ObjectiveTo analyze the expression level of triggering receptor expressed on myeloid cells-1 （TREM-1） in serum and ascites of patients with cirrhotic ascites， and to investigate its correlation with clinical features and inflammatory markers and its role in the diagnosis of infection and prognostic evaluation. MethodsA total of 110 patients with cirrhotic ascites who were hospitalized in The Fifth Hospital of Shijiazhuang from January 2019 to December 2020 were enrolled， and according to the presence or absence of intra-abdominal infection， they were divided into infection group with 72 patients and non-infection group with 38 patients. The patients with infection were further divided into improvement group with 38 patients and non-improvement group with 34 patients. Clinical data and laboratory markers were collected from all patients. Serum and ascites samples were collected， and ELISA was used to measure the level of TREM-1. The independent-samples t test was used for comparison of normally distributed continuous data between two groups； the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate the correlation between indicators. A multivariate Logistic regression analysis was used to identify the influencing factors for the prognosis of patients with cirrhotic ascites and infection. The receiver operating characteristic （ROC） curve was used to evaluate the diagnostic and prognostic efficacy of each indicator， and the Delong test was used for comparison of the area under the ROC curve （AUC）. ResultsThe level of TREM-1 in ascites was significantly positively correlated with that in serum （r=0.50， P<0.001）. Compared with the improvement group， the non-improvement group had a significantly higher level of TREM-1 in ascites （Z=-2.391， P=0.017） and serum （Z=-2.544， P=0.011）， and compared with the non-infection group， the infection group had a significantly higher level of TREM-1 in ascites （Z=-3.420， P<0.001）， while there was no significant difference in the level of TREM-1 in serum between the two groups （P>0.05）. The level of TREM-1 in serum and ascites were significantly positively correlated with C-reactive protein （CRP）， procalcitonin （PCT）， white blood cell count， and neutrophil-lymphocyte ratio （r=0.288， 0.344， 0.530， 0.510， 0.534， 0.454， 0.330， and 0.404， all P<0.05）. The ROC curve analysis showed that when PCT， CRP， and serum or ascitic TREM-1 were used in combination for the diagnosis of cirrhotic ascites with infection， the AUCs were 0.715 and 0.740， respectively. The multivariate Logistic regression analysis showed that CRP （odds ratio ［OR］=1.019， 95% confidence interval ［CI］： 1.001‍ ‍—‍ ‍1.038， P=0.043） and serum TREM-1 （OR=1.002， 95%CI： 1.000‍ ‍—‍ ‍1.003， P=0.016） were independent risk factors for the prognosis of patients with cirrhotic ascites and infection， and the combination of these two indicators had an AUC of 0.728 in predicting poor prognosis. ConclusionThe level of TREM-1 is closely associated with the severity of infection and prognosis in patients with cirrhotic ascites， and combined measurement of TREM-1 and CRP/PCT can improve the diagnostic accuracy of infection and provide support for prognostic evaluation.

Objective:To evaluate the efficacy and safety of daratumumab in treating patients with monoclonal immunoglobulin deposition disease (MIDD) with renal injury.Methods:A case-series analysis study was conducted in MIDD patients with renal injury who received daratumumab treatment at the Department of Nephrology, Ruijin Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, from December 2021 to October 2023. The clinical data of patients at the time of diagnosis and during the follow-up period were collected. Hematological and renal responses were assessed and adverse reaction events were recorded.Results:Seven patients diagnosed with MIDD were included in this study, with a male-to-female ratio of 5∶2 and age of 46 (43, 52) years. One patient was light-heavy chain deposition disease, and the remaining 6 patients were light chain deposition disease. Among them, 5 patients had received prior treatment (1-2 lines of treatment with the regimen of cyclophosphamide, bortezomib and dexamethasone), while 2 patients were newly treated, one of whom had already started hemodialysis at diagnosis. Prior to receiving monoclonal antibody treatment, difference of serum free light chain (dFLC) among the 7 patients was 52 (7, 295) mg/L. Excluding 1 patient on dialysis, the remaining 6 patients had 24-hour urinary protein of 1.1 (0.2, 4.7) g, serum creatinine of 178.5 (157.8, 279.8) μmol/L and estimated glomerular filtration rate of 33.9 (24.2, 41.1) ml·min -1·（1.73 m 2） -1. The daratumumab treatment was 17 (10, 20) infusions, with treatment duration of 17 (9, 23) months and follow-up time of 24 (13, 32) months. After treatment, among 5 previously treated patients, hematological response evaluation showed that 1 patient with baseline dFLC <20 mg/L and minimal residual disease negativity upon re-examination, while the remaining 4 patients achieved hematological responses of complete response or better. Renal response evaluation revealed that, except for 1 patient with partial response, the other 4 patients achieved very good partial response (VGPR) or better. Among 2 newly diagnosed patients, both achieved hematological efficacy at least VGPR, with one achieving renal complete response, while the other one remaining dialysis- dependent. Overall, dFLC of 7 patients was 4.9 (2.1, 11.5) mg/L. Among 6 non-dialysis patients, 24-hour urinary protein was 0.19 (0.06, 0.42) g, serum creatinine was 153.0 (120.8, 188.0) μmol/L and estimated glomerular filtration rate was 40.4 (35.2, 57.3) ml·min -1·(1.73 m 2) -1. No severe adverse reactions were observed during daratumumab treatment. Conclusion:The application of daratumumab in the treatment of MIDD with renal injury is effective and well tolerated, achieving high-quality hematological responses, with high renal responses reaching or exceeding VGPR and improvement of renal function.

