ObjectiveTo study the effect and efficacy of Nirmatrelvir tablet/Ritonavir tablet in the treatment of patients with COVID‑19 infection aged ≥90 years, to inform pharmacological treatment of patients aged ≥90 years with COVID‑19 infection. MethodsMild to moderate COVID-19 patients who were hospitalized in the Department of Geriatrics of the First Affiliated Hospital of the Naval Medical University from March 2022 to June 2024, aged ≥90 years, and who had not been vaccinated against novel coronavirus were selected as the research subjects. A total of 112 patients who received Nirmatrelvir tablet/Ritonavir tablet antiviral treatment within 5 days after the diagnosis of COVID‑19 infection were referred to the drug group, and 80 patients who were not treated with antiviral drugs were referred to as the control group. A retrospective research method was employed to gather and compare patitents’ clinical laboratory data before and after antiviral treatment, such as blood routine tests, inflammatory markers, coagulation function tests, liver and renal function tests, electrolyte levels, and blood gas analysis, between the drug group and the control group. Additionally, the time duration to negative conversion and 28-day all-cause mortality rates were compared between the two groups. Logistic regression analysis was conducted on factors associated with mortality, such as the oxyhemoglobin saturation after treatment, time duration to negative conversion, and the use of Nirmatrelvir tablet/Ritonavir tablet or not, while correlation analysis was performed to evaluate the efficacy of Nirmatrelvir tablet/Ritonavir tablet based on the level of oxyhemoglobin saturation, time duration to negative conversion, and all-cause mortality rates within 28 days. ResultsAfter treatment, oxyhemoglobin saturation increased in the drug group (t=-2.726, P=0.011), and the differences between the indicators in the control group compared to the pre-treatment period were not statistically significant (all P>0.05). The time to negative conversion and 28-day all-cause mortality of control group were higher than those in the drug group (all P<0.05). Logistic regression analysis revealed that the lower the post-treatment oxyhemoglobin saturation, the lower the use of Nirmatrelvir tablet/Ritonavir tablet, the longer the time to conversion, and the higher the mortality rate of the patients (all P<0.05). Correlation analysis showed that treatment with Nirmatrelvir tablet/Ritonavir tablet resulted in higher oxyhemoglobin saturation (r=0.425, P=0.008), shorter time to negative conversion (r=-0.398, P=0.013), and lower all-cause mortality rates within 28 days (r=-0.370, P=0.022). ConclusionNirmatrelvir tablet/Ritonavir tablet is effective in mild and moderate infection patients aged ≥90 years who have not been vaccinated against COVID‑19 infection, and can increase patients’ oxyhemoglobin saturation, shorten the time to negative conversion, and reduce 28-day all-cause mortality rate.

ObjectiveTo investigate the differences in the risk factors for postoperative pancreatic fistula （POPF） after pancreaticoduodenectomy （PD） between the 2005 and 2016 editions of the definition and classification standards for pancreatic fistula， and to establish a risk prediction model for pancreatic fistula based on the 2016 edition. MethodsA retrospective analysis was performed for the clinical data of 303 patients who were admitted to Tianjin Third Central Hospital and underwent PD from January 2016 to May 2022， and the patients with POPF were identified based on the new and old editions. The independent-samples t test or the non-parametric Mann-Whitney U test was used for comparison of continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. The univariate and multivariate logistic regression analyses were used to investigate the differences in the risk factors for pancreatic fistula after PD between the two editions； a risk prediction model was established for POPF based on the 2016 edition， and the receiver operating characteristic curve was used to invesitgate the accuracy of this model in predicting POPF and perform model validation. ResultsAccording to the 2005 edition， the univariate analysis showed that the diameter of the main pancreatic duct （χ²=31.641， P<0.001）， main pancreatic duct index （χ²=52.777， P<0.001）， portal vein invasion （χ²=6.259， P=0.012）， intra-abdominal fat thickness （χ²=7.665， P=0.006）， preoperative biliary drainage （χ²=5.999， P=0.014）， pancreatic cancer （χ²=5.544， P=0.019）， marginal pancreatic thickness （t=2.055， P=0.032）， pancreatic CT value （t=-3.224， P=0.002）， and preoperative blood amylase level （Z=-2.099， P=0.036） were closely associated with POPF， and the multivariate logistic regression analysis showed that main pancreatic duct index （odds ratio ［OR］=0.000， 95% confidence interval ［CI］： 0.000‍ ‍—‍ ‍0.011， P<0.05）， pancreatic cancer （OR=4.843， 95%CI： 1.285‍ ‍—‍ ‍18.254， P<0.05）， and pancreatic CT value （OR=0.869， 95%CI： 0.806‍ ‍—‍ ‍0.937， P<0.05） were independent risk factors； based on the 2016 edition， the univariate analysis showed the diameter of the main pancreatic duct （χ²=5.391， P=0.020）， main pancreatic duct index （χ²=11.394， P=0.001）， intra-abdominal fat thickness （χ²=8.899， P=0.003）， marginal pancreatic thickness （t=2.665， P=0.009）， pancreatic CT value （t=-2.835， P=0.004） were closely associated with POPF， and the multivariate logistic regression analysis showed that main pancreatic duct index （OR=0.001， 95%CI： 0.000‍ ‍—‍ ‍0.050， P<0.05） and pancreatic CT value （OR=0.943， 95%CI： 0.894‍ ‍—‍ ‍0.994， P<0.05） were independent risk factors. A risk prediction model was established for POPF after PD， and the ROC curve analysis showed that this model had an area under the ROC curve of 0.788 （95%CI： 0.707‍ ‍—‍ ‍0.870） in the modeling group and 0.804 （95%CI： 0.675‍ ‍—‍ ‍0.932） in the validation group. ConclusionMain pancreatic duct index and pancreatic CT value are closely associated with POPF after PD， and the risk prediction model for pancreatic fistula based on the 2016 edition has a good prediction accuracy.

