OBJECTIVE To systematically evaluate the influential factors for the clinical efficacy of tigecycline in the treatment of severe infections caused by multidrug-resistant Gram-negative bacteria （MDR-GNB）. METHODS Retrieved from PubMed， Embase， The Cochrane Library， CNKI database， Wanfang database and VIP database， the studies about the influential factors for the clinical efficacy of tigecycline in the treatment of adult patients with severe infections caused by MDR-GNB from the database construction to April 30， 2025. After screening literature， extracting data and evaluating the quality of literature， systematic review was performed by using RevMan 5.3 software. RESULTS A total of 14 studies involving 2 033 patients were included， of which 1 355 patients showed effective treatment outcomes. The meta-analysis results showed that Acute Physiology and Chronic Health Evaluation （APACHE）-Ⅱ ＞ 20 [OR＝4.50， 95%CI （2.28， 8.85）， P＜0.001]， malignant tumor [OR＝1.96， 95%CI （1.41， 2.72）， P＜0.001]， hemodialysis [OR＝2.09， 95%CI （1.40， 3.12）， P＜0.001]， septic shock [OR＝3.07， 95%CI （2.00， 4.72）， P＜0.001]， mechanical ventilation [OR＝2.31， 95%CI （1.57， 3.39）， P＜0.001]， coagulation dysfunction [OR＝ 3.03， 95%CI （2.09， 4.37）， P＜0.001]， glucocorticoids use＞3 days [OR＝2.26， 95%CI （1.14， 4.45）， P＝0.020]， and longer hospitalization time before using tigecycline [OR＝3.33， 95%CI （1.34， 8.30）， P＝0.010] were risk factors for the clinical efficacy of tigecycline in treatment of severe infections caused by MDR-GNB. Tigecycline initial double-dose regimen [OR＝0.23， 95%CI （0.13， 0.42）， P＜0.001]， combination therapy [OR＝0.15， 95%CI （0.05， 0.48）， P＝0.001]， and prolonged treatment course [OR＝0.91， 95%CI （0.88， 0.95）， P＜0.001] were protective factors. CONCLUSIONS There are many influential factors for the clinical efficacy of tigecycline in the treatment of severe infections caused by MDR-GNB， among which APACHE-Ⅱ score＞20， malignant tumor， hemodialysis， septic shock， mechanical ventilation， coagulation dysfunction， glucocorticoids＞3 d and longer hospitalization time before using tigecycline before tigecycline （No.20251606） use are risk factors； tigecycline double dose， combined medication and longer treatment course are protective factors.

BACKGROUND:Exercise is an important strategy for the prevention and management of sarcopenic obesity in older adults,but there is a lack of exploration and research on accurate and personalized exercise prescription for sarcopenic obesity in older adults.OBJECTIVE:To review the tandem mechanism of sarcopenic obesity in older adults and the effects of different exercise interventions in older patients with sarcopenic obesity,in order to provide theoretical and practical guidance for the formulation of exercise prescriptions for sarcopenic obesity in older adults.METHODS:PubMed,Web of Science,CNKI,VIP,and WanFang databases were retrieved for relevant literature using the keywords of"sarcopenic obesity,sarcopenic adiposity,aging,sport,exercise,exercise intervention,exercise prescription,resistant training,aerobic training,combination training,muscle strength,muscle mass,physical activity"in Chinese and English,respectively.A total of 85 articles were included for review according to the inclusive and exclusive criteria.RESULTS AND CONCLUSION:(1)Resistance exercise is still an effective exercise method to prevent and alleviate sarcopenic obesity in older adults.Resistance exercise is more significant in improving and improving skeletal muscle mass,muscle strength and endurance,and physical function ability.However,in practice,it should be applied in a gradual manner,with a gradual increase in intensity to a medium-to-high level.(2)Aerobic exercise is also an important intervention to control and slow the progress of sarcopenic obesity,and it is more effective in improving cardiorespiratory endurance,decreasing percentage of body fat,and decreasing the area of visceral fat in older patients with sarcopenic obesity.(3)Combining the advantages of aerobic exercise and resistance exercise can better improve body composition and reduce cardiovascular disease risk factors.To some extent,combined exercise is better than single exercise.

ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

ObjectiveTo evaluate the efficacy and safety of Xiaoji Hufei Formula in protecting children with close contact exposure to influenza， and to provide reference and evidence-based support for better clinical prevention and treatment of influenza in children. MethodsA multicenter， prospective， non-randomized， parallel， controlled trial was conducted from October 2021 to May 2022 in five hospitals， including Dongfang Hospital of Beijing University of Chinese Medicine. Confirmed influenza cases and influenza-like illness （ILI） cases were collected， and eligible children with close contact exposure to these cases were recruited in the outpatient clinics. According to whether the enrolled close contacts were willing to take Xiaoji Hufei formula for influenza prevention， they were assigned to the observation group （108 cases） or the control group （108 cases）. Follow-up visits were conducted on days 7 and 14 after enrollment. The primary outcomes were the incidence of ILI and the rate of laboratory-confirmed influenza. Secondary outcomes included traditional Chinese medicine （TCM） symptom score scale for influenza， influenza-related emergency （outpatient） visit rate， influenza hospitalization rate， and time to onset after exposure to influenza cases. ResultsA total of 216 participants were enrolled， with 108 in the observation group and 108 in the control group. Primary outcomes： （1） Incidence of ILI： The incidence was 12.0% （13/108） in the observation group and 23.1% （25/108） in the control group， with the observation group showing a significantly lower incidence （χ²=4.6， P<0.05）. （2） Influenza confirmation rate： 3.7% （4/108） in the observation group and 4.6% （5/108） in the control group， with no statistically significant difference. Secondary outcomes： （1） TCM symptom score scale： after onset， nasal congestion and runny nose scores differed significantly between the two groups （P<0.05）， while other symptoms such as fever， sore throat， and cough showed no significant differences. （2） Influenza-related emergency （outpatient） visit rate： 84.6% （11 cases） in the observation group and 96.0% （24 cases） in the control group， with no significant difference. （3） Time to onset after exposure： The median onset time after exposure to index patients was 7 days in the observation group and 4 days in the control group， with a statistically significant difference （P<0.05）. ConclusionIn previously healthy children exposed to infectious influenza cases under unprotected conditions， Xiaoji Hufei formula prophylaxis significantly reduced the incidence of ILI. Xiaoji Hufei Formula can be recommended as a specific preventive prescription for influenza in children.

Objective:To investigate the clinical efficacy and safety of ultrasound-guided thyroid injection of dexamethasone in the treatment of subacute thyroiditis (SAT).Methods:This is a randomized controlled study involving 32 patients with SAT who received treatment at Endocrinology Clinic of Heilongjiang Provincial Hospital between June 2022 and March 2023. The patients were randomly divided into an observation group and a control group ( n = 16 per group) using a random number table method. The observation group received ultrasound-guided injection of dexamethasone (5 mg per injection, once a week) into the thyroid lesion, while the control group was treated with oral prednisone acetate tablets (5 mg per dose, three times a day). Both groups were treated for 4 weeks. The clinical efficacy, time taken for body temperature to return to normal, time for pain resolution, time for goiter regression, time for thyroid function to normalize, as well as recurrence rates and adverse reactions, were compared between the two groups. Results:The response rate in the observation group was 100% (16/16), which was significantly higher than that in the control group [75% (12/16), χ2 = 4.57, P = 0.033]. The time taken for body temperature to return to normal, the time for goiter regression, and the time for goiter regression in the observation group were (3.5 ± 3.6) days, (7.4 ± 2.5) days, and (11.6 ± 7.4) days, respectively, which were significantly shorter than those in the control group [(6.1 ± 3.2) days, (9.9 ± 3.5) days, (16.9 ± 6.8) days, t = -2.16, -2.33, -2.11, all P < 0.05]. After 4 weeks of treatment, the observation group showed significantly lower body mass index, fasting blood glucose, and serum triglyceride levels compared to the control group ( t = -2.07, -2.46, -2.13, all P < 0.05). The recurrence rate in the observation group was 0%, which was significantly lower than that in the control group [25% (4/16), χ2 = 4.57, P = 0.033]. Conclusions:The efficacy and safety of ultrasound-guided local thyroid injection of dexamethasone for the treatment of SAT are superior to those of the oral treatment regimen.

