biomarker combination provides optimal prognostic stratification.

Objective:To explore the risk assessment and intervention effect of WeChat platform-based health management in high-risk populations for cardiovascular diseases (CVD).Methods:It was a randomized controlled trial. A total of 480 individuals at high risk of CVD who underwent physical examinations at the Health Management Center of Sichuan Provincial People′s Hospital from February to April in 2023 were selected using a simple random sampling method. The participants were randomly assigned to either the intervention group or the control group (240 cases each) using a random number table. The control group received routine follow-up and health assessments, while the intervention group received an additional 12-month WeChat-based health management intervention. During the study, 28 participants were lost to follow-up, resulting in 227 participants in the intervention group and 225 in the control group being included in the final analysis. The 10-year CVD risk was assessed using the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) model, and psychological status was evaluated using the self-rating anxiety Scale (SAS) and the self-rating depression scale (SDS). Changes in health behaviors, adherence, life style, blood pressure, metabolic indicators, psychological status, and CVD risk were compared before and after the intervention in both groups to evaluate the intervention′s effectiveness.Results:Among the 452 high-risk participants analyzed, the intervention group included 227 individuals [mean age: (53.16±10.81) years; 117 males and 110 females], and the control group included 225 individuals [mean age: (52.60±10.25) years; 118 males and 107 females]. There was no significant differences in baseline characteristics between the two groups (all P>0.05). After 12 months of intervention, the intervention group showed significant improvements in medication adherence, intake of vegetables and fruits, exercise duration, sleep time, proportion of regular lifestyle, and high density lipoprotein cholesterol (HDL-C) levels, all of which were all higher than both the baseline values and those in the control group (all P<0.05). Conversely, the intervention group showed reductions in medical visit rate, smoking and drinking rates, high-salt diet, meat intake, body mass index (BMI), fasting blood glucose, systolic and diastolic blood pressure, low density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides, SAS and SDS scores when compared to the baseline values and those in the control group (all P<0.05). The proportions of participants with 10-year CVD risk levels of 10%-<20%, 20%-<30%, 30%-<40%, and ≥40% significantly decreased in the intervention group after intervention (18.94% vs 36.12%, 12.78% vs 26.43%, 7.93% vs 19.82%, 3.96% vs 17.63%), and were also significantly lower than those in the control group (18.94% vs 40.45%, 12.78% vs 30.67%, 7.93% vs 22.67%, 3.96% vs 16.89%) (all P<0.001). After 12 months, the intervention group showed significantly higher improvement rates in both medication adherence and non-medication-related compliance behaviors, including smoking, alcohol consumption, meat and salt intake, fruit and vegetable intake, exercise duration, sleep duration, and lifestyle regularity, when compared to those in the control group (16.74% vs -3.11%, 14.54% vs -0.89%, 16.74% vs -0.44%, 57.71% vs 8.44%, 21.15% vs -0.44%, 56.83% vs -6.67%, 51.54% vs -3.56%, 60.79% vs -7.11%, 26.87% vs -13.78%, 22.91% vs -1.78%) (all P<0.001). Conclusion:The WeChat platform-based health management intervention can effectively improve the behavioral patterns, compliance, control of CVD risk factors and psychological status of high-risk populations for CVD, and help reduce their 10-year risk of CVD.