Objective:To establish and internally validate a nomogram model for predicting complicated acute appendicitis (CA).Methods:The clinical data from 663 acute appendicitis patients from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from October 2015 to October 2022 were retrospectively analyzed. There were 411 males and 252 females, aged ( M (IQR)) 41 (22) years (range: 18 to 84 years). There were 516 cases of CA and 147 cases of uncomplicated acute appendicitis. The minimum absolute contraction and selection operator regression model was used to screen the potential relative factors of CA, and the screened factors were included in the Logistic regression model for multivariate analysis. Software R was used to establish a preoperative CA nomogram prediction model, the receiver operating characteristic curve of the model was drawn, and the value of area under the curve (AUC) was compared to evaluate its identification ability, and the Bootstrap method was used for internal verification. Results:The elderly (age≥60 years) ( OR=2.428, 95% CI: 1.295 to 4.549), abdominal pain time (every rise of 1 hour) ( OR=1.089, 95% CI: 1.072 to 1.107), high fever (body temperature≥39 ℃) ( OR=1.122, 95% CI: 1.078 to 1.168), total bilirubin (every rise of 1 μmol/L) ( OR=2.629, 95% CI: 1.227 to 5.635) were independent relative factors of CA (all P<0.05). The AUC of this model was 0.935 (95% CI: 0.915 to 0.956). After internal verification using the Bootstrap method, the model still had a high discrimination ability (AUC=0.933), and the predicted CA curve was still in good agreement with the actual clinical CA curve. Conclusion:The clinical prediction model based on the elderly (age≥60 years), prolonged abdominal pain time, high fever (body temperature≥39 ℃), and increased total bilirubin can help clinicians effectively identify CA.

Objective:To establish and internally validate a nomogram model for predicting complicated acute appendicitis (CA).Methods:The clinical data from 663 acute appendicitis patients from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from October 2015 to October 2022 were retrospectively analyzed. There were 411 males and 252 females, aged ( M (IQR)) 41 (22) years (range: 18 to 84 years). There were 516 cases of CA and 147 cases of uncomplicated acute appendicitis. The minimum absolute contraction and selection operator regression model was used to screen the potential relative factors of CA, and the screened factors were included in the Logistic regression model for multivariate analysis. Software R was used to establish a preoperative CA nomogram prediction model, the receiver operating characteristic curve of the model was drawn, and the value of area under the curve (AUC) was compared to evaluate its identification ability, and the Bootstrap method was used for internal verification. Results:The elderly (age≥60 years) ( OR=2.428, 95% CI: 1.295 to 4.549), abdominal pain time (every rise of 1 hour) ( OR=1.089, 95% CI: 1.072 to 1.107), high fever (body temperature≥39 ℃) ( OR=1.122, 95% CI: 1.078 to 1.168), total bilirubin (every rise of 1 μmol/L) ( OR=2.629, 95% CI: 1.227 to 5.635) were independent relative factors of CA (all P<0.05). The AUC of this model was 0.935 (95% CI: 0.915 to 0.956). After internal verification using the Bootstrap method, the model still had a high discrimination ability (AUC=0.933), and the predicted CA curve was still in good agreement with the actual clinical CA curve. Conclusion:The clinical prediction model based on the elderly (age≥60 years), prolonged abdominal pain time, high fever (body temperature≥39 ℃), and increased total bilirubin can help clinicians effectively identify CA.