Objective:To investigate the clinical efficacy and safety of ultrasound-guided thyroid injection of dexamethasone in the treatment of subacute thyroiditis (SAT).Methods:This is a randomized controlled study involving 32 patients with SAT who received treatment at Endocrinology Clinic of Heilongjiang Provincial Hospital between June 2022 and March 2023. The patients were randomly divided into an observation group and a control group ( n = 16 per group) using a random number table method. The observation group received ultrasound-guided injection of dexamethasone (5 mg per injection, once a week) into the thyroid lesion, while the control group was treated with oral prednisone acetate tablets (5 mg per dose, three times a day). Both groups were treated for 4 weeks. The clinical efficacy, time taken for body temperature to return to normal, time for pain resolution, time for goiter regression, time for thyroid function to normalize, as well as recurrence rates and adverse reactions, were compared between the two groups. Results:The response rate in the observation group was 100% (16/16), which was significantly higher than that in the control group [75% (12/16), χ2 = 4.57, P = 0.033]. The time taken for body temperature to return to normal, the time for goiter regression, and the time for goiter regression in the observation group were (3.5 ± 3.6) days, (7.4 ± 2.5) days, and (11.6 ± 7.4) days, respectively, which were significantly shorter than those in the control group [(6.1 ± 3.2) days, (9.9 ± 3.5) days, (16.9 ± 6.8) days, t = -2.16, -2.33, -2.11, all P < 0.05]. After 4 weeks of treatment, the observation group showed significantly lower body mass index, fasting blood glucose, and serum triglyceride levels compared to the control group ( t = -2.07, -2.46, -2.13, all P < 0.05). The recurrence rate in the observation group was 0%, which was significantly lower than that in the control group [25% (4/16), χ2 = 4.57, P = 0.033]. Conclusions:The efficacy and safety of ultrasound-guided local thyroid injection of dexamethasone for the treatment of SAT are superior to those of the oral treatment regimen.

BACKGROUND:Exercise is an important strategy for the prevention and management of sarcopenic obesity in older adults,but there is a lack of exploration and research on accurate and personalized exercise prescription for sarcopenic obesity in older adults.OBJECTIVE:To review the tandem mechanism of sarcopenic obesity in older adults and the effects of different exercise interventions in older patients with sarcopenic obesity,in order to provide theoretical and practical guidance for the formulation of exercise prescriptions for sarcopenic obesity in older adults.METHODS:PubMed,Web of Science,CNKI,VIP,and WanFang databases were retrieved for relevant literature using the keywords of"sarcopenic obesity,sarcopenic adiposity,aging,sport,exercise,exercise intervention,exercise prescription,resistant training,aerobic training,combination training,muscle strength,muscle mass,physical activity"in Chinese and English,respectively.A total of 85 articles were included for review according to the inclusive and exclusive criteria.RESULTS AND CONCLUSION:(1)Resistance exercise is still an effective exercise method to prevent and alleviate sarcopenic obesity in older adults.Resistance exercise is more significant in improving and improving skeletal muscle mass,muscle strength and endurance,and physical function ability.However,in practice,it should be applied in a gradual manner,with a gradual increase in intensity to a medium-to-high level.(2)Aerobic exercise is also an important intervention to control and slow the progress of sarcopenic obesity,and it is more effective in improving cardiorespiratory endurance,decreasing percentage of body fat,and decreasing the area of visceral fat in older patients with sarcopenic obesity.(3)Combining the advantages of aerobic exercise and resistance exercise can better improve body composition and reduce cardiovascular disease risk factors.To some extent,combined exercise is better than single exercise.

BACKGROUND:Chronic rotator cuff injury is often companied by tendon degeneration and impaired function of tendon-derived stem cells.As am important cytokine,platelet-derived growth factor-DD has a regulatory effect on the proliferation and differentiation of tendon-derived stem cells.OBJECTIVE:To investigate the effect of platelet-derived growth factor-DD on the proliferation and multilineage differentiation of tendon-derived stem cells in human chronic rotator cuff injury.METHODS:Tendon-derived stem cells were isolated from human chronic rotator cuff injury tissue and cultured in vitro.Immunofluorescence staining was used to observe the cytoskeletal morphology of tendon-derived stem cells.Flow cytometry was used to identify the phenotype of tendon-derived stem cells.Tendon-derived stem cells were divided into two groups.The control group did not receive any intervention.The platelet-derived growth factor-DD group was treated with 5 μg/mL platelet-derived growth factor-DD.The effect of platelet-derived growth factor-DD on the proliferation and multilineage differentiation of tendon-derived stem cells was evaluated by cell proliferation assay and three-lineage differentiation assay.RESULTS AND CONCLUSION:(1)The number of EdU-positive cells in the platelet-derived growth factor-DD group was significantly increased compared with the control group(P＜0.05).Tendon-derived stem cells entered the rapid proliferation phase earlier,and the cell growth was logarithmic.(2)The positive areas of Oil Red O staining,Alcian Blue staining,and Alizarin Red staining in the platelet-derived growth factor-DD group were significantly larger than those in the control group(P＜0.05).(3)The above results show that platelet-derived growth factor-DD significantly promotes the proliferation and adipogenic,osteogenic,and chondrogenic differentiation of tendon-derived stem cells.

