1. Treatment advice of small molecule antiviral drugs for elderly COVID-19
Min PAN ; Shuang CHANG ; Xiao-Xia FENG ; Guang-He FEI ; Jia-Bin LI ; Hua WANG ; Du-Juan XU ; Chang-Hui WANG ; Yan SUN ; Xiao-Yun FAN ; Tian-Jing ZHANG ; Wei WEI ; Ling-Ling ZHANG ; Jim LI ; Fei-Hu CHEN ; Xiao-Ming MENG ; Hong-Mei ZHAO ; Min DAI ; Yi XIANG ; Meng-Shu CAO ; Xiao-Yang CHEN ; Xian-Wei YE ; Xiao-Wen HU ; Ling JIANG ; Yong-Zhong WANG ; Hao LIU ; Hai-Tang XIE ; Ping FANG ; Zhen-Dong QIAN ; Chao TANG ; Gang YANG ; Xiao-Bao TENG ; Chao-Xia QIAN ; Guo-Zheng DING
Chinese Pharmacological Bulletin 2023;39(3):425-430
		                        		
		                        			
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
2. Monitoring second polar body exclusion by time-lapse in predicting fertilization and embryo development efficiency of intracytoplasmic sperm injection
Lin-Tao XUE ; Shi-Kai WANG ; Xian-Bao MAO ; Zheng-Da LI ; Xiao-Hui ZHANG ; Pin-Pin WEI
Acta Anatomica Sinica 2023;54(2):226-230
		                        		
		                        			
		                        			 Objective To explore the clinical value of second polar body (Pb2) exclusion monitoring by timelapse in predicting the fertilization and embryo development efficiency for intracytoplasmic sperm injection ( ICSI). Methods A retrospective research was performed on 278 patients treated with ICSI, the clinical data and Time-lapse monitoring embryo culture data were collected and analyzed, to explore the exclusion of Pb2 after ICSI and the relationship between the specific exclusion time and the outcome of fertilization and embryo development. Results The average time of Pb2 exclusion after ICSI was ( 3. 03 ± 1. 21) hours; The fertilization rate, 2 pronucleus(PN) fertilization rate and 5 days ( D5) blastocyst formation rate in the Pb2 exclusion group were significantly higher than those in the without Pb2 exclusion group (99.95% vs f. 75%, P < 0 . 001; 97.18% vs 0.66%, P< 0.001; 60.50% vs 16.67%, P < 0 . 0 5 ) ; The 2PN fertilization rate in Pb2 exclusion time >3-4 hours group was significantly higher than that in 0-2 hours group and >5 hours group (98.80% vs 9 3 . 8 1 % , P<0. 05; 98.80% vs 95.40%, P<0. 0 5 ) ; The exclusion time of Pb2 was significantly correlated with the average number of blastomeres in D3 embryos (P<0. OOf). The D5 blastocyst formation rate of 3-4 hours group was significantly lower than that of > 2-3 hours group ( 56. 23% vs 67. 23%, P < 0. 05 ) , > 4-5 hours group was significantly lower than 0-2 hours group and >2-3 hours group ( 46. 6f % vs 62. 30% , P<0. 05; 46. 6f % vs 67. 23% , P< 0. 05) , and D5 blastocyst formation rate of >5 hours group was 7. f 4 % , which were significantly lower than that of the other four groups (P<0. 05). The fonnation rate of D5 high-quality blastocysts in 3-4 hours group was significantly lower than 0-2 hours group and > 2-3 hours group ( 9. 92% vs 16. 39% , P<0. 05; 9. 92% vs 20. 72% , P<0. 05) , and D5 highquality blastocysts formation rate in > 4-5 hours group was significantly lower than that in > 2-3 hours group (11. 02% vs 20.72%, P<0. 05). Conclusion Monitoring Pb2 exclusion by Time-lapse can accurately predict fertilization outcome. The time of Pb2 exclusion is significantly correlated with embiyo development potential. It is a valuable morphological index to predict fertilization and embiyo development outcome in ICSI. 
		                        		