The establishment of standardized statistical analysis strategies is of great significance to ensuring scientific value and promoting high-quality development in pharmacoepidemiology research.Based on the Guide on Methodological Standards in Pharmacoepidemiology(2nd edition),this article interprets the statistical analysis content within it section of the Guidelines.The first part outlines the importance and specific content of statistical analysis strategies in pharmacoepidemiology studies,introduces the variable definitions and sample size estimation and elaborates on data preprocessing and statistical methods.It also briefly discusses bias control and sensitivity analysis.The second part focuses on considerations for developing statistical analysis strategies,with further clarification on subgroup analysis,interim analysis,and the preparation of the statistical analysis reports.

To ensure the safety and efficacy of Chinese herbs, it is of great significance to conduct rapid quality detection of Chinese herbs at every link of their supply chain. Spectroscopic technology can reflect the overall chemical composition and structural characteristics of Chinese herbs, with the multi-component and multitarget characteristics of Chinese herbs. This review took the genus Paris as an example, and applications of spectroscopic technology with machine learning (ML) in supply chain of the genus Paris from seeds to medicinal materials were introduced. The specific contents included the confirmation of germplasm resources, identification of growth years, cultivar, geographical origin, and original processing and processing methods. The potential application of spectroscopic technology in genus Paris was pointed out, and the prospects of combining spectroscopic technology with blockchain were proposed. The summary and prospects presented in this paper will be beneficial to the quality control of the genus Paris in all links of its supply chain, so as to rationally use the genus Paris resources and ensure the safety and efficacy of medication.

To ensure the safety and efficacy of Chinese herbs,it is of great significance to conduct rapid quality detection of Chinese herbs at every link of their supply chain.Spectroscopic technology can reflect the overall chemical composition and structural characteristics of Chinese herbs,with the multi-component and multitarget characteristics of Chinese herbs.This review took the genus Paris as an example,and applications of spectroscopic technology with machine learning(ML)in supply chain of the genus Paris from seeds to medicinal materials were introduced.The specific contents included the confirmation of germplasm resources,identification of growth years,cultivar,geographical origin,and original pro-cessing and processing methods.The potential application of spectroscopic technology in genus Paris was pointed out,and the prospects of combining spectroscopic technology with blockchain were pro-posed.The summary and prospects presented in this paper will be beneficial to the quality control of the genus Paris in all links of its supply chain,so as to rationally use the genus Paris resources and ensure the safety and efficacy of medication.

