Hematopoietic stem cell transplantation (HSCT) has been widely performed for patients with various genetic and acquired malignant and non-malignant diseases.Central nervous system (CNS) complications are considered an important cause of morbidity and mortality after HSCT.This review discuss the main causes of CNS after HSCT such as infection,drug toxicity,graft-versus-host disease,metabolic encephalopathy,neurologic relapses etc,so as to benefit the early recognition of CNS complications and to improve the prognosis of patients after HSCT.

Objective:To monitor the effects of intervention and management on the quality of life and the incidence of cardiovascular events in patients with chronic heart failure in the community setting.Methods:Based on questionnaire data, 200 patients with chronic heart failure in the community were randomly divided into an observation group and a control group, with 100 cases in each group.The control group was followed up for routine health information collection at home, while the observation group received standardized community intervention for patients with chronic heart failure.The awareness rate of heart failure, rate of patients receiving drug treatment, rate of standardized drug utilization, cardiac function, satisfaction with quality of life and incidence of cardiovascular events were compared between the two groups.Results:Scientific intervention for community-dwelling patients with chronic heart failure was able to significantly improve standardized drug usage and quality of life( P<0.05).Compared with the control group, patients in the observation group showed a significantly lower probability of cardiovascular events and more favorable results measured with parameters such as blood pressure, blood glucose and heart rate after intervention.Especially noteworthy was that the effective control rate of blood pressure in the observation group reached 72.4%, which was much higher than 45.9% in the control group( χ2=14.543, P<0.05), the effective control rate of blood glucose in the observation group reached 69.4%, which was much higher than 32.7% in the control group( χ2=12.588, P<0.05), and the effective control rate of heart rate in the observation group(80.6%)was much higher than in the control group(53.1%)( χ2=13.137, P<0.05).The observation group also had better results than the control group in quitting smoking, eating a low-salt, low-fat diet, and regularly measuring blood pressure, blood glucose and body fat percentage.The MNLF score in the control group(31.21±3.01)was higher than that in the observation group(22.66±2.87), and the difference was statistically significant( t=7.26, P<0.05).The LiHFe score in the control group(39.85±6.09)was lower than that in the observation group(71.36±4.32), and the difference was statistically significant( t=18.44, P<0.05).The observation group had lower readmission frequency(46.9% vs.29.6%)and incidence of cardiovascular events(56.1% vs.31.6%)than the control group and the difference was statistically significant( χ2=12.64, 15.01, both P<0.05). Conclusions:The establishment of community intervention and management for patients with chronic heart failure can significantly improve the awareness rate of heart failure, rate of drug treatment, rate of standardized drug usage, self-management ability and quality of life, and reduce the incidence of cardiovascular events.The practice should be promoted in communities.

OBJECTIVE To evaluate the influence of pharmaceutical quality control on the efficiency and outcomes of standardized medication therapy management （MTM） services for patients with coronary heart disease by using Economic， Clinical and Humanistic Outcomes （ECHO） model. METHODS This study collected case data of coronary heart disease patients who received MTM services during January-March 2023 （pre-quality control implementation group， n＝96） and June-August 2023 （post-quality control implementation group， n＝164）. Using propensity score matching analysis， 80 patients were selected from each group. The study subsequently compared the economic， clinical， and humanistic outcome indicators of pharmaceutical services between the two matched groups. RESULTS There were no statistically significant differences in baseline data between the two groups after matching （P＞0.05）. Compared with pre-quality control implementation group， the daily treatment cost （16.26 yuan vs. 24.40 yuan， P＜0.001）， cost-effectiveness ratio [23.12 yuan/quality-adjusted life year （QALY） vs. 32.32 yuan/QALY， P＜0.001]， and the incidence of general adverse drug reactions （2.50% vs. 10.00%， P＝0.049） of post-quality control implementation group were decreased significantly； the utility value of the EuroQol Five-Dimensional Questionnaire （0.74± 0.06 vs. 0.71±0.07， P＝0.003）， the reduction in the number of medication related problems （1.0 vs. 0.5， P＜0.001）， the medication adherence score （[ 6.32±0.48） points vs. （6.10±0.37） points， P＝0.001]， and the satisfaction score （[ 92.56±1.52） points vs. （91.95±1.56） points， P＝0.013] all showed significant improvements. Neither group experienced serious adverse drug reactions. There was no statistically significant difference in the incidence of new adverse reactions between the two groups （1.25% vs. 3.75%， P＝0.310）. CONCLUSIONS Pharmaceutical quality control can improve the quality of pharmaceutical care， and the ECHO model can quantitatively evaluate the effect of MTM services， making pharmaceutical care better priced and more adaptable to social needs， thus being worthy of promotion.

Objective: To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy. Methods: This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer′s protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS. Results: There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109). Conclusion There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.