Objective To construct a module for drug-induced central nervous system adverse reactions(CNS-ADR)within the Clinical Adverse Drug Event Active Monitoring and Intelligent Assessment Alert System-Ⅱ(ADE-ASAS-Ⅱ),and to conduct a large-scale,real-world active monitoring and evaluation of CNS-ADR specifically related to imipenem/cilastatin.Methods Based on literature review,spontaneous report evaluation,and initial word set of CNS-ADR related descriptions in electronic medical records,text recognition technology was used to construct and optimize the condition settings of the CNS-ADR automatic monitoring module.Hospitalized patients using imipenem/cilastatin were retrospectively monitored from 2017 to 2021,and the positive patients which had CNS-ADR were statistically described in terms of the demographic characteristics,CNS symptoms,and hospital departments.Results Based on a repeated testing optimization using 1 185 manually monitored results,the best setting for the determined module includes 62 sets of keywords,with a positive predictive value(PPV)of 13.63％and a recall rate of 100％.Expanding the monitoring to 8 222 medication users using this module,281 cases of positive causality were identified,with an incidence rate of 3.42％.Among them,patients over 60 years old accounted for 50.17％,and the main manifestations of CNS-ADR were epileptic seizures,headaches,mania,and delirium.Conclusion The CNS-ADR automatic monitoring module established based on ADE-ASAS-Ⅱ provides fast and reliable text data mining support for conducting real-world research on CNS-ADR.

The incidence of sarcopenia in end-stage renal disease is high and closely related to adverse outcomes such as falls, fractures, and cardiovascular diseases in patients. End-stage renal disease and sarcopenia interact with each other, forming a vicious cycle that imposes a significant burden on the prognosis and quality of life of patients. This article reviews the status quo, pathogenesis, and non-pharmacological interventions of sarcopenia in end-stage renal disease to provide a reference for early prevention and intervention in clinical settings.

Objective To understand the incidence and characteristics of adverse drug reactions(ADRs)of carbapenems,explore the relevant risk signals,and provide a reference for clinically safe drug use.Methods All spontaneous reports of carbapenem drug-related ADRs from January 2008 to October 2022 in the Adverse Drug Reaction Monitoring Center,PLA General Hospital's ADR database were retrieved,and information such as patients'general conditions,involved systems and organs damage,and the names of ADRs involved were retrospectively analysed.Using the reporting odd ratio method,the proportional reporting ratio method,the Medicines and Healthcare Products Regulatory Agency method,and information component method to obtain risk signals of carbapenem antimicrobial drug-related ADR.Results A total of 2 642 ADR reports of carbapenems were reported,of which 410 serious ADR reports(15.52％)were serious ADR reports,five cabapenem antimirobial drug species were mainly involved.In descending order of composition were imipenem cilastatin(51.28％),meropenem(32.13％),biapenem(8.10％),ertapenem(7.68％),and panipenem(0.79％).The male to female ratio of patients was 1.74:1,with the most age＞60 years(59.69％).A total of 14"drug-ADR name"combinations generated risk signals in all four data mining methods,with meropenem being the most signals,and imipenem cilastatin and ertapenem had a high number of reported ADR in nervous system.Conclusion The results of risk signal mining are basically consistent with the known carbapenem ADR information,during the use of carbapenem antimicrobial drugs in the clinic,it is recommended to monitor patients'liver and kidney functions as well as blood biochemical indexes,so as to strengthen the awareness of vigilance in the clinical use of carbapenem antimicrobial drugs,and timely recognize and deal with ADRs in a timely manner,and to avoid the occurrence of serious ADRs.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the characteristics,clinical indicators and risk factors of levofloxacin-induced arrhythmias in large hospitalized populations.Methods Using the"Adverse Event Active Monitoring and Intelligent Assessment Alert System-Ⅱ"(ADE-ASAS-Ⅱ),the electronic medical record of inpatients using levofloxacin in 2019 was monitored to obtain relevant data for patients with arrhythmias.Patients without arrhythmia were selected by propensity score matching,and the risk factors of levofloxacin-induced arrhythmias were analyzed by univariate and multivariate conditional logistic regression.Results The incidence of levofloxacin-induced arrhythmias was 1.64％in 12 879 people who used levofloxacin.The incidence in people over 65 years was 3.22％.The main manifestations of levofloxacin-induced arrhythmias were extrasystole(0.84％),tachycardia(0.63％),QT interval prolongation(0.44％),and no severe arrhythmias such as torsades de pointes and ventricular fibrillation.Multivariate Logistic regression analysis showed that the course of administration(OR=1.030,95％CI 1.009 to 1.050,P=0.004)and intravenous administration(OR=2.392,95％CI 1.478 to 3.870,P＜0.001)independent risk factors for levofloxacin-induced arrhythmias.Conclusion Arrhythmias caused by levofloxacin are common and have various types,among which the occurrence of QT interval prolongation is occasional.We should pay more attention to elderly patients who receive intravenous levofloxacin and try to avoid long courses of medication.