Objective To analyze the expression level of triggering receptor expressed on myeloid cells-1(TREM-1)in serum and ascites of patients with cirrhotic ascites,and to investigate its correlation with clinical features and inflammatory markers and its role in the diagnosis of infection and prognostic evaluation.Methods A total of 110 patients with cirrhotic ascites who were hospitalized in The Fifth Hospital of Shijiazhuang from January 2019 to December 2020 were enrolled,and according to the presence or absence of intra-abdominal infection,they were divided into infection group with 72 patients and non-infection group with 38 patients.The patients with infection were further divided into improvement group with 38 patients and non-improvement group with 34 patients.Clinical data and laboratory markers were collected from all patients.Serum and ascites samples were collected,and ELISA was used to measure the level of TREM-1.The independent-samples t test was used for comparison of normally distributed continuous data between two groups;the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the Kruskal-Wallis H test was used for comparison between multiple groups;the chi-square test was used for comparison of categorical data between two groups.A Spearman correlation analysis was used to investigate the correlation between indicators.A multivariate Logistic regression analysis was used to identify the influencing factors for the prognosis of patients with cirrhotic ascites and infection.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic and prognostic efficacy of each indicator,and the Delong test was used for comparison of the area under the ROC curve(AUC).Results The level of TREM-1 in ascites was significantly positively correlated with that in serum(r=0.50,P<0.001).Compared with the improvement group,the non-improvement group had a significantly higher level of TREM-1 in ascites(Z=-2.391,P=0.017)and serum(Z=-2.544,P=0.011),and compared with the non-infection group,the infection group had a significantly higher level of TREM-1 in ascites(Z=-3.420,P<0.001),while there was no significant difference in the level of TREM-1 in serum between the two groups(P>0.05).The level of TREM-1 in serum and ascites were significantly positively correlated with C-reactive protein(CRP),procalcitonin(PCT),white blood cell count,and neutrophil-lymphocyte ratio(r=0.288,0.344,0.530,0.510,0.534,0.454,0.330,and 0.404,all P<0.05).The ROC curve analysis showed that when PCT,CRP,and serum or ascitic TREM-1 were used in combination for the diagnosis of cirrhotic ascites with infection,the AUCs were 0.715 and 0.740,respectively.The multivariate Logistic regression analysis showed that CRP(odds ratio[OR]=1.019,95%confidence interval[CI]:1.001-1.038,P=0.043)and serum TREM-1(OR=1.002,95%CI:1.000-1.003,P=0.016)were independent risk factors for the prognosis of patients with cirrhotic ascites and infection,and the combination of these two indicators had an AUC of 0.728 in predicting poor prognosis.Conclusion The level of TREM-1 is closely associated with the severity of infection and prognosis in patients with cirrhotic ascites,and combined measurement of TREM-1 and CRP/PCT can improve the diagnostic accuracy of infection and provide support for prognostic evaluation.

Objective To analyze the antiviral effect of molnupiravir against influenza virus in vitro and in vivo.Methods The antiviral ability of molnupiravir against influenza virus strain H1N1 PR8 was detected in vitro and in vivo.H uman non-small cell lung cancer cell line(A549 cells)was used as an in vitro model of PR8 infection.The antiviral effects of molnupiravir on virus replication,protein synthesis,and viral particle formation were analyzed using real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),Western blot(WB)assay,and plaque assay.PR8 nose-dripping infected C57BL/6 female mice were used as an in vivo infection model.The antivi-ral ability of molnupiravir was evaluated by detecting viral load,pathological changes,and immunohistochemistry in the control group,administration group,inoculation group,and inoculation-administration group.Results In vitro test results showed that molnupiravir had no significant inhibitory effect on influenza virus replication,protein syn-thesis,and virus particle formation(all P＞0.05).In vivo test results showed that compared with mice infected with H1N1 alone,the viral load in the lung tissue of mice treated with molnupiravir declined significantly,and the extent of pathological changes was milder.Immunohistochemical detection showed a significant weakening in nuclear protein(NP)antigen signal,and the expression levels of interferon(IFN)-α,interleukin(IL)-4,and IL-6 in the lungs were lower(all P＜0.01).Conclusion As a precursor with antiviral activity,molnupiravir can not exert anti-viral activity in lung-derived cells cultured in vitro,but can be transformed into an active form in the host,which significantly decreases the ability of H1N1 influenza virus to proliferate in the lungs and thereby alleviates the da-mage of virus to lung tissue.

The establishment of standardized statistical analysis strategies is of great significance to ensuring scientific value and promoting high-quality development in pharmacoepidemiology research.Based on the Guide on Methodological Standards in Pharmacoepidemiology(2nd edition),this article interprets the statistical analysis content within it section of the Guidelines.The first part outlines the importance and specific content of statistical analysis strategies in pharmacoepidemiology studies,introduces the variable definitions and sample size estimation and elaborates on data preprocessing and statistical methods.It also briefly discusses bias control and sensitivity analysis.The second part focuses on considerations for developing statistical analysis strategies,with further clarification on subgroup analysis,interim analysis,and the preparation of the statistical analysis reports.