		                        		
		                        		
		                        	
3.The Value of MSCT Based Radiomics in Differential Diagnosis of Borrmann Ⅳ Gastric Cancer and Primary Gastric Lymphoma
Qin-xian CHEN ; Yu LIU ; Lie-bin HUANG ; Bao FENG ; Hui-min XUE ; Chang-lin LI ; Yong QUAN ; Wan-sheng LONG
Journal of Sun Yat-sen University(Medical Sciences) 2022;43(5):852-860
		                        		
		                        			
		                        			ObjectiveTo explore the predictive value of CT based radiomics model in differentiating Borrmann type Ⅳ gastric cancer (GC) from primary gastric lymphoma (PGL). MethodsA total of 186 cases (Borrmann type Ⅳ GC: 132; PGL: 86) pathologically diagnosed by surgical resection and/or endoscopic biopsy were enrolled from June 2008 to April 2018 retrospectively. Radiomics features were extracted from CT arterial phase and venous phase images by computed algorithm, and selected by least absolute shrinkage and selection operator (Lasso) logistic regression, and then the CT-based radiomics models were established. CT subjective signs were reviewed to build CT subjective signs model, while CT subjective signs and radiomics signature were assembled to build combined model. The receiver operating characteristic (ROC) curve was used to evaluate the performance of CT subjective sign model, radiomics model and the combined model. ResultsTwo signs(the bright line sign of serosa and the irregular nodular protrusion on the serosa side)were selected into the CT subjective sign model. Among the radiomics features, 9 venous phase features, 8 arterial phase features and 14 arteriovenous combination features related to tumor classification were selected, and the corresponding radiomics models were constructed respectively. When the cut-off value of CT subjective sign model was 0.188, the area under curve (AUC) was 0.846, the sensitivity was 61.9%, the specificity was 81.7%, and the accuracy was 76.5%. The cut-off values of arterial phase, venous phase and arteriovenous phase radiomics model were -0.315, -0.669 and -0.858, respectively, and the AUCs were 0.864, 0.955 and 0.890, the sensitivity were 71.4%, 95.2% and 81.0%, the specificity were 85.0%, 88.3% and 80.0%, the accuracy were 81.5%, 90.1% and 80.3%, respectively. The cut-off values of arterial phase, venous phase and arteriovenous phase in the combined model were 0.257, 0.556 and 0.497, respectively, and the AUCs were 0.883, 0.956 and 0.918, the sensitivity was 71.4%, 90.5% and 71.4%, the specificity was 85.0%, 93.3% and 90.0% and the accuracy were 81.5%, 92.6% and 85.2%, respectively. The diagnostic performance of the models from high to low were the combined model, radiomics model and CT subjective finding model ( P< 0.001), and CT venous phase images were more effective in the differential diagnosis of the two tumors. ConclusionsThe radiomics model based on the arterial and venous phases CT images could differentiate Borrmann type Ⅳ gastric carcinoma from primary gastric lymphoma effectively. 
		                        		
		                        		
		                        		
		                        	
4.Swallowing function and its related factors in elderly people in welfare homes of Wenzhou City
Xian-jun WENG ; Jian-ping HUANG ; Yi-wei YE ; Jin-ying BAO ; Ling-qin HU ; Xia SHAO ; Hui-jing MA
Shanghai Journal of Preventive Medicine 2021;33(8):750-753
		                        		