BACKGROUND:Chronic rotator cuff injury is often companied by tendon degeneration and impaired function of tendon-derived stem cells.As am important cytokine,platelet-derived growth factor-DD has a regulatory effect on the proliferation and differentiation of tendon-derived stem cells.OBJECTIVE:To investigate the effect of platelet-derived growth factor-DD on the proliferation and multilineage differentiation of tendon-derived stem cells in human chronic rotator cuff injury.METHODS:Tendon-derived stem cells were isolated from human chronic rotator cuff injury tissue and cultured in vitro.Immunofluorescence staining was used to observe the cytoskeletal morphology of tendon-derived stem cells.Flow cytometry was used to identify the phenotype of tendon-derived stem cells.Tendon-derived stem cells were divided into two groups.The control group did not receive any intervention.The platelet-derived growth factor-DD group was treated with 5 μg/mL platelet-derived growth factor-DD.The effect of platelet-derived growth factor-DD on the proliferation and multilineage differentiation of tendon-derived stem cells was evaluated by cell proliferation assay and three-lineage differentiation assay.RESULTS AND CONCLUSION:(1)The number of EdU-positive cells in the platelet-derived growth factor-DD group was significantly increased compared with the control group(P＜0.05).Tendon-derived stem cells entered the rapid proliferation phase earlier,and the cell growth was logarithmic.(2)The positive areas of Oil Red O staining,Alcian Blue staining,and Alizarin Red staining in the platelet-derived growth factor-DD group were significantly larger than those in the control group(P＜0.05).(3)The above results show that platelet-derived growth factor-DD significantly promotes the proliferation and adipogenic,osteogenic,and chondrogenic differentiation of tendon-derived stem cells.

Objective:To investigate the efficacy of robot-assisted femoral tunnel localization in reconstruction of the medial patellofemoral ligament (MPFL).Methods:A retrospective study was conducted to analyze the 36 patients who had been admitted to Department of Sports Medicine, The Fourth Hospital of Wuhan between January 2019 and January 2022 due to recurrent patellar dislocation. There were 15 males and 21 females; age: 23.5 (18.3, 29.0) years; number of dislocations: 2.5 (2.0, 3.0). They were stratified into 2 cohorts based on utilization of robot-assistance. In the observation group (17 cases), the femoral tunnel localization was robot-assisted in MPFL reconstruction; in the control group (19 cases), the femoral tunnel localization was guided by C-arm fluoroscopy in MPFL reconstruction. The 2 groups were compared in terms of operation time, frequency of guide wire placement, visual analogue scale (VAS) at postoperative 1 d, patellar tilt angle (PTA) and the disparity between actual femoral tunnel insertion and ideal tunnel insertion point (Sch?ttle point) at postoperative 1 to 3 d, and Lysholm knee score and International Knee Documentation Committee (IKDC) score at the last follow-up.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). All patients were followed up for 12.0 (10.3, 13.0) months. In the observation group, the operation time [(64.1±16.7) min], frequency of guide wire placement [1.0 (1.0, 2.0) times], VAS [2.5 (2.0, 3.0) points], and disparity between actual femoral tunnel insertion and ideal tunnel insertion point [(4.7±1.2) mm] were significantly better than those in the control group [(84.2±19.7) min, 3.0 (2.0, 4.0) times, 3.5 (3.0, 4.0) points, and (6.1±1.2) mm] ( P<0.05). There was no statistical difference between the 2 groups in PTA, Lysholm knee score or IKDC score ( P>0.05). Conclusions:The short-term clinical efficacy of robot-assisted femoral tunnel localization is satisfactory in MPFL reconstruction. Compared with the intraoperative C-arm fluoroscopy, robot-assisted localization can decrease the frequency of guide wire placement, enhance femoral tunnel accuracy and efficiency, and alleviate more postoperative pain for the patients.