Objective:To investigate the association of serum/body fluid heparin-binding protein (HBP) and blood lactate levels with disease severity and their impact on prognosis in intensive care unit (ICU) patients with sepsis.Methods:Clinical data from 100 sepsis patients admitted to Ma'anshan Shiqiye Hospital ICU (January 2023-September 2024) were retrospectively analyzed. According to Sepsis-3.0 criteria, patients were divided into: uncomplicated sepsis (general group, n=28), sepsis with organ failure/hypotension (severe group, n=61), and septic shock (shock group, n=11). Comparisons included serum/body fluid HBP, lactate, APACHE Ⅱ scores, and mortality across severity groups and laboratory parameters between survivors and non-survivors. Logistic regression was used to identify prognostic predictors. Non-normally distributed data were presented as M(Q1,Q3), comparison between groups were completed by Kruskal-Wallis H test and Mann-Whitney U tests. Spearman correlation was used to analyze relationships between biomarkers and APACHE Ⅱ scores. Categorical data were presented as n(%), and comparison between groups were completed by χ2 test or Fisher's exact tests. ROC curves was used to evaluate predictive value. Results:Shock group demonstrated significantly higher serum HBP [13.3 (12.6-16.4) μg/L], infection-site HBP [230.3 (226.3-241.1) μg/L], lactate [5.4 (4.9-5.6) mmol/L], and APACHE Ⅱ[22.0 (21.0-24.0)] than severe group [9.6 (8.9-10.5) μg/L; 208.9 (200.5-216.1) μg/L; 2.7 (2.6-2.8) mmol/L; 18.0 (17.0-19.0)] and general group [7.4 (6.3-8.1) μg/L; 190.6 (180.5-202.1) μg/L; 1.5 (1.4-1.7) mmol/L; 13.0 (12.0-14.0)] (all P<0.001). There was statistically significant difference in the mortality rate during hospita lization among three groups of patients ( χ2=30.49, P<0.001). Mortality was higher in shock group than severe group than general group [72.7% (8/11) vs. 11.5% (7/61) vs. 3.6% (1/28), all P<0.001]. Non-survivors exhibited elevated lactate [4.8 (2.7-5.5) vs. 2.6 (1.7-2.8) mmol/L, Z=-4.13, P=0.001], serum HBP [12.2 (9.2-13.3) vs. 9.3 (7.8-10.4) μg/L, Z=-3.12, P=0.002], and infection-site HBP [226.8 (209.9-237.6) vs. 203.6 (194.0-212.8) μg/L, Z=-4.32, P<0.001] vs. survivors. Serum HBP ( r=0.74), infection-site HBP ( r=0.64), and lactate ( r=0.86) were all positively correlated with APACHE Ⅱ (all P<0.001). After adjusting for age and APACHE Ⅱ, elevated serum HBP ( OR=3.743, 95% CI:1.834-7.640), infection-site HBP ( OR=3.540, 95% CI:1.932-6.486), and lactate ( OR=5.155, 95% CI:1.868-14.229) independently predicted mortality (all P<0.001). Combined biomarker detection showed superior predictive value (AUC=0.909) versus individual markers (serum HBP:0.747, infection-site HBP:0.842, lactate:0.827, all P<0.001). Conclusion:Elevated blood lactate and serum/infection-site HBP levels correlate with sepsis severity and independently predict mortality. The biomarker combination provides optimal prognostic stratification.

Objective:To explore the risk assessment and intervention effect of WeChat platform-based health management in high-risk populations for cardiovascular diseases (CVD).Methods:It was a randomized controlled trial. A total of 480 individuals at high risk of CVD who underwent physical examinations at the Health Management Center of Sichuan Provincial People′s Hospital from February to April in 2023 were selected using a simple random sampling method. The participants were randomly assigned to either the intervention group or the control group (240 cases each) using a random number table. The control group received routine follow-up and health assessments, while the intervention group received an additional 12-month WeChat-based health management intervention. During the study, 28 participants were lost to follow-up, resulting in 227 participants in the intervention group and 225 in the control group being included in the final analysis. The 10-year CVD risk was assessed using the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) model, and psychological status was evaluated using the self-rating anxiety Scale (SAS) and the self-rating depression scale (SDS). Changes in health behaviors, adherence, life style, blood pressure, metabolic indicators, psychological status, and CVD risk were compared before and after the intervention in both groups to evaluate the intervention′s effectiveness.Results:Among the 452 high-risk participants analyzed, the intervention group included 227 individuals [mean age: (53.16±10.81) years; 117 males and 110 females], and the control group included 225 individuals [mean age: (52.60±10.25) years; 118 males and 107 females]. There was no significant differences in baseline characteristics between the two groups (all P>0.05). After 12 months of intervention, the intervention group showed significant improvements in medication adherence, intake of vegetables and fruits, exercise duration, sleep time, proportion of regular lifestyle, and high density lipoprotein cholesterol (HDL-C) levels, all of which were all higher than both the baseline values and those in the control group (all P<0.05). Conversely, the intervention group showed reductions in medical visit rate, smoking and drinking rates, high-salt