		                        			
		                        			Objective:To understand the swallowing function of the elderly in welfare homes of Wenzhou City,Zhejiang Province and to analyze the related factors of swallowing dysfunction. Methods:A total of 507 elderly people aged 60 years and over were surveyed by questionnaires in three welfare homes of Wenzhou City from January 2018 to January 2020.Hinds time-limited water drinking test was used to screen dysphagia. Multivariate unconditional logistic regression analysis was used to analyze the related factors of swallowing dysfunction. Results:The incidence of swallowing dysfunction was 26.04% (132 out of 507). Univariate analysis showed that there were significant differences in the incidence of swallowing dysfunction among the elderly in terms of age, spouse condition, self-care ability, health status, taking sleeping pills, cerebrovascular disease, nervous system disease and depression (
		                        		
		                        	
5.A multicenter study on the establishment and validation of autoverification rules for coagulation tests
Linlin QU ; Jun WU ; Wei WU ; Beili WANG ; Xiangyi LIU ; Hong JIANG ; Xunbei HUANG ; Dagan YANG ; Yongzhe LI ; Yandan DU ; Wei GUO ; Dehua SUN ; Yuming WANG ; Wei MA ; Mingqing ZHU ; Xian WANG ; Hong SUI ; Weiling SHOU ; Qiang LI ; Lin CHI ; Shuang LI ; Xiaolu LIU ; Zhuo WANG ; Jun CAO ; Chunxi BAO ; Yongquan XIA ; Hui CAO ; Beiying AN ; Fuyu GUO ; Houmei FENG ; Yan YAN ; Guangri HUANG ; Wei XU
Chinese Journal of Laboratory Medicine 2020;43(8):802-811
		                        		
		                        			
		                        			Objective:To establish autoverification rules for coagulation tests in multicenter cooperative units, in order to reduce workload for manual review of suspected results and shorten turnaround time (TAT) of test reports, while ensure the accuracy of results.Methods:A total of 14 394 blood samples were collected from fourteen hospitals during December 2019 to March 2020. These samples included: Rules Establishment Group 11 230 cases, including 1 182 cases for Delta check rules; Rules Validation Group 3 164 cases, including 487cases for Delta check; Clinical Application Trial Group 77 269 cases. Samples were analyzed for coagulation tests using Sysmex CS series automatic coagulation analyzers, and the clinical information, instrument parameters, test results, clinical diagnosis, medication history of anticoagulant and other relative results such as HCT, TG, TBIL, DBIL were summarized; on the basis of historical data, the 2.5 and 97.5 percentile of all data arranged from low to high were initially accumulated; on the basis of clinical suggestions, critical values and specific drug use as well as relative guidelines, autoverification rules and limits were established.The rules were then input into middleware, in which Stage I/Stage II validation was done. Positive coincidence, negative coincidence, false negative, false positive, autoverification pass rate, passing accuracy (coincidence of autoverification and manual verification) were calculated. Autoverification rules underwent trial application in coagulation results reports.Results:(1) The autoverification algorisms involve 33 rules regarding PT/INR, APTT, FBG, D-dimer, FDP,Delta check, reaction curve and sample abnormalities; (2)Autoverification Establishment Group showed autoverification pass rate was 68.42% (7 684/11 230), the false negative rate was 0%(0/11230), coincidence of autoverification and manual verification was 98.51%(11 063/11 230), in which positive coincidence and negative coincidence were respectively 30.09% (3 379/11 230) and 68.42%(7 684/11 230); Autoverification Validation Group showed autoverification pass rate was 60.37%(1 910/3 164), the false negative rate was 0%(0/11 230), coincidence of autoverification and manual verification was 97.79%(3 094/3 164), in which positive coincidence and negative coincidence were respectively 37.42%(1 184/3 164) and 60.37%(1 910/3 164); (3) Trialed implementation of these autoverification rules on 77 269 coagulation samples showed that the average TAT shortened by 8.5 min-83.1 min.Conclusions:This study established 33 autoverification rules in coagulation tests. Validation showedthese rules could ensure test quality while shortening TAT and lighten manual workload.
		                        		
