Humans ; Female ; Coronary Artery Disease/complications* ; Hyperlipoproteinemia Type II/complications* ; Aortic Valve Stenosis/etiology* ; Treatment Outcome

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.

Intestinal flora is the largest microbial community in human body， which consists of more than 1 000 species. Its structure and metabolites change dynamically with the age， diet and intestinal environment of the host. Study shows that the intestinal microbes play a pivotal role in regulating human physiological and pathological processes， and intestinal flora imbalance may be the key factors affecting the occurrence and development of bone and joint diseases， including osteoporosis， osteoarthritis， rheumatoid arthritis and gouty arthritis. At present， calcitonin， estrogen， nonsteroidal anti-inflammatory drugs， immunosuppressants， xanthine oxidase inhibitors and other western drugs are mostly used to treat the above diseases. However， long-term use of western drugs leads to poor compliance and obvious gastrointestinal adverse reactions among patients. Traditional Chinese medicine （TCM） predominates in the treatment of bone and joint diseases due to its low price， high efficacy and slight side effects， with the advantages of multi-targets， multi-mechanism and multi-levels. In recent years， many scholars have carried out experiments and clinical studies on the treatment of bone and joint diseases by TCMs on the basis of the liver and kidney theory such as "tonifying liver and kidney and strengthening muscles and bones". Gratifying results have been achieved. However， the mechanism of action has not been fully clarified. Intestinal flora becomes a hot spot in medical research， and a close relationship between intestinal flora and bone and joint diseases has been unveiled. Relevant literature in China and abroad showed that TCM has a significant effect on the treatment of bone and joint diseases by regulating intestinal flora. In this paper， the relationship between intestinal flora and bone and joint diseases was summarized and the intervention of TCM active ingredients and compounds on intestinal flora was reviewed to facilitate the prevention and treatment of bone and joint diseases by TCM.

The expression of histone lysine-specific demethylase 1 (LSD1) in colorectal cancer cells is increased, and LSD1 is closely related to its occurrence, development, proliferation, invasion and metastasis. LSD1 is a demethylase whose function depends on flavin adenine dinucleoside. It can specifically catalyze the demethylation reaction of histone lysine, and regulate the expression of target genes by reaction of demethyl and dimethyl (H3K4me, H3K4me2, H3K9me, and H3K9me2) at the 4th and 9th positions of lysine H3. Targeted inhibition of LSD1 has been proved to be able to exert significant anti-tumor effect, but since the tumors involve multiple centers and factors, later studies have found that single inhibition of LSD1 cannot completely and effectively kill tumor cells. Moreover, the specificity of the LSD1 catalytic substrate depends to a large extent on the synergistic factors that bind to it and form complexes. The double-target inhibitors based on LSD1 shows more remarkable effect in tumor inhibition. Therefore, finding the combined synergistic factors of LSD1 may provide the basis for the research of multi-target inhibitors.

BACKGROUND: An increase in high-density lipoprotein (HDL) is well associated with a decreased cardiovascular risk, especially atherosclerosis. Recent studies suggest that lower levels of HDL may also be associated with an increased risk of sepsis and an increased rate of mortality in septic patients. However, this conclusion remains controversial. METHODS: MEDLINE, EMBASE, and CENTRAL databases were searched from inception to September 30, 2019. All studies were conducted to evaluate the correlation of lipoprotein levels and the risk and outcomes of sepsis in adult patients. The primary outcomes were the risk and mortality of sepsis. RESULTS: Seven studies comprising 791 patients were included. Lower levels of HDL had no marked relevance with the risk of sepsis (odds radio [OR] for each 1 mg/dL increase, 0.94; 95% CI 0.86–1.02; P=0.078), whereas lower HDL levels were related to an increased mortality rate in septic patients (OR for below about median HDL levels, 2.00; 95% CI 1.23–3.24; P=0.005). CONCLUSION: This meta-analysis did not reveal a significant association between lower HDL levels and an increase in the risk of sepsis, whereas it showed that lower HDL levels are associated with a higher mortality rate in septic adult patients. These findings suggest that HDL may be considered as a promising factor for the prevention and treatment of sepsis in the future.

