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.

Specific tumor-targeted gene delivery remains an unsolved therapeutic issue due to aberrant vascularization in tumor microenvironment (TME). Some bacteria exhibit spontaneous chemotaxis toward the anaerobic and immune-suppressive TME, which makes them ideal natural vehicles for cancer gene therapy. Here, we conjugated ZIF-8 metal-organic frameworks encapsulating eukaryotic murine interleukin 2 (Il2) expression plasmid onto the surface of VNP20009, an attenuated Salmonella typhimurium strain with well-documented anti-cancer activity, and constructed a TME-targeted Il2 delivery system named Il2/ZIF-8@Salmonella. Both in vitro and in vivo experiments demonstrated that Il2/ZIF-8@Salmonella maintained the tumor-targeting feature of bacteria, and could be effectively phagocytosed by intratumoral macrophages, thus leading to the expression and secretion of IL2 in TME. The detailed analysis of tumor immune microenvironment (TIME) showed that one dose of combinatorial Il2/ZIF-8@Salmonella achieved synergistic actions on a potent remodeling of TIME, marked by the activation of cytotoxic T cells and M1-polarization of macrophages in TME, thus leading to significant anti-tumor effects in melanoma, orthotopic hepatocellular carcinoma, and pulmonary metastasis models. More importantly, Il2/ZIF-8@Salmonella exhibited high safety to major organs and hematopoietic systems. Taken together, we report a novel plasmid/ZIF-8@Salmonella system that simultaneously achieves effective TME-targeted delivery of therapeutic gene, as well as synergistic re-activation of TIME.

OBJECTIVE: To analyze the medical equipment operation data of 44 clinical departments in the hospital from three aspects: materials and consumables, operation and maintenance depreciation, and operation management. METHODS: To formulate the evaluation standards and scoring criteria for the operation indicators, the lowest score is 0 points, and the highest score is 5 points. Based on the operation indicators of medical equipment, establish a hierarchical structure model, determine the criterion layer and sub-criteria layer, construct a judgment matrix, normalize it, and calculate the weight coefficient. RESULTS: Count equipment operation data in 2021 and 2022. Score according to the assessment standards, assign weights through the analytic hierarchy process, calculate the total score and sort, and making a special analysis on the top 10 departments and departments with a score below 4 points, and formulate a rectification plan. CONCLUSIONS The establishment of index assessment standards and the weight distribution of AHP can effectively enhance the control of equipment operating costs.
Analytic Hierarchy Process ; Rationalization ; Surgical Equipment ; Reference Standards ; Cost Control

Objective:To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China.Methods:From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results.Results:The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of “new rural cooperative medical care (NRCMC)” accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of “NRCMC” were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with “NRCMC” were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with “NRCMC” were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results.Conclusion:The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

Objective:To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China.Methods:From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results.Results:The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of “new rural cooperative medical care (NRCMC)” accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of “NRCMC” were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with “NRCMC” were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with “NRCMC” were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results.Conclusion:The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

OBJECTIVEEstablish a regional cloud account of hospital medical equipment based on dynamic two-dimensional code link.

METHODSEstablish a medical equipment data platform based on B/S architecture. Combined with mobile internet means such as WeChat and try the industrial 4.0 designed intelligent boxes.

RESULTSThe problem of no interface transmission and integration of the regional medical equipment account information is solved. It dynamically collects equipment data, operation cost and efficiency. The real-time operation data is visualized.

CONCLUSIONSThe dynamic management platform of regional medical equipment helps to standardize the management of large medical equipment and improve the utilization ratio of medical equipment. The platform provides basis of management decisions and equipment allocation for relevant departments.

This study based on the technology evolution theory, S-curve and bibliometrics, verified product evolution was accompanied by the evolution and transition of a number of sub technologies. It judged MRI was in the stage of underdevelopment and a new round of technology was being developed. It was found that the value of MRI equipment in scientific research or clinical application in foreign countries was higher than that in China by comparing the literatures at home and abroad. And there was a gap between China and the world scientific center in the independent R&D capability. The study verified the applicability of the technical evolution theory and the evaluation empirical laws in the medical devices evaluation, and explored the operability of the assessment tools. This paper not only provided a reference for equipment configuration, but also showed the gaps of key technologies in home and abroad and provided a reference for upgrading China's independent innovation and industrial technology.
China ; Industry ; Magnetic Resonance Imaging ; instrumentation ; Technology ; trends

This paper reviews the principle and clinical application of hydrosurgery system, including the burn debridement, diabetic foot wounds debridement and other trauma debridement. Meanwhile, this paper introduces the development direction of waterjet technology. Furthermore, the safety, effectiveness and suitability can be discussed.
Burns ; therapy ; Debridement ; methods ; Foot Ulcer ; therapy ; Humans ; Hydrotherapy ; Treatment Outcome ; Wound Healing

This paper introduces the technical features of hydrosurgery system and evaluates it from three aspects:safety and effectiveness, economy and technology maturity. The evaluation results show that the safety and effectiveness are high, and the safety mainly involves the misuse of the system, which cause the adverse events. A large number of literatures have proved that the system is more suitable for the debridement of fine parts. It is estimated that hydrosurgery system has better economic performance, but the cost and patients' cost is also increased correspondingly. In the aspect of technology maturity assessment, this technology is a patented technology, and the number of published papers both at home and abroad is on the rise, indicating that the initial application of the technology is better and the technology is in infancy stage. Therefore, hydrosurgery system has certain advantages in all aspects. Hospitals need to allocate the equipment according to their own needs and clinical application, while a wider range of clinical trials is needed to provide evidence-based evidence for clinical applications and promotion.
Debridement ; instrumentation ; Equipment and Supplies ; Humans ; Water Purification

OBJECTIVE:To investigate the correlation of blood concentrations of tamoxifen (TAM) and its metabolites with endometrial hyperplasia in estrogen receptor(ER)-positive breast cancer patients. METHODS:A total of 69 patients with ER-posi-tive breast cancer selected from our hospital during Mar. 2015-Apr. 2016 received TAM (twice a day,one tablet each time) for more than 6 months. According to endometrial thickness,they were divided into abnormal hyperplasia group(40 cases)and normal group(29 cases). The steady state concentrations of TAM and its metabolites [4-OH-tamoxifen(OHT),N-demethylation tamoxifen (DMT),Endoxifen] were determined by HPLC-FLU. The correlation of blood concentration and other factors with endometrial thickness were investigated by Pearson test and multiple regression analysis. RESULTS:The medication time and Endoxifen steady state concentration in abnormal hyperplasia group were both significantly longer or higher than normal group,with statistical signifi-cance (P<0.05). There was no statistical significance in age,BMI,complication and steady state concentrations of TAM,OHT and DMT between 2 groups(P>0.05). The endometrial thickness was positively correlated with Endoxifen steady state concentra-tion and medication time(r=0.447,0.460,P<0.05). Using endometrial thickness(y)as dependent variable,medication time(x1) and Endoxifen steady state concentration(x2)as independent variable,multiple regression analysis was conducted. Multiple regres-sion equation was calculated as follows:y=2.436+0.123x1+0.082x2(F=12.610,r=0.526,P<0.05). CONCLUSIONS:Medication time and Endoxifen steady state concentration may be related to endometrial hyperplasia,which can provide reference for predicting TAM induced endometrial abnormal hyperplasia in ER-positive breast cancer patients.