		                        		
		                        		
		                        	
6.Differences in spatial distribution of medicinal plant resources in Yinshan region of Inner Mongolia.
Ming-Xu ZHANG ; Zhi-Xian JING ; Ting-Ting SHI ; Bao-Chang ZHOU ; Chun-Hong ZHANG ; Xiao-Bo ZHANG ; Li MIN-HUI
China Journal of Chinese Materia Medica 2020;45(21):5143-5149
		                        		
		                        			
		                        			Yinshan Mountains stands on the southern edge of the Inner Mongolia Plateau, which stretches 1 200 km from east to west and 50 to 100 km from north to south. The rich and varied topographic environment of the Yinshan Mountains has created a variety of vegetation floras, which also makes the species of medicinal plant resources in this area unevenly distributed. Therefore, studying the spatial distribution difference of medicinal plant resources among various banners, counties, and districts in the Yinshan area is of great significance to formulate the protection policy and promote the industry development of medicinal plant. This study is based on the fourth national survey of traditional Chinese medicine resources in Inner Mongolia, regarding the results of the third national survey of traditional Chinese medicine resources. The species of medicinal plant resources in the Yinshan area around 31 banners, counties and districts were counted in detail. Then, using exploratory spatial data analysis(ESDA), trend surface analysis, spatial autocorrelation, geographical detector and other geostatistical analysis methods to analyze the differences in the spatial distribution of medicinal plant resources of the Yinshan area in Inner Mongolia. After discussing and analyzing the experimental results to account for the reasons for the overall trend of change and the degree of aggregation, the author further put forward relevant constructive suggestions. The results show that the areas with the most abundant and concentrated distribution of medicinal plant resources in the Yinshan area are located in Guyang county, Shiguai District of Baotou city, Tutou right banner, and Tuoketuo county; the higher richness and concentrated distribution of medicinal plant resources is in Wulate front banner, Wulate middle banner, Wulate back banner; areas with relatively low abundance and concentrated distribution of medicinal plant resources located in Qingshan district of Baotou city, Saihan district and Yuquan district of Hohhot city; areas with the lowest abundance and concentrated distribution of medicinal plant resources are located in Xincheng district and Huimin district of Hohhot city. It can be concluded that the horizontal distribution difference of multiple ecological factors, the special wetland environment of the river, the vertical difference of elevation, the farmland and other factors have an important influence on the richness of the medicinal plant resources species.
		                        		
		                        		
		                        		
		                        			China
		                        			;
		                        		
		                        			Medicine, Chinese Traditional
		                        			;
		                        		
		                        			Plants, Medicinal
		                        			
		                        		
		                        	
7.Clinical features of children with recurrent Kawasaki disease: a Meta analysis.
Gang LUO ; Si-Lin PAN ; Si-Bao WANG ; Zhan-Hui DU ; Zhi-Xian JI
Chinese Journal of Contemporary Pediatrics 2020;22(12):1306-1312
		                        		
		                        			OBJECTIVE:
		                        			To study the clinical features of children with recurrent Kawasaki disease (KD).
		                        		
		                        			METHODS:
		                        			PubMed, Web of Science, Embase, CNKI, Wanfang Med Online, and Weipu Data were searched for case-control studies on the clinical features of initial and recurrent KD. The articles were screened according to the inclusion and exclusion criteria. RevMan 5.3 software was used to perform the Meta analysis. Effect models were selected based on the results of heterogeneity test, and then pooled 
		                        		
		                        			RESULTS:
		                        			A total of 9 case-control studies were included, with 12 059 children with KD in total, among whom 206 children had recurrent KD (127 boys/61.7%; 79 girls/38.3%). The results of the Meta analysis showed that compared with the initial KD onset, the children with recurrent KD had a shorter duration of fever (
		                        		
		                        			CONCLUSIONS
		                        			Current evidence shows that children with recurrent KD tend to have a shorter duration of fever and a lower incidence of swelling of the hands and feet. KD recurrence is more common in boys. Current evidence does not show an increased risk of developing coronary artery lesions in children with recurrent KD.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Chronic Disease
		                        			;
		                        		
