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

Aortic Valve ; Aortic Valve Stenosis/surgery* ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Risk Factors ; Transcatheter Aortic Valve Replacement ; Treatment Outcome

AIM: To compare the efficacy and safety of dexamethasone intravitreal implant combined with anti-VEGF drug and anti-VEGF drug monotherapy in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).METHODS: A total of 133 patients(133 eyes)diagnosed with central retinal vein occlusion(CRVO)or branch vein occlusion(BRVO)secondary to macular edema in the Xiamen Eye Center of Xiamen University from June 2019 to December 2020, including 48 patients with CRVO-ME and 85 patients with BRVO-ME were analyzed. All patients were randomly assigned to monotherapy or combination therapy. The monotherapy group(66 eyes)received a monthly injection of conbercept for consecutive 3mo, followed by monthly follow-up visits; The combination therapy group(67 eyes)received once intravitreal dexamethasone implantation, and conbercept was injected once 1wk later, followed by monthly follow-up visits.All patients in the two treatment groups were evaluated at baseline and every subsequent visit until 6mo after treatment with the best corrected visual acuity(BCVA), macular central retinal thickness(CRT), and injection times of conbercept and ocular and systemic adverse events associated with intravitreal injection therapy were recorded.RESULTS: At 1, 2, 3 and 6mo after treatment, the BCVA and CRT in both groups were significantly improved than before.But there was no significant difference in the improvement of BCVA and CRT(P >0.05). From the initial intravitreal injection to 6mo, the injection times of the monotherapy group and the combination therapy group were 3.56±0.12 and 2.96±0.17 times, respectively. The injection times of the combination therapy group were significantly lower than those of the monotherapy group(P=0.004). Both the incidences of intraocular hypertension and cataract in the combination therapy group were higher than those in the anti-VEGF monotherapy group.CONCLUSION: dexamethasone intravitreal implant combined with anti-VEGF drugs is an effective method for the treatment of RVO-ME, with significantly improved visual acuity and significantly lower CRT; The combined treatment regimen can reduce the times of injections and achieve similar results to anti-VEGF drug monotherapy. However, monitoring of intraocular pressure and cataract progression is required.

ObjectiveTo investigate the efficacy and safety of sertraline combined with low-dose aripiprazole in the treatment of obsessive-compulsive disorder in children and adolescents. MethodsA total of 62 cases pediatric patients aged 9~16 years who attended the outpatient clinic of a psychiatric hospital in Xiamen from June 2018 to May 2020 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for obsessive-compulsive disorder were enrolled in the study. The selected children were randomly classified into two groups for different treatments. Control group （n=30） received sertraline monotherapy， and study group （n=32） received sertraline combined with low-dose aripiprazole treatment. At the baseline and the end of the 2^nd， 4^th， 8^th and 12^th weeks of treatment， children were assessed using Children's Yale-Brown Obsessive Compulsive Scale （CY-BOCS） and Treatment Emergent Symptoms Scale （TESS）. Thereafter， the clinical efficacy and adverse reactions were compared between two groups. ResultsThe compulsive behavior dimensional score of CY-BOCS of study group was lower than that of control group at end of the 2^nd and 4^th weeks of treatment （t=-2.083， -2.176， P<0.05）. At the end of the 2^nd week of treatment， the effective rate was 40.63% in study group， which was significantly higher than 3.33% in control group （χ²=12.317， P<0.01）. By the end of the 12^th weeks of treatment， the incidence rate of side effects yielded no statistical difference between two groups （χ²=1.608， P=0.205）. ConclusionCompared with sertraline monotherapy， its combination with low-dose aripiprazole treatment can effectively accelerate the improvement of clinical symptoms in childrenand adolescents with obsessive-compulsive disorder， while the combination therapy and sertraline monotherapy have equivalent safety.

