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.

Pulse wave analysis plays an important role in the theoretical and clinical studies of both the traditional Chinese medicine and the modern western medicine.In recent years,some researchers raised the opinion of resonance between the harmonics of the pulse wave and the viscera,and applied it to explain the mechanism and the clinical application of the pulse waves,which had a great impact on the related research in the traditional Chinese medicine especially about the pulse diagnosis.To evaluate the feasibility of this opinion,this study summarized the theoretical model and the main arguments of the harmonics-viscera resonance opinion,analyzed the opinion from the aspects of Zang-xiang theory and meridian theory in the traditional Chinese medicine,the anatomy in Western medicine,observations in biology,the resonance phenomenon in physics,and the blood flow study in hemodynamics.Some technical thoughts in the harmonics-viscera resonance opinion that need to be further improved and refined were also identified for further exploration.

Objective To assess and compare the passing rates of 3 radiotherapy dosimetric verification systems,namely Portal Dosimetry(PD),SunCheck(SNC),and ArcCheck(ARC)for different gamma criteria,and to analyze their performance across different irradiation sites.Methods A retrospective analysis was conducted on 185 radiotherapy plans,including those for head and neck,chest,and pelvic regions.The passing rates of 3 systems for different gamma criteria(3%/2 mm,3%/1 mm,2%/2 mm,and 2%/1 mm)were collected and compared across different sites.Results For the 3%/2 mm criterion,PD system had the highest passing rate across all evaluation standards,especially for the 2%/1 mm criterion,where it significantly outperformed both ARC and SNC systems.The high-resolution imaging capability of PD system enabled it to deliver exceptional performance in complex treatment plans,particularly for chest and pelvic tumors.ARC system performed well at looser criteria but showed a significant drop in passing rates with stricter gamma criteria,particularly in head and neck and complex anatomical regions.SNC system demonstrated intermediate performance,surpassing ARC under stricter criteria,while its automation and efficient processing capabilities offered a distinct advantage in high-volume clinical environments.Conclusion All 3 verification systems meet the fundamental requirements for clinical radiotherapy plan verification.However,their performance varies depending on the gamma criteria.It is recommended to select the appropriate verification system based on the complexity of the treatment plan,irradiation site,and gamma criteria.PD system is best suited for high-precision treatment areas(e.g.,chest and pelvis),whereas ARC and SNC are more suitable for routine and moderately complex treatment plans.

Objective:To conduct a systematic review of risk prediction models for enteral feeding intolerance in ICU patients.Methods:Relevant literature was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and Scopus, with search limits from the establishment of the databases up to July 24, 2024. Two researchers independently screened the literature and extracted data, using Prediction model Risk Of Bias ASsessment Tool to evaluate the quality of the included studies.Results:A total of 12 studies were included, which included 20 prediction models. The area under the receiver operating characteristic curve or C-index for these models ranged from 0.70 to 0.94. The overall bias risk of the 12 studies was high, with three studies having good applicability. The bias risk primarily stemmed from issues such as measurement of prediction factors, variable handling, sample size, outcome definition, and model performance evaluation.Conclusions:Existing risk prediction models for enteral feeding intolerance in ICU patients exhibit a high risk of bias. Further validation, optimization, or development of new models is required in the future.

Objective To assess and compare the passing rates of 3 radiotherapy dosimetric verification systems,namely Portal Dosimetry(PD),SunCheck(SNC),and ArcCheck(ARC)for different gamma criteria,and to analyze their performance across different irradiation sites.Methods A retrospective analysis was conducted on 185 radiotherapy plans,including those for head and neck,chest,and pelvic regions.The passing rates of 3 systems for different gamma criteria(3%/2 mm,3%/1 mm,2%/2 mm,and 2%/1 mm)were collected and compared across different sites.Results For the 3%/2 mm criterion,PD system had the highest passing rate across all evaluation standards,especially for the 2%/1 mm criterion,where it significantly outperformed both ARC and SNC systems.The high-resolution imaging capability of PD system enabled it to deliver exceptional performance in complex treatment plans,particularly for chest and pelvic tumors.ARC system performed well at looser criteria but showed a significant drop in passing rates with stricter gamma criteria,particularly in head and neck and complex anatomical regions.SNC system demonstrated intermediate performance,surpassing ARC under stricter criteria,while its automation and efficient processing capabilities offered a distinct advantage in high-volume clinical environments.Conclusion All 3 verification systems meet the fundamental requirements for clinical radiotherapy plan verification.However,their performance varies depending on the gamma criteria.It is recommended to select the appropriate verification system based on the complexity of the treatment plan,irradiation site,and gamma criteria.PD system is best suited for high-precision treatment areas(e.g.,chest and pelvis),whereas ARC and SNC are more suitable for routine and moderately complex treatment plans.