		                        			Coronary Vessels/pathology*
		                        			;
		                        		
		                        			Edema/etiology*
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		                        			Female
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		                        			Fever/etiology*
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		                        			Humans
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		                        			Male
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		                        			Mucocutaneous Lymph Node Syndrome/physiopathology*
		                        			;
		                        		
		                        			Recurrence
		                        			
		                        		
		                        	
8.Chromosome polymorphisms and their influence on semen quality and sperm DNA integrity in males undergoing IVF/ICSI.
Xian-Bao MAO ; Lin-Tao XUE ; Wei-Ying MO ; Yao-Xi MO ; Jun-Ping CHENG ; Shi-Kai WANG ; Yue-Yue HUANG ; Zheng-da LI ; Xiao-Hui ZHANG ; Ting-Ting ZHOU ; Ping-Pin WEI ; Wei-Hong TAN
National Journal of Andrology 2019;25(3):223-230
		                        		
		                        			Objective:
		                        			To investigate the incidence of chromosome polymorphisms and their influence on semen quality and sperm DNA integrity in male patients receiving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).
		                        		
		                        			METHODS:
		                        			We retrospectively analyzed the chromosomal karyotypes and the types and incidence rate of chromosome polymorphisms in 2 370 male patients undergoing IVF/ICSI between June 2016 and June 2018. We classified the patients into groups A (with variation in the secondary constriction region in the autosomal long arm), B (with variation in the short arm of the D/G group chromosomes), C (with interbrachial inversion of chromosome 9) and D (with Y chromosome polymorphisms), and compared the semen parameters and sperm DNA fragmentation indexes (DFI) between the patients with chromosome polymorphisms and those with normal chromosomes.
		                        		
		                        			RESULTS:
		                        			Totally, 154 (6.50%) of the patients undergoing IVF/ICSI were found with chromosome polymorphisms, including 34 cases of secondary constriction variation in the long arm of the autosome (1.43% [34/2 370], 22.08% [34/154]), 82 cases of short arm polymorphisms of the D/G group chromosomes (3.46% [82/2 370], 53.25% [82/154]), 26 cases of interbrachial inversion of chromosome 9 (1.10% [26/2 370], 16.88% [26/154]), 10 cases of Y chromosome polymorphisms (0.42% [10/2 370], 6.50% [10/154]), and 2 cases of mixed chromosome polymorphisms (0.08% [2/2 370], 1.42% [2/154]). The total sperm count was lower in group D than in the other polymorphism groups and the normal chromosome group, but with no statistically significant difference among the five groups (P > 0.05). The sperm progressive motility was also lower in group D than in the other five groups, with statistically significant difference from group B (27.5 ± 13.5 vs. 41.5 ± 21.1, P = 0.027), but not from the other groups (P > 0.05). No statistically significant difference was observed in the sperm DFI between the polymorphism groups and the normal chromosome group (P > 0.05), or among the polymorphism groups (P > 0.05). The proportion of normal semen was lower in group D than in the other four groups, but with no statistically significant difference among the five groups (P > 0.05). The incidence rate of asthenospermia was higher in group D than in the other four groups, but with no statistically significant difference among the five groups (P > 0.05), and so was that of oligoasthenospermia, with statistically significant difference from the normal chromosome group (30.0% vs 8.0%, P = 0.041), but not from the other polymorphism groups (P > 0.05).
		                        		
		                        			CONCLUSIONS
		                        			Short arm polymorphisms of the D/G group chromosomes are the most common type of chromosome polymorphisms in male patients undergoing IVF/ICSI. Polymorphisms of the Y chromosome have a negative effect on semen quality, while those of the other chromosomes do not significantly affect semen quality and sperm DNA integrity.
		                        		