Objective To investigate the current status of sleep and its influencing factors among diabetic patients in communities. Methods Using the method of cluster sampling,a total of 449 diabetic patients were selected from 20 communities in Beilun District,Ningbo City. A well -structured questionnaire and physical examination were applied to obtain information,and pittsburgh Sleep Quality Index( pSQI)was also used to compare the sleeping quality of diabetic patients with norm population. Results Out of 449 patients,177(39. 42%)had poor sleeping quality. Compared with norm (3. 88 ± 2. 52),sleeping quality of diabetic patients(5. 50 ± 3. 82)was poorer(p<0. 01). Multivariable logistic regression showed that BMI,family income and cardiovascular diseases( CVD)were the influencing factors of sleeping quality,the value of OR and 95% confidence interval(95%CI)were 0. 93(0. 87-0. 99),0. 35(0. 15-0. 80)and 1. 58(1. 01-2. 47) respectively. Besides,multivariable linear regression showed that family income and retirement were associated with sleeping quality(p<0. 05). Conclusion Sleep disorder remains a common problem among diabetic patients Low BMI,low family income,non-retiree and CVD contribute to poor status of sleep.

OBJECTIVETo assess the value of magnetic resonance (MR) myocardial perfusion imaging (MRMPI) in evaluating the myocardial viability in patients with myocardial infarction.

METHODSMRMPI was performed in 51 patients with myocardial infarction using a 1.5 T MR scanner. All the patients were examined using IR-turbo FLASH sequence during the first-pass and delayed phase 5-30 min after injection of 0.1 mmol/kg Gd-DTPA at the rate of 4 ml/s. The short axis images were acquired during the first-pass, and both the short axis and long axis images were obtained during the delayed phase. The left ventricular wall on the short-axis slice was divided into 8 segments. A correlative study of the results of the rest and stress (99m)Tc single photon emission computed tomography (SPECT) was carried out in 21 patients.

RESULTSIn the 51 patients with myocardial infarction, 42(82.3%) showed hypoperfusion during the first-pass imaging and 50(98%) had delayed hyperenhancement. In the 21 patients receiving SPECT, 48 nonviable segments was detected among the 168 segments scanned by (99m)TcSPECT, and MRMPI showed delayed hyperenhancement in all the infracted areas. Of the 120 viable segments detected by rest and stress (99m)Tc SPECT, 97 segments (80.8%) were found to be free of delayed hyperenhancement by MRMPI. With the rest and stress (99m)Tc SPECT as the reference, the sensitivity and the specificity of MRMPI were 100.0% and 80.8%, respectively.

CONCLUSIONMRMPI allows effective identification of the myocardial viability and nonviability as well as the severity and extent of the myocardial infraction.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Female ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; diagnostic imaging ; physiopathology ; Myocardial Perfusion Imaging ; methods ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon

Obiective To evaluate the clinical efficacy of microsurgical resection of third ventricle tumors involving the lateral ventricle through the transcallosal interfomiceai approach. Methods From October 2005 to April 2009, 12 patients with third ventricle tumors involving the lateral ventricle received microsurgical resection of the tumors through the transcollasal interfomiceal approach. Results The tumors were totally removed in 4 cases, subtotally in 3 cases and partially in 5 cases without any fatal consequences. Conclusion This approach is safe and effective for removing third ventricle tumors involving the lateral ventricle by accessing the tumor through the anatomical space in the brain, and allows clear exposure of the operative field and causes minimal invasiveness of the surrounding structure with reduced complications.

Objective To study the relationship between the biological behavior of gliomas and the state of adjacent fiber tract. Methods Regular MRI and DTI were performed in 24 patients with histologically confirmed brain gliomas. The fiber tracts adjacent gliomas reconstructed with 3-dimensional, the state of fiber tracts were evaluated with displaced, infiltrated or destroyed. Reflection the infiltration of glioma of MMP-9 、CD44 and the proliferative activity of VEGF and Ki-67 expression were evaluated by SP immunohistochemical staining method in surgical specimens. Results The expression of VEGF or Ki-67 was higher in high grade gliomas than low grade (P＜0.05) and a negative correlation (P＞0.05) between MMP-9 or CD44 expression and the grade of gliomas was found. The states of fiber tracts were damaged greatly in the periphery of high grade gliomas than low grade (P＜0.05).Further, the states of fiber tracts were destroyed heavily in the periphery of gliomas that had higher expression of VEGF or Ki-67 (P＜0.05). But there were poor correlation (P＞0.05) between MMP-9 or CD44 expression and the state of fiber tracts adjacent to gliomas. Conclusions The grade of and proliferation of gliomas can influence the state of fiber tracts in the periphery of gliomas but the infiltration did not. It was helpful to estimate the biological behavior of gliomas on imagines and useful in deciding the therapeutic regimen.