To investigate the effect of miR-331-3p on the proliferation of porcine renal epithelial cells (PK15) and its mechanism, the pcDNA 3.1(+) overexpression vector of miRNA-331-3p (pcDNA 3.1(+)-miR-331-3p) was constructed. PK15 cells were divided into four groups, including experimental group, experimental control group, inhibitor group and inhibitor control group. Experimental group and experimental control group were transfected with pcDNA 3.1(+)-miR-331-3p and pcDNA 3.1(+), respectively. Inhibitor group and inhibitor control group were transfected with miR-331-3p inhibitor and miR-331-3p negative control (miR-331-3p NC), respectively. Above all, CCK-8 reagent was used to plot the cell proliferation curve and Propidium (PI) staining was used to detect the proportion of cell stages. Secondly, its expression change were detected by quantitative real-time PCR that included the growth inhibitory protein family member 5 (ING5), cyclin-dependent kinase 2 (CDK2), cyclin-dependent kinase 3 (CDK3), cyclin-dependent kinase 4 (CDK4), Cyclin B and cyclin-dependent kinase inhibitor 1A (CDKN1A). The results showed that the expression of miRNA-331-3p was significantly increased in the experimental group. The cell proliferation curve showed that the number of cells in experimental group was significantly higher than that in experimental control group or inhibitor control group at 48 h and 72 h (P<0.05). Simultaneously, Inhibitor group was significantly lower than experimental control group or inhibitor control group in the number of cells at 48 h and 72 h (P<0.05), but there was no significant difference between the experimental group and the control group. Compared with the experimental control group, the proportion of cells of experimental group in G0/G1 phase decreased, the proportion of S phase and G2/M phase increased, and the inhibitor control group showed the opposite trend. Simultaneously, the expression levels of CDK2, CDK3, CDK4 and Cyclin B genes in the experimental group were significantly increased, while ING5 and CDKN1A genes inhibiting proliferation showed a significant downward trend. These results demonstrate that the miR-331-3p overexpression vector was successfully constructed, and miR-331-3p has the ability to promote the proliferation of PK15 cells. The study lays a solid foundation for further research for its role in pig growth and development.
Animals ; Cell Line ; Cell Proliferation ; genetics ; Epithelial Cells ; cytology ; Genetic Vectors ; MicroRNAs ; genetics ; Swine

Posttraumatic stress disorder (PTSD) refers to the sudden, threatening or catastrophic life events leading to delay and long-term persistence of mental disorders. Hippocampus, amygdala, prefrontal cortex and hypothalamus-pituitary-adrenal axis (HPA) may be involved in PTSD, but the exact pathogenesis is not entirely clear. Traditional Chinese Medicine, including Chinese herbs, acupuncture and emotion-thought therapy, are considered as the main methods for PTSD, which may play a role in neuroprotection, adjustment of learn-ing-memory, anti-stress, adjusting HPA, etc.

Objective To evaluate the ventilation modes and factors influencing the tidal volume(VT)in the nonventilated lung during one-lung ventilation(OLV)in patients undergoing thorascopic surgery using electrical impedance tomography.Methods Thirteen American Society of Anesthesiologists physical statusⅠ or Ⅱ patients of both sexes,aged 45-64 yr,weighing 45-80 kg,undergoing elective pulmonary surgery performed via video-assisted thoracoscope,were enrolled in the study.After anesthesia induction,a double lumen tube was placed,and correct tube placement was confirmed with a fiberoptic bronchoscope.Two-lung ventilation and OLV were performed sequentially when in supine position with a fixed VT of 8 ml/kg and respiratory rate(RR)of 12 breaths/min.When the patients were turned to lateral position(with the operated lung on the upper side),correct placement of the tube was reconfirmed with a fiberoptic bronchoscope.Bilateral lungs were ventilated with VT of 8 ml/kg and RR of 12 breaths/min,and unilateral lungs were then ventilated in the following modes in sequence:VT 8 ml/kg and RR 12 breaths/min for the lung on the upper side;VT 8 ml/kg and RR 12 breaths/min for the lung on the lower side;VT 8 ml/kg,RR 12 breaths/min and positive end-expiratory pressure(PEEP)4 cmH2O for the lung on the lower side;VT 6 ml/kg and RR 16 breaths/min for the lung on the lower side;VT 4 ml/kg and RR 24 breaths/min for the lung on the lower side.Each ventilation mode stabilized for 2 min.At 2 min of OLV in each mode,electrical impedance tomography was used to record the ventilation mode in the nonventilated lung,anesthesia machine was used to record VT in the nonventilated lung,and the percentage of VT on nonventilated side in VT on ventilated side(VT-non/VT-ven%)was calculated.When the unilateral lung on the lower side was ventilated in lateral position,logistic regression analysis was used to analyze the correlation between VT on ventilated side(no PEEP)and that on nonventilated side.Results Opposite ventilation was found in the nonventilated lung during OLV.VT-non/VT-ven% was significantly higher in lateral position than in supine position(P<0.05).VT-non/VT-ven% was significantly higher when the lung on the lower side was ventilated than that when the lung on the upper side was ventilated(P<0.05).Four cmH2O PEEP exerted no effect on VT-non/VT-ven%.When the lung on the lower side was ventilated in lateral position,there was a linear positive correlation between VT on ventilated side(no PEEP)and that on nonventilated side(r=0.899,P<0.05).Conclusion During OLV in patients undergoing thorascopic surgery,there is opposite ventilation in the nonventilated lung,and VT is influenced by body positions and VT in contralateral lungs.

Objective: To confirm the structure and preferential conformation of the Schiff base of gossypol with 1, 3, 4, 6-tetra-O-acetyl-β-D-glucosamine and explore its anti-HIV-1 activity.Methods: The Schiff base of gossypol with 11, 3, 4, 6-tetra-O-acetyl-β-D-glucosamine was synthesized and identified by FT-IR, NMR spectroscopy and the PM6 semi-classical calculation.The inhibitory activity of the novel compound against the laboratory-adapted HIV-1IIIB strain was examined using the HIV-1IIIB/TZM-bl indicator cell culture system.Results: The 1H and 13C-NMR signals of the new Schiff base were assigned.The PM6 semi-classical calculation indicated that enamine-enamine tautomeric form of the new Schiff base was more stable,which was stabilized by the intramolecular hydrogen bonds.The anti-HIV-1 test showed that the compound could block the entry of HIV-1IIIB into the target cells.Conclusion: The Schiff base of gossypol with 1, 3, 4, 6-tetra-O-acetyl-β-D-glucosamine exhibits enamine-enamine tautomeric form in solution, which shows potential anti-HIV-1 activity.

It is difficult for regeneration of central nervous system (CNS) in adult mammals, and myelin-associated inhibitors (MAIs) are believed to be major contributors. Paired immunoglobulin-like receptor B (PirB), as a co-receptor of MAIs, and expresses highly in CNS after injury, plays a vital role in the signal transduction of inhibition in the injured CNS. Knockout or block of PirB in vitro and in vivo may promote the neuro-regeneration after spinal cord injury or hypoxic-ischemic brain damage, release the damage induced byβ-amyloid in Al-zheimer's disease, recover the neural function in brain inflammation models, improve the reconstruction of vision after optic nerve injury, and so on. PirB may be a potential therapeutic target for neuro-regeneration and synaptic plasticity.

Objective To evaluate the effects of different doses of compound Xuelian capsule on bone cancer pain (BCP) in rats.Methods Fifty pathogen-free adult female Sprague-Dawley rats,weighing 200-220 g,aged 7-8 weeks,were randomly divided into 5 groups (n =10 each) using a random number table:sham operation group (group S),group BCP,and compound Xuelian capsule 50,100 and 200 mg · kg-1 · d-1 groups (group CX50,group CX100 and group CX200).BCP was produced by injecting Walker256 mammary gland carcinoma cells into the intramedullary space of the right femur bone.At 11-21 days after inoculation of the tumor ceils,normal saline containing compound Xuelian capsule 50,100 and 200 mg · kg 1 · d 1 was injected through a tube into stomach once a day in CX50,CX100 and CX200 groups,respectively.The mechanical paw withdrawal threshold (MWT) and limb use score were measured at 1 day before inoculation of the tumor cells (baseline) and 4,7,11,14,17,19,and 21 days after inoculation of the tumor cells.Results Compared with group S,the MWT at 4-21 days after inoculation of the tumor cells was significantly decreased,and limb use score was significantly decreased at 11-21 days after inoculation of the tumor cells in BCP,CX50,CX100 and CX200 groups (P＜0.05).Compared with group BCP,the MWT was significantly increased at 19-21 days after inoculation in group CX50,at 17-21 days after inoculation in group CX100 and at 14-21 days after inoculation in group CX200,and limb use score was significantly increased at 14-21 days after inoculation in group CX100 and at 17-21 days after inoculation in group CX200 (P＜0.05).Conclusion Compound Xuelian capsule 50,100 and 200 mg· kg 1 · d 1 (for 11 consecutive days) can reduce BCP in a dose-dependent manner in rats.