diet, meat intake, body mass index (BMI), fasting blood glucose, systolic and diastolic blood pressure, low density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides, SAS and SDS scores when compared to the baseline values and those in the control group (all P<0.05). The proportions of participants with 10-year CVD risk levels of 10%-<20%, 20%-<30%, 30%-<40%, and ≥40% significantly decreased in the intervention group after intervention (18.94% vs 36.12%, 12.78% vs 26.43%, 7.93% vs 19.82%, 3.96% vs 17.63%), and were also significantly lower than those in the control group (18.94% vs 40.45%, 12.78% vs 30.67%, 7.93% vs 22.67%, 3.96% vs 16.89%) (all P<0.001). After 12 months, the intervention group showed significantly higher improvement rates in both medication adherence and non-medication-related compliance behaviors, including smoking, alcohol consumption, meat and salt intake, fruit and vegetable intake, exercise duration, sleep duration, and lifestyle regularity, when compared to those in the control group (16.74% vs -3.11%, 14.54% vs -0.89%, 16.74% vs -0.44%, 57.71% vs 8.44%, 21.15% vs -0.44%, 56.83% vs -6.67%, 51.54% vs -3.56%, 60.79% vs -7.11%, 26.87% vs -13.78%, 22.91% vs -1.78%) (all P<0.001). Conclusion:The WeChat platform-based health management intervention can effectively improve the behavioral patterns, compliance, control of CVD risk factors and psychological status of high-risk populations for CVD, and help reduce their 10-year risk of CVD.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective:To observe any effect of electroacupuncture (EA) on the expression of phosphorylated extracellular signal-regulated protein kinase (p-ERK1/2) and phosphorylated cyclic adenosine monophosphate response element binding protein (p-CREB) in the spinal dorsal horns of diabetics experiencing neuropathic pain.Methods:Eight rats were randomly selected from 30 healthy male Sprague-Dawley rats as the normal group (N), and the remaining twenty-two rats were treated with a single high-dose intraperitoneal injection of streptozotocin (STZ) to establish a neuropathic pain model. The rats modeled successfully were randomly divided into a model group (M, n=8) and an EA group ( n=8). In the EA group, electroacupuncture was applied at the bilateral Hou san li and Kunlun acupoints starting on the 15th day after the STZ injection. The daily sessions lasted 30 minutes for 1 week. Body weight (BW), fasting blood glucose (FBG) and paw withdrawal latency (PWL) were observed before the STZ injection and on the 7th, 14th, and 21st days afterward. The expression of p-ERK1/2 and p-CREB in the dorsal horns of the rats′ spinal cords was detected using western blotting. The count of p-CREB-positive cells in the dorsal horns and their co-localization with neurons was detected using immunofluorescence. Results:In comparison with the N group, the average BW of the M group on the 7th, 14th and 21st days after the STZ injection was significantly lower, while the average FBG was significantly higher. There was no significant difference between the M and N groups in the average PWL on the 7th day after the STZ injection, but it had decreased significantly in the M group on the 14th and 21st days. Compared with the M group, the average PWL of the EA group was significantly longer on the 21st day after the injection. The expression of p-ERK1/2 and p-CREB protein in the spines of the M group was significantly higher than in the N group. p-CREB positive cells were more numerous in the M group compared with the N group, while in the EA group they were fewer. P-CREB was co-located with neurons in the spinal dorsal horn.Conclusion:EA can alleviate neuropathic pain effectively, perhaps by inhibiting the expression of p-ERK1/2 and p-CREB in the dorsal horns of the spinal cord.

【Objective】 To explore B lymphocytes’ role and mechanisms in angiotensinⅡ/phenylephrine (AngⅡ/PE) induced cardiomyopathy so as to understand the role of inflammatory cells in myocardial injury. 【Methods】 AngⅡ/PE was administered to wild-type (WT) and B cells deficiency (μMT) mice for 14 days or 28 days. The mice were analyzed by blood pressure measurement, echocardiography imaging, flow cytometry, and histology. Cardiac fibrosis was evaluated by Masson staining. 【Results】 Compared with the control group, the left ventricular mass (P<0.01), heart mass/tibia length ratio (P<0.01) and cross-sectional area of cardiomyocytes in AngⅡ/PE group were significantly increased (P<0.01). After 2 weeks of AngⅡ/PE treatment, B lymphocytes (P<0.05), CD45⁺ leukocytes (P<0.05), CD64^-Ly6C⁺ monocytes (P<0.05), CD64⁺Ly6C^-macrophages (P<0.05) and Ly6g⁺ neutrophils (P<0.05) were recruited in myocardial tissue. Compared with WT_AngⅡ/PE group, the heart weight/tibia length ratio (P<0.05), left ventricular weight (P<0.05) and myocardial cell cross-sectional area (P<0.05) of μMT_AngⅡ/PE mice were significantly improved. CD45⁺Ly6C⁺CD64^- monocytes (P<0.05) and CD45⁺Ly6C^-CD64⁺ macrophages (P<0.05) were significantly decreased. 【Conclusion】 B lymphocytes deficiency improves AngⅡ/PE induced cardiac hypertrophy by reducing the infiltration of CD45⁺Ly6C⁺CD64^- monocytes and CD45⁺Ly6C^- CD64⁺ macrophages.