In recent years, incentive spirometry has been gradually applied to prevent and reduce postoperative pulmonary complications due to its advantages of simple operation, low price and visual feedback for patients. In this paper, the use device and method of incentive spirometry, and the prevent and application status of incentive spirometry in pulmonary complications after chest, abdomen and heart surgery are reviewed, with a view to providing reference for the promotion and application of incentive spirometry in China.

OBJECTIVE To analyze the clinical manifestation and characteristics of ocular adverse drug reaction （ADR） related to dupilumab， so as to provide reference for clinically safe drug use. METHODS Retrieved from CNKI， Wanfang data， VIP and PubMed databases， the case reports about ocular ADR caused by dupilumab were collected， and then analyzed statistically in terms of gender， age， primary disease， drug use， occurrence time of ADR， main clinical manifestations， treatment or outcome， etc. RESULTS A total of 20 pieces of literature were selected， involving 46 patients， among which there were 29 males and 17 females. Mainly patients were under 60 years old. The results of the association evaluation was given as follows： 13 were “very likely” and 33 were “likely”. All patients were treated with dupilumab for atopic dermatitis （AD） without off-label medication. The occurrence time of ADR was 2 weeks to 2 years after administration， mainly within 6 months after medication. All patients received dupilumab monotherapy except that 3 patients with hypertension and 1 patient with chronic obstructive pulmonary disease and human immunodeficiency virus received other drugs simultaneously. Twenty-eight patients had a history of allergic disease， and 11 patients had a history of eye disease. Ocular ADRs were mainly conjunctivitis and uveitis， and the clinical manifestations mainly included conjunctival congestion， swelling， eye secretions， etc. Ten patients developed severe ADR， including uveitis， severe conjunctivitis， and tear point stenosis； 45 patients were improved after symptomatic treatment. AD， serious initial symptoms of AD， allergic disease and underlying ocular diseases might be the high-risk factors of ocular ADR caused by dupilumab. CONCLUSIONS Whether the patient has the history of allergic diseases and basic eye diseases should be asked in detail before clinical use of dupilumab. When using the drug， attention should be paid to monitoring whether the patient has intraocular inflammation， be alert to the occurrence of new or serious ADR， and give timely symptomatic treatment to ensure the safety of drug use.

OBJECTIVE: To investigate the characteristics and regularity of ADR induced by antineoplastic drugs and provide reference for safe drug use in clinic. METHODS: ADR reports induced by antineoplastic drugs reported by 108 hospitals during Jan. 2009-Dec. 2016 were collected from PLA ADR Monitoring Center. ADR reports were analyzed respectively in respects of types of ADR reports, patients ' gender and age, administration route, occurrence time, types of antineoplastic drug, the situation of patients suffering tumor, systems/organs involved in ADR, clinical manifestations, outcome, etc. RESULTS: Among 15 183 ADR reports, there were 462 cases of new ADR and 2 873 cases of severe ADR; there were 8 039 male (52. 95％) and 7 144 female (47. 05％). The proportion of severe ADR in female (20. 00％) was significantly higher than male (17. 96％), with statistical significance (P=0. 001). ADR was mainly induced by intravