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.

Cervical chondrocutaneous branchial remnants (CCBRs) are a rare congenital benign abnormality resulting from branchial arch dysplasia, characterized primarily by the presence of ectopic exophytic cartilaginous tissue in the neck present at birth. In July 2024, a case of CCBRs was treated at Plastic Surgery Hospital, Chinese Academy of Medical Sciences, involving a 7-year-and-10-month-old female patient. At birth, a bean-sized, rod-shaped, firm mass was noted on the left side of her neck, which progressively grew to the size of a corn kernel, measuring approximately 1.0 cm×1.2 cm. No significant local tenderness, redness, swelling, or ulceration was observed. Comprehensive examinations revealed no associated comorbidities. The patient underwent surgical excision of the neck mass. Postoperative pathological examination with hematoxylin-eosin (HE) staining revealed elastic cartilage in the central region of the lesion. The neck incision healed primarily, and no subsequent reappearance of the lesion was observed during the four-month follow-up. This article summarized the diagnostic and therapeutic process of this patient with CCBRs, and through a comprehensive literature review, highlighted that CCBRs represent one of the superficial markers of branchial arch dysplasia, with surgical excision being the primary treatment. Given that branchial arch abnormalities may be associated with structural or functional anomalies in other organs, a thorough systemic evaluation is recommended prior to surgery. Notwithstanding the absence of concomitant malformations detected on initial evaluation, continuous long-term follow-up monitoring is recommended to mitigate the risk of potential diagnoses being overlooked.

AIM: To investigate the alterations in corneal aberration and relative refractive power following the reduction of back optic zone diameters(BOZD)of orthokeratology lenses.METHODS: Myopic children aged 8-12 years, deemed suitable and willing to wear orthokeratology lenses, were randomly allocated to wear lenses with a 6.0 mm BOZD or a 5.0 mm BOZD. Data collection included changes in higher-order aberrations, relative refractive power and the treatment zone diameter of the two groups after wearing lenses for 1 d, 1 wk, 1, and 3 mo. The correlation of increase in corneal higher-order aberrations with refractive power was analyzed.RESULTS: The increases in total higher-order aberrations, spherical aberrations and coma aberrations varied over time following lens wear(all P<0.001), and there were no statistically significant differences in the changes of total higher-order aberrations and coma aberrations between the two groups of patients(all P>0.05). A significant difference was observed in the increment of spherical aberrations in the 5 mm range between the two groups of patients, which varied over time(Ftime=40.179, Ptime<0.001; Fgroup=11.948, Pgroup=0.001; Finteraction=3.262, Pinteraction=0.03). A significant difference was observed in the increment of spherical aberrations in the 4 mm range between the two patient groups(Ftime=34.462, Ptime<0.001; Fgroup=13.094, Pgroup<0.001; Finteraction=1.372, Pinteraction=0.25). There was no statistically significant distinction in relative refractive power between the two groups(Fgroup=0.048, Pgroup=0.83; Finteraction=1.208, Pinteraction=0.31); however, relative refractive power changed over time(Ftime=40.030, Ptime<0.001). The difference in treatment zone diameter between the two groups was statistically significant, with changes over time(Ftime=11.212, Ptime<0.001; Fgroup=74.073, Pgroup<0.001; Finteraction=0.312, Pinteraction=0.82). The total higher-order aberrations, spherical aberrations, and coma aberrations in 4, 5 and 6 mm range showed a positive correlation with relative refractive power values(all P<0.001). Statistically significant difference was observed in the axial length between the two groups after wearing lenses for 3, 6 and 12 mo(Ftime=185.398, Ptime<0.001; Fgroup=5.618, Pgroup=0.02; Finteraction=2.315, Pinteraction=0.11).CONCLUSION: Orthokeratology lenses leaded to elevated higher-order aberrations. Orthokeratology lenses with smaller BOZD produced significantly greater spherical aberrations at 4 and 5 mm range and smaller treatment zone diameters. The corneal total higher-order aberration was positively correlated with relative refractive power. Wearing orthokeratology lenses with a smaller BOZD can cause slower axial growth and better myopia control.

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.

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.

Cervical chondrocutaneous branchial remnants (CCBRs) are a rare congenital benign abnormality resulting from branchial arch dysplasia, characterized primarily by the presence of ectopic exophytic cartilaginous tissue in the neck present at birth. In July 2024, a case of CCBRs was treated at Plastic Surgery Hospital, Chinese Academy of Medical Sciences, involving a 7-year-and-10-month-old female patient. At birth, a bean-sized, rod-shaped, firm mass was noted on the left side of her neck, which progressively grew to the size of a corn kernel, measuring approximately 1.0 cm×1.2 cm. No significant local tenderness, redness, swelling, or ulceration was observed. Comprehensive examinations revealed no associated comorbidities. The patient underwent surgical excision of the neck mass. Postoperative pathological examination with hematoxylin-eosin (HE) staining revealed elastic cartilage in the central region of the lesion. The neck incision healed primarily, and no subsequent reappearance of the lesion was observed during the four-month follow-up. This article summarized the diagnostic and therapeutic process of this patient with CCBRs, and through a comprehensive literature review, highlighted that CCBRs represent one of the superficial markers of branchial arch dysplasia, with surgical excision being the primary treatment. Given that branchial arch abnormalities may be associated with structural or functional anomalies in other organs, a thorough systemic evaluation is recommended prior to surgery. Notwithstanding the absence of concomitant malformations detected on initial evaluation, continuous long-term follow-up monitoring is recommended to mitigate the risk of potential diagnoses being overlooked.

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.

A 31-year-old man sought medical evaluation for a 2-year history of edema and proteinuria, with prior pathology suggesting atypical membranous nephropathy (MN). Despite treatment with a combination of steroids, calcineurin inhibitors, and four courses of rituximab (1 g, intravenous injection), the patient′s nephrotic syndrome showed no relief (24 h urine protein peaked at 31.18 g/d), indicating refractory nephrotic syndrome. Later in the disease course, a sudden surge of creatinine level (322.5 μmol/L) prompted a renal biopsy, which revealed concurrent acute interstitial nephritis. Further treatment involving steroids, cyclophosphamide, and a fifth rituximab infusion (1 g, intravenous injection) resulted in improvement in renal function (serum creatinine: 322.5?147 μmol/L), but the MN failed to achieve partial relief. Subsequent treatment with the novel humanized CD20 monoclonal antibody obinutuzumab (1 g, intravenous injection) was initiated. In the latest follow-up, anti-phospholipase-A2-receptor antibody (PLA2R) antibody were negative, B cells were eliminated, serum albumin was 36 g/L, urine protein-to-creatinine ratio was 4 810 mg/g, and serum creatinine was 162 μmol/L. This case underscores the potential efficacy of obinutuzumab in refractory MN. For advanced MN cases, prompt identification of the cause of acute kidney injury is crucial, emphasizing the need for targeted interventions to potentially stall renal function decline.

Objective To investigate the effects of sodium-glucose cotransporter 2 inhibitor combined with Lepidium seed on cardiac,digestive,and pulmonary function in patients with heart failure complicated by pulmonary infection.Methods A total of 168 patients with heart failure and lung infection admitted to Zigui County Hospital of Traditional Chinese Medicine from August 2017 to March 2019 were selected as the research objects.They were divided into observation group and control group according to different treatment methods(84 patients per group).The control group received sodium-glucose cotransporter 2 inhibitor combined with ceftazidime,while the observation group was treated with Lepidium seed on the basis of control group for 30 days.Nutritional status[prealbumin(PA),albumin(ALB),red blood cell count(RBC),body mass index(BMI)],immune function[cytoplasmic domains(CD3,CD4,CD8),immunoglobulins(IgG,IgM)],inflammatory cytokines[interleukins(IL-8,IL-10,IL-17),tumor necrosis factor-α(TNF-α)],intestinal flora(Enterococcus,Escherichia coli,Lactobacillus,Bifidobacterium,Saccharomycetes,Digestion),and cardiopulmonary function[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),heart rate(HR),maximum oxygen consumption(VO2max),maximum exercise load(Wmax),maximum oxygen pulse,anaerobic threshold(AT),forced expiratory volume in one second/forced lung volume ratio(FEV1/FVC),FEV1 and maximal voluntary ventilation(MVV)]were compared between the two groups before and after treatment.Results After treatment,PA,ALB,RBC,BMI,CD3,CD4,CD8,IgG and IgM,Lactobacillus,Bifidobacterium,PaO2,VO2max,Wmax,maximum oxygen pulse,AT,FEV1/FVC,FEV1,MVV all increased significantly compared to before treatment.IL-8,IL-17,TNF-α,Enterococcus,Escherichia coli,PaCO2,and heart rate were significantly reduced compared to before treatment.The levels of PA,ALB,RBC,BMI,CD3,IgG,IgM,IL-10,Bifidobacterium,Lactobacillus,PaO2,VO2max,Wmax,maximum oxygen pulse,AT,FEV1/FVC,FEV1,and MVV in the observation group were significantly higher than those in the control group after treatment[PA(mg/L):259.69±20.73 vs.217.69±20.73,ALB(g/L):41.46±4.58 vs.36.56±3.73,RBC(×1012/L):4.52±0.24 vs.4.21±0.31,BMI(kg/m2):22.37±2.73 vs.19.66±2.24,CD3:0.63±0.08 vs.0.56±0.08,IgG(g/L):21.85±3.68 vs.15.72±4.36,IgM(g/L):4.68±1.68 vs.3.73±1.67,IL-10(ng/L):65.28±7.23 vs.50.23±6.14,Bifidobacterium(CFU/kg):83.5±8.6 vs.78.5±8.3,Lactobacillus(CFU/kg):62.1±6.5 vs.53.5±6.0,PaO2(mmHg,1 mmHg≈0.133 kPa):98.36±1.75 vs.91.95±2.95,VO2max(L/min):1.71±0.35 vs.1.22±0.39,Wmax(W):127.49±19.54 vs.97.49±15.37,maximum oxygen pulse(L/time):11.27±2.42 vs.9.46±2.79,AT:(50.49±7.48)%vs.(41.35±6.67)%,FEV1/FVC:(75.68±5.86)%vs.(65.48±8.54)%,FEV1:(82.44±5.73)%vs.(73.57±7.75)%,MVV(L/min):74.86±10.64 vs.64.63±9.68,all P<0.05].CD4,CD8,IL-8,IL-17,TNF-α.Enterococcus,Escherichia coli,PaCO2,and heart rate levels were significantly lower than those in the control group[CD4:0.32±0.06 vs.0.39±0.05,CD8:0.28±0.06 vs.0.34±0.05,IL-8(ng/L):16.64±2.63 vs.26.35±4.13,IL-17(ng/L):112.38±30.16 vs.207.75±42.23,TNF-α(ng/L):45.27±10.23 vs.61.26±14.29,Enterococcus(CFU/kg):63.6±5.6 vs.69.5±6.8,Escherichia coli(CFU/kg):65.8±6.4 vs.70.5±7.0,PaCO2(mmHg):41.84±4.45 vs.56.18±5.37,heart rate(bpm):75.96±11.57 vs.91.57±12.68,all P<0.05].Conclusions Treatment with Lepidium seed combined with sodium-glucose cotransporter 2 inhibitor improved cardiopulmonary function,reduced inflammation,enhanced nutrition,and normalized gut flora in heart failure patients with lung infections.Our findings support integrating this combination into clinical guidelines for optimized management of these critically ill patients.