Pulse wave analysis plays an important role in the theoretical and clinical studies of both the traditional Chinese medicine and the modern western medicine.In recent years,some researchers raised the opinion of resonance between the harmonics of the pulse wave and the viscera,and applied it to explain the mechanism and the clinical application of the pulse waves,which had a great impact on the related research in the traditional Chinese medicine especially about the pulse diagnosis.To evaluate the feasibility of this opinion,this study summarized the theoretical model and the main arguments of the harmonics-viscera resonance opinion,analyzed the opinion from the aspects of Zang-xiang theory and meridian theory in the traditional Chinese medicine,the anatomy in Western medicine,observations in biology,the resonance phenomenon in physics,and the blood flow study in hemodynamics.Some technical thoughts in the harmonics-viscera resonance opinion that need to be further improved and refined were also identified for further exploration.

Objective:To conduct a systematic review of risk prediction models for enteral feeding intolerance in ICU patients.Methods:Relevant literature was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and Scopus, with search limits from the establishment of the databases up to July 24, 2024. Two researchers independently screened the literature and extracted data, using Prediction model Risk Of Bias ASsessment Tool to evaluate the quality of the included studies.Results:A total of 12 studies were included, which included 20 prediction models. The area under the receiver operating characteristic curve or C-index for these models ranged from 0.70 to 0.94. The overall bias risk of the 12 studies was high, with three studies having good applicability. The bias risk primarily stemmed from issues such as measurement of prediction factors, variable handling, sample size, outcome definition, and model performance evaluation.Conclusions:Existing risk prediction models for enteral feeding intolerance in ICU patients exhibit a high risk of bias. Further validation, optimization, or development of new models is required in the future.

Objective:To investigate the effect of highly active antiretroviral therapy(HAART) on thyroid function in adult patients with acquired immunodeficiency syndrome(AIDS).Methods:A cross-sectional retrospective study was conducted on 1 276 AIDS patients hospitalized in the Department of Infection, Guangzhou Eighth People′s Hospital from June 2017 to May 2020. General data, the first laboratory examination on admission, thyroid function, and related antibodies were collected and analyzed. A total of 176 patients were included in the study and divided into HAART group( n=83) and no-HAART group( n=93) according to whether they received HAART treatment. Results:Among 176 AIDS patients, the rate of thyroid dysfunction was 53.98%. It was significantly lower in the HAART group, compared with no-HAART group(40.96% vs 65.59%), with a statistically significant difference ( P=0.001). The course of AIDS, body mass index, CD4 + T lymphocyte count, free triiodothyronine, and serum creatinine in HAART group were significantly higher than those in no-HAART group, and aspartate aminotransferase was significantly lower than those in no-HAART group, with statistical significance(all P<0.05). There was no significant difference in age, sex, smoking history, free thyroxine, thyroid stimulating hormone, thyroid peroxidase antibody, thyroglobulin antibodies, and alanine aminotransferase between HAART group and no-HAART group(all P>0.05). The prevalence of low T 3 syndrome in HAART group was significantly lower than that in no-HAART group(14.46% vs 39.78%), and the difference was statistically significant( P<0.001). There was no significant difference in the prevalence of hyperthyroidism, hypothyroidism, and isolated low T 4 between HAART group and No-HAART group(all P>0.05). Multivariate logistics regression analysis showed that HAART was an independent protective factor for thyroid dysfunction and isolated low T 4 in AIDS patients. Conclusions:Thyroid dysfunction is a common endocrine disorder in AIDS patients that requires attention from infectious disease specialists. HAART therapy serves as a protective factor against thyroid dysfunction. Thyroid dysfunction mainly manifests as low T3 syndrome and requires continuous monitoring of thyroid function changes.