AIM: To investigate the efficiency and safety of 3D visualization assisted phacoemulsification combined with intraocular lens(IOL)implantation. METHODS: Prospective non-randomized controlled clinical study. A total of 100 patients(103 eyes)who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Among them, according to the way of surgery chosen by the participants, 24 cases(25 eyes)were enrolled from January to March 2020(3D-1 group), 24 cases(25 eyes)were enrolled from April to June 2020(3D-2 group), and 52 cases(53 eyes)were enrolled from January to June 2020(binocular microscope group)as the control group. Total operative time, capsulorhexis time, phacoemulsification operation time, cortical aspiration time, IOL implantation time, viscoelastic agent aspiration time, ultrasound time(UST), cumulative dissipated energy(CDE), fluid flow loss, intraoperative and postoperative complications were recorded in the three groups. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP)and corneal endothelial cell count(CECC)were recorded preoperatively and 1mo postoperatively. RESULTS: The total operative time, the time of capsulorhysis, the operation time of phacoemulsification, and the time of removing viscoelastic agent between 3D-1 group and control group were statistically significant(all P<0.01). There were no significant differences in the total operation time and each operation step time between the 3D-2 group and the control group(all P>0.05). The differences of UST, liquid flow loss, and CDE between 3D-1 group and the control group were statistically significant(all P<0.05). There were no significant differences between the 3D-2 group and the control group in intraoperative parameters(all P>0.05). There were no statistical significances in UCVA, BCVA, IOP, and CECC among the three groups 1mo after surgery(all P>0.05). CONCLUSION: Phacoemulsification combined with IOL implantation using 3D visualization technology is safe and feasible. After a certain learning curve period, there is no significant difference in the surgical efficiency compared with traditional binocular surgery.

Primary angle-closure glaucoma(PACG)is one of the most common types of sight-threatening glaucoma. Patients with PACG often have abnormal ocular anatomical variations when compared to normal subjects. With the development of ophthalmic imaging technology, the knowledge is accumulating on the correlation between ocular biometric parameters and PACG pathogenesis and development. It is now known that parameters such as the anterior chamber(AC)depth, AC area, AC volume, AC width, AC angle parameters, iris parameters, lens thickness and positioning, lens vault, ciliary body positioning and thickness, and choroid thickness are all correlated with the pathogenesis of PACG. The associations between PACG and corneal thickness, corneal curvature and corneal diameter need to be further confirmed. Research on the ocular biometry measurement plays important role in the prevention and treatment of PACG.

【Objective】 To analyze the influencing factors of the repeat reactive (RR) rates of minipools implicated in minipool (MP) nucleic acid testing(NAT) in Xiamen Blood Center, in order to provide reference for NAT. 【Methods】 Samples of blood donors from January 1, 2019 to October 31, 2022 were collected in Xiamen Blood Center and tested by MP-NAT(pools of six). Statistical analysis and comparison of MP-NAT RR rates was performed among different years, testers, reagent batches, instrument combinations, CT values of MP-NAT reactive pools and sample backgrounds. 【Results】 A total of 234 715 blood samples were tested by MP-NAT, and 428 pools were reactive, in which 248 pools were individual-donor NAT reactive, with a MP-NAT RR rate of 57.9%. The difference of MP-NAT RR rates were not statistically significant among different years, testers, reagent batches, instrument combinations, and sample backgrounds (P> 0.05). The difference of MP-NAT RR rates among different CT values of MP-NAT reactive pools was statistically significant (χ²=69.587, P<0.05). Significantly abnormal RR rate accurred in two months in 2022, and returned to normal after timely handling. 【Conclusion】 The MP-NAT RR rates is one of the important indicators to monitor the quality of NAT. Once there is a significant change in the MP-NAT RR rates, comprehensive analysis and timely handling should be carried out to ensure the quality of blood detection.

Objective: To evaluate the safety and immunogenicity of hepatitis E vaccine(HEV)in Maintenance hemodialysis(MHD)patients. Methods: Based on an open-labeled controlled trial, from May 2016 to March 2018, 35 eligible MHD patients were recruited in the Hemodialysis Center of Zhongshan Hospital Affiliated to Xiamen University as the experimental group, and 70 MHD patients with matched age, gender and underlying diseases as the control group. The experimental group received HEV at 0, 1 and 6 months according to the standard vaccination procedures, while the control group received routine diagnosis and treatment without vaccine and placebo injection to observe the safety and immunogenicity of the vaccine. The safety of vaccine in MHD population was evaluated by the incidence of adverse reactions/events in the experimental and control groups. The immunogenicity of HEV in MHD patients was evaluated by comparing the data from the phase Ⅲ clinical trial. Results: The overall incidence of adverse reactions/events was 17.1% (18/105), and there were no grade 3-4 adverse reactions/events related to vaccination. In the experimental group, the incidence of local adverse reactions/events was 20.0% (7/35), and the incidence of systemic adverse reactions/events was 17.1% (6/35).There was no significant difference in the incidence of systemic adverse reactions/events between the experimental group and the control group (P>0.05). There were 23 patients receiving 3 doses with the standard schedule. The positive rate of HEV-IgG antibody was 100% and the GMC was 14.47(95%CI:13.14-15.80) WU/ml, which showed no significant difference compared with the 46 patients in Phase Ⅲ clinical trial (t=-1.04, P>0.05). Conclusion: Recombinant HEV has good safety and immunogenicity in MHD patients.
Clinical Trials, Phase III as Topic ; Female ; Hepatitis E ; Humans ; Immunogenicity, Vaccine ; Immunoglobulin G ; Male ; Renal Dialysis ; Viral Hepatitis Vaccines/adverse effects*

A dispensing cabinet of total nutrient admixture is introduced in this paper. Which can be used for nutrient solution dispensing. The clinical application shows that it can provide a practical, simple, safe and satisfactory sterile environment.
Equipment Design ; Equipment and Supplies ; Humans ; Parenteral Nutrition, Total ; Pharmacy Service, Hospital ; Solutions ; Sterilization

OBJECTIVE To assess the correlation between the steady-state minimal concentration （cmin） and 24 h area under the drug concentration-time curve （AUC24）/minimal inhibitory concentration （MIC） ratio （AUC24/MIC） of vancomycin in pediatric patients， and analyze independent risk factors for treatment failure. METHODS Data of hospitalized children treated with vancomycin and receiving therapeutic drug monitoring in our hospital from January 2021 to July 2024 were retrospectively collected and divided into success group and failure group according to whether the treatment was successful or not. Spearman correlation analysis was used to analyze the correlation between cmin and AUC24/MIC of vancomycin， and one-way and multifactorial Logistic regression analyses were used to screen the independent risk factors for vancomycin treatment failure. RESULTS A total of 59 children were included， with 41 in the success group and 18 in the failure group. Compared with the failure group， AUC24/MIC of vancomycin was significantly higher in the success group （P＝0.038）， but there was no statistically significant difference in the cmin of the two groups （P＞0.05）； cmin of vancomycin was significantly positively correlated with AUC24/MIC （r＝0.499， P＜0.001）， but it has a certain efficacy in predicting the achievement of the AUC24/MIC standard （≥400） （area under the receiver operator characteristic curve＝0.696）， with an optimal cutoff value of 6.05 mg/L determined by the Youden index. The efficacy of AUC24/ MIC in predicting treatment failure was superior to cmin （areas under the receiver operator characteristic curve were 0.671 vs. 0.523， P were 0.038 vs. 0.684）， with higher sensitivity （83.3% vs. 66.7%）. Hypoproteinemia and AUC24/MIC≤369.1 were independent risk factors for vancomycin treatment failure （P＜0.05）. The incidence of nephrotoxicity was 3.4%. CONCLUSIONS There is a significant positive correlation between cmin and AUC24/MIC of vancomycin in pediatric patients； hypoproteinemia and AUC24/MIC≤369.1 are independent risk factors for vancomycin treatment failure in children.