Objective:To explore the clinical features and risk factors of systemic lupus erythematosus(SLE) concomitant with interstitial lung disease(ILD) in children.Methods:A retrospective analysis was performed.A total of 111 hospitalized children diagnosed with SLE in the Department of Rheumatology and Immunology, Children′s Hospital of Soochow University from February 2016 to November 2018 were selected as the research subjects and divided into the SLE-ILD group(18 cases) and the SLE-non-ILD group(93 cases)according to the lung high-resolution CT manifestations. T-test and Wilcoxon rank sum test were used to compare and analyze the general situation, clinical manifestations and laboratory results.Multivariate Logistic regression was used to analyze the risk factors of SLE-ILD. Results:The prevalence of SLE-ILD was 16.2%(18/111 cases). There were significant differences between the SLE-ILD group and the SLE-non-ILD group in the course of disease [14.00 (12.00-24.25) months vs.1.00(1.00-2.00) months], the incidence of serositis [55.6%(10/18 cases) vs.8.6%(8/93 cases)], post-activity shortness of breath [83.3%(15/18 cases) vs.25.8%(24/93 cases)], nervous system damage [27.8%(5/18 cases) vs.6.5%(6/93 cases)], cardiovascular system damage [38.9%(7/18 cases) vs.9.7%(9/93 cases)], the occu-rrence of increased erythrocyte sedimentation rate [66.7%(12/18 cases) vs.31.2%(29/93 cases)], the decreased C 3[88.9%(16/18 cases) vs.62.4%(58/93 cases)], positive anti neutrophil cytoplasmic antibody (ANCA) [88.9%(16/18 cases) vs.18.3%(17/93 cases)], positive anti-Sm antibody [61.1%(11/18 cases) vs.15.1%(14/93 cases)] and anti ribonucleoprotein antibody (anti RNP antibody)[66.7%(12/18 cases) vs.16.1%(15/93 cases)](all P<0.05). Logistic regression analysis demonstrated that serositis( OR=30.535, 95% CI: 2.167-430.336, P=0.011), shortness of breath after exercise( OR=55.115, 95% CI: 1.117-2 579.852, P=0.041), positive ANCA( OR=65.090, 95% CI: 4.488-944.071, P=0.002) and positive anti-RNP antibody( OR=10.007, 95% CI: 1.362-73.500, P=0.024) were risk factors for SLE-ILD. Conclusions:The longer the course of SLE, the higher the incidence of ILD; serositis, shortness of breath after exercise, positive ANCA and positive anti RNP antibody may be risk factors for SLE-ILD.

Objective To study the feasibility and safety of individual laparoscopic pancreatectomy for patients with pancreatic neuroendocrine neoplasm(pNEN).Methods 16 patients with pNEN admitted from Jan.2007 to Nov.2016 undergoing individual laparoscopic pancreatectomy were retrospectively analyzed.Results The operations were successfully accomplished in all the 16 patients,including 2 cases of local excision,2 cases of bundling method excision,2 cases of central pancreatectomy and pancreaticojejunostomy,4 cases of spleen-preserving distal pancreatectomy and 6 cases of distal pancreatectomy combined with splenectomy.The operation time was ranging from 60 to 260 mins,and the blood loss was from 50 to 300 ml.Three cases suffered from level A postoperative pancreatic leakage.The cases of grade G1,G2,G3 were 10,5,1,respectively.The follow-up period was from 3 to 121 months.One case of grade G2 died 46 months postoperatively and 1 case of grade G3 died 36 months postoperatively.Conclusion Individual laparoscopic pancreatectomy is safe and feasible for early pNEN.