Objective To analyze the antiviral effect of molnupiravir against influenza virus in vitro and in vivo.Methods The antiviral ability of molnupiravir against influenza virus strain H1N1 PR8 was detected in vitro and in vivo.H uman non-small cell lung cancer cell line(A549 cells)was used as an in vitro model of PR8 infection.The antiviral effects of molnupiravir on virus replication,protein synthesis,and viral particle formation were analyzed using real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),Western blot(WB)assay,and plaque assay.PR8 nose-dripping infected C57BL/6 female mice were used as an in vivo infection model.The antivi-ral ability of molnupiravir was evaluated by detecting viral load,pathological changes,and immunohistochemistry in the control group,administration group,inoculation group,and inoculation-administration group.Results In vitro test results showed that molnupiravir had no significant inhibitory effect on influenza virus replication,protein syn-thesis,and virus particle formation(all P＞0.05).In vivo test results showed that compared with mice infected with H1N1 alone,the viral load in the lung tissue of mice treated with molnupiravir declined significantly,and the extent of pathological changes was milder.Immunohistochemical detection showed a significant weakening in nuclear protein(NP)antigen signal,and the expression levels of interferon(IFN)-α,interleukin(IL)-4,and IL-6 in the lungs were lower(all P＜0.01).Conclusion As a precursor with antiviral activity,molnupiravir can not exert anti-viral activity in lung-derived cells cultured in vitro,but can be transformed into an active form in the host,which significantly decreases the ability of H1N1 influenza virus to proliferate in the lungs and thereby alleviates the da-mage of virus to lung tissue.

Objective:To evaluate the efficacy and safety of daratumumab in treating patients with monoclonal immunoglobulin deposition disease (MIDD) with renal injury.Methods:A case-series analysis study was conducted in MIDD patients with renal injury who received daratumumab treatment at the Department of Nephrology, Ruijin Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, from December 2021 to October 2023. The clinical data of patients at the time of diagnosis and during the follow-up period were collected. Hematological and renal responses were assessed and adverse reaction events were recorded.Results:Seven patients diagnosed with MIDD were included in this study, with a male-to-female ratio of 5∶2 and age of 46 (43, 52) years. One patient was light-heavy chain deposition disease, and the remaining 6 patients were light chain deposition disease. Among them, 5 patients had received prior treatment (1-2 lines of treatment with the regimen of cyclophosphamide, bortezomib and dexamethasone), while 2 patients were newly treated, one of whom had already started hemodialysis at diagnosis. Prior to receiving monoclonal antibody treatment, difference of serum free light chain (dFLC) among the 7 patients was 52 (7, 295) mg/L. Excluding 1 patient on dialysis, the remaining 6 patients had 24-hour urinary protein of 1.1 (0.2, 4.7) g, serum creatinine of 178.5 (157.8, 279.8) μmol/L and estimated glomerular filtration rate of 33.9 (24.2, 41.1) ml·min -1·（1.73 m 2） -1. The daratumumab treatment was 17 (10, 20) infusions, with treatment duration of 17 (9, 23) months and follow-up time of 24 (13, 32) months. After treatment, among 5 previously treated patients, hematological response evaluation showed that 1 patient with baseline dFLC <20 mg/L and minimal residual disease negativity upon re-examination, while the remaining 4 patients achieved hematological responses of complete response or better. Renal response evaluation revealed that, except for 1 patient with partial response, the other 4 patients achieved very good partial response (VGPR) or better. Among 2 newly diagnosed patients, both achieved hematological efficacy at least VGPR, with one achieving renal complete response, while the other one remaining dialysis- dependent. Overall, dFLC of 7 patients was 4.9 (2.1, 11.5) mg/L. Among 6 non-dialysis patients, 24-hour urinary protein was 0.19 (0.06, 0.42) g, serum creatinine was 153.0 (120.8, 188.0) μmol/L and estimated glomerular filtration rate was 40.4 (35.2, 57.3) ml·min -1·(1.73 m 2) -1. No severe adverse reactions were observed during daratumumab treatment. Conclusion:The application of daratumumab in the treatment of MIDD with renal injury is effective and well tolerated, achieving high-quality hematological responses, with high renal responses reaching or exceeding VGPR and improvement of renal function.