Objective To investigate the effect and mechanism of Nuanxinkang on plaque formation in obstructive sleep apnea-hypopnea syndrome(OSAHS)comorbid with atherosclerosis(AS)mice by inhibiting endothelial-to-mesenchymal transition(EndMT).Methods Male ApoE-/-mice were randomly divided into six groups:control group,model group,atorvastatin group(2.6 mg·kg-1)and Nuanxinkang low-,medium-and high-dose groups(crude drug 3.5,7.0,14.0 g·kg-1),with eight mice in each group.The mice were exposed to chronic intermittent hypoxia(CIH)environment during sleep for a long time,and fed with high-fat diet to replicate OSAHS comorbid with AS mouse model.Oil red O staining was used to observe the formation of plaque on aortic intima in mice.Masson trichrome staining was used to evaluate the collagen content of atherosclerotic plaques in the aortic root of mice.The expressions of endothelial cell marker CD31 and EndMT marker Vimentin in aortic plaque were detected by immunofluorescence.Blood lipid levels were determined by ELISA;the mRNA expression levels of EndMT markers α-SMA and Cdh2 in aortic tissue were detected by qPCR.Results Compared with the control group,the area of aortic atherosclerotic plaque in the model group was significantly increased(P＜0.01),and the area of collagen deposition in the aortic root plaque was significantly increased(P＜0.01).The number of CD31 positive cells in the plaque were significantly decreased(P＜0.01),and the number of Vimentin positive cells were significantly increased(P＜0.01).Serum TG,T-CHO and LDL-C levels were significantly increased(P＜0.01),and HDL-C level was significantly decreased(P＜0.01).The mRNA expression levels of α-SMA and Cdh2 in aortic tissue were significantly increased(P＜0.01).Compared with the model group,the area of aortic atherosclerotic plaque in Nuanxinkang groups were significantly reduced(P＜0.05,P＜0.01),and the collagen deposition area of aortic root atherosclerotic plaque were significantly reduced(P＜0.05,P＜0.01).The number of CD31 positive expression cells in the plaque of Nuanxinkang high-dose group were significantly increased(P＜0.05),and the number of Vimentin positive expression cells in the plaque of Nuanxinkang medium-and high-dose groups were significantly decreased(P＜0.05,P＜0.01).The serum TG level of mice in the high-dose group of Nuanxinkang was significantly decreased(P＜0.01).The serum T-CHO and LDL-C levels of mice in each Nuanxinkang administration group were significantly decreased(P＜0.05,P＜0.01).The serum HDL-C levels of mice in the medium-and high-dose groups of Nuanxinkang were significantly increased(P＜0.01).The mRNA expression levels of α-SMA and Cdh2 in aortic tissue of mice in each treatment group were significantly decreased(P＜0.01).Conclusion Nuanxinkang can effectively reduce the plaque formation in OSAHS comorbid with atherosclerosis mice,which may be related to its inhibition of EndMT and reduction of collagen fiber formation.

Objective:To explore the predictive ability of systemic immune-inflammation index（SII）and prognostic nutrition index（PNI）for early-onset sepsis in preterm infants.Methods:Seventy preterm infants of 28 to 32 weeks，who were born in the Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2022, and transferred to neonatal intensive care unit within 1 h conforming to EOS diagnostic criteria were selected as the EOS group，and 1∶1 matched non-infected preterm infants hospitalized during the same period were selected as control group.Relevant data were collected to compare the differences regarding clinical data，blood routine indicators，C-reactive protein（CRP），serum albumin levels（ALB），SII and PNI between two groups.The ability of SII and PNI to predict EOS was evaluated by Logistic regression analysis and receiver operating characteristic（ROC）curve.Results:Compared with control group,the EOS group had lower 1-minute and 5-minute Apgar scores,higher rates of cesarean section delivery and tracheal intubation,as well as higher rates of suppurative meningitis,bronchopulmonary dysplasia,retinopathy of prematurity and intracranial hemorrhage.The levels of blood routine parameters,ALB,SII and PNI in the EOS group were lower than those in control group,while CRP was increased.The differences were all statistically significant（ P<0.05）.Multivariate Logistic regression analysis showed that tracheal intubation，CRP，SII and PNI were independently influential factors of EOS（ P<0.05）.ROC curve analysis showed that the areas under curve of SII，PNI，CRP and SII combined with PNI were 0.808（95% CI 0.730-0.886），0.792（95% CI 0.718-0.865），0.633（95% CI 0.541-0.725）and 0.866（95% CI 0.803-0.929），the sensitivity were 74.3%，64.3%，42.9%，78.6%，and the specificity were 88.6%，82.9%，81.4%，90.0%,respectively.The cut-off values of SII，PNI and CRP were 221.36，38.65 and 0.80 mg/L,respectively. Conclusion:SII and PNI have a certain predictive value for EOS in preterm infants，and their combined diagnosis efficiency is more stronger.