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 expression characteristics and regulatory mechanisms of the circadian clock gene period circadian regulator 1(PER1)and the tumor suppressor gene serine peptidase inhibitor Kazal type 5(SPINK5)in head and neck squamous cell carcinoma(HNSCC),and to elucidate the molecular mechanism by which PER1 regulates SPINK5 transcription via the NF-κB signaling pathway.METHODS Differentially expressed genes in HNSCC were screened using The Cancer Genome Atlas(TCGA)and GSE205155 datasets.The association between SPINK5 expression and patient prognosis was assessed via the GEPIA database.mRNA and protein expression levels of SPINK5 and PER1 in 60 clinical samples were detected by RT-qPCR,immunohistochemistry,and Western blot.PER1 knockdown(using siRNA)and overexpression(via plasmid transfection)were performed in the AMC-HN-8 cell line.Wound healing and colony formation assays were applied to evaluate the effects of PER1,SPINK5,and their interaction on HNSCC cell migration and proliferation.Western blot was utilized to examine the regulatory effect of NF-κB on SPINK5.RESULTS SPINK5 and PER1 were significantly downregulated in HNSCC tissues(all P<0.01),and their low expression was correlated with poor patient prognosis(for SPINK5,HR=0.69,P=0.006 7).A significant positive correlation was observed between PER1 and SPINK5 expression(R2=0.719 2,P=0.001 0).Knockdown and overexpression of PER1 respectively resulted in synchronous alterations in SPINK5 mRNA levels(all P<0.05).PER1 knockdown enhanced cell migration and proliferation(P<0.05),whereas SPINK5 overexpression suppressed these capabilities(P<0.01).Importantly,SPINK5 overexpression reversed the phenotypic changes induced by PER1 knockdown.Mechanistically,PER1 overexpression led to concomitant changes in NF-κB expression,activating the NF-κB pathway and thereby promoting SPINK5 transcription.CONCLUSION PER1 positively regulates SPINK5 transcription via the NF-κB pathway,inhibiting HNSCC cell proliferation and migration.These findings suggest that PER1 and SPINK5 may serve as potential therapeutic targets for HNSCC.

With the rapid development of modern economy, road traffic has become increasingly busy, and the accompanying environmental pollution problem is becoming increasingly prominent. Air pollutants emitted from automobile exhaust, including particulate matters, NO_x, CO, and hydrocarbons (PAHs), can cause high risk of cardiovascular disease and premature death. This article summarizes the related epidemiological research progress on this topic from published literatures in recent years. We reviewed acute and chronic health damage to the cardiovascular system caused by traffic related air pollutants, including changes in heart rate variability and blood system indicators, potential association with coronary arteriosclerosis, coronary heart disease, and death of cardiovascular disease. The results show that traffic-related air pollutants can cause decrease in heart rate variability, increased blood pressure and changes in blood indicators, increase acute mortality from cardiovascular diseases. Long-term exposure to traffic-related air pollutants can induce increased risk of coronary atherosclerosis and coronary heart disease, and lead to increased mortality from cardiovascular diseases. In the future, more attention should be paid to traffic-related air pollution, and more researches are recommended to comprehensively evaluate the relationship between traffic-related air pollution and cardiovascular health damages, especially in early-stage. At the same time, active researches on the mechanism of cardiovascular toxicity of traffic-related air pollutants are needed, so as to promote the early prevention of cardiovascular diseases.

Objective To evaluate the feasibility of increasing the perfraction dose in treatment of neoplasms by 3DCRT (three- dimention confornial radiation therapy). Methods From May 1998 to June 2002, the radiation therapy plans of 300 out- cranial neoplasms patients were analysed retrospectively, including 143 patients with chest neoplasms and 157 patients with abdomen neoplasms. The PTV was 7.0 ~ 1 478 cm3, major PTV was encircled by 90 % isodose curve, minor 95 % PTV were encircled by 80 % isodose curve. Prescription dose was 90 % reference point dose, perfraction dose was 5 ~ 10 Gy, a majority of dose was 6 ~ 8 Gy, period of treatment was 5 ~ 15 days with an interval of 0 ~ 1 day. The general dose was given to radical cure dose or appeasement dose. The biological effect increased 10 % ~ 30 %. Results All treatment plans were accomplished and there were not complication which reduced patients' QOL. Conclusions 1.Owing to the f factor, increasing dose of perfraction, shortening general period of treatment and improving radiative biological effect were possible during the 3DCRT. 2. It was suggested that the larger out- cranial neoplasms should be treated by 3DCRT firstly, but precise plan, precise design and precise treatment can not intensely be pursued because of the limit of knowledge. 3. During the 3DCRT for out- cranial neoplasms, 2 ~ 3 times routine radiation therapy dose was secure, credible and effective according to different purpose.