		                        		
		                        		
		                        	
9. Drug resistance and molecular characteration of hemagglutinin and neuraminidase for influenza A H3N2 viruses
Shen-jiao WANG ; Xian QI ; Fei DENG ; Jie-fu PENG ; Hui-yan YU ; Yuan-fang QIN ; Qi-gang DAI ; Chang-jun BAO
Journal of Medical Postgraduates 2019;32(12):1254-1258
		                        		
		                        			
		                        			 Objective To analyze the variations and drug resistance of influenza A (H3N2) viruses in Jiangsu Province in 2017, and provide evidence for prevention and control strategies on influenza. Methods Reverse transcription polymerase chain reaction (RT-PCR) was used for the sequencing of H3N2 subtype influenza strains. The influenza reference sequences were obtained from the global shared influenza site GISAID. The sequence alignment and phylogenetic analysis were performed using MAGE7.0 software. Viral resistance was analyzed by a neuraminidase inhibition assay. Results The H3N2 subtype influenza isolates and vaccine strains belonged to the 3C.2a branch of the H3 subtype. Some of the strains showed amino acid mutations on the immune-related sites named N121K, T135K and N171K. The isolates were sensitive to the flu drugs oseltamivir and zanamivir. Conclusion The H3N2 epidemic strains in Jiangsu have genetic recombination within subtypes and are still sensitive to neuraminidase inhibitors. As the H3N2 influenza virus mutations continue, a close monitoring of the viral genetic evolution and the drug resistant genes should be guaranteed. 
		                        		
		                        		
		                        		
		                        	
10.Establishment of a predictive model for inpatient sudden cardiac death in a Chinese cardiac department population: a retrospective study.
Lu-Xiang SHANG ; Xian-Hui ZHOU ; Jiang-Hua ZHANG ; Wen-Hui ZHANG ; ZuKe-La TUER-HONG ; Yang ZHAO ; Wen-Kui LYU ; Yao-Dong LI ; Bao-Peng TANG
Chinese Medical Journal 2019;132(1):17-24
		                        		
		                        			BACKGROUND:
		                        			Little is known about the risk factors for sudden cardiac death (SCD) in the overall hospitalized cardiac department population. This study was conducted to investigate the risk factors and develop a predictive model for SCD in a hospitalized cardiac department population.
		                        		
		                        			METHODS:
		                        			We conducted a retrospective study of patients admitted to the cardiac department of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to February 2017. We collected the clinical data from medical records. Multiple stepwise logistic regression analysis was carried out to confirm the risk factors for SCD and develop a predictive risk model. The risk score was assessed by the area under receiver operating characteristic (AUROC) curve and the Hosmer-Lemeshow goodness-of-fit test.
		                        		
		                        			RESULTS:
		                        			A total of 262 patients with SCD and 4485 controls were enrolled in our study. Logistic regression modeling identified eight significant risk factors for in-hospital SCD: age, main admitting diagnosis, diabetes, corrected QT interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate. A predictive risk score including these variables showed an AUROC curve of 0.774 (95% confidence interval: 0.744-0.805). The Hosmer-Lemeshow goodness-of-fit test showed the chi-square value was 2.527 (P = 0.640). The incidence of in-hospital SCD was 1.3%, 4.1%, and 18.6% for scores of 0 to 2, 3 to 5 and ≥6, respectively (P < 0.001).
		                        		
		                        			CONCLUSIONS
		                        			Age, main admitting diagnosis, diabetes, QTc interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate are factors related to in-hospital SCD in a hospitalized cardiac department population. We developed a predictive risk score including these factors that could identify patients who are predisposed to in-hospital SCD.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Death, Sudden, Cardiac
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			Electrocardiography
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Glomerular Filtration Rate
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Inpatients
		                        			;
		                        		
		                        			statistics & numerical data
		                        			;
		                        		
		                        			Logistic Models
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		                        			Male
		                        			;
		                        		
		                        			Middle Aged
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		                        			Predictive Value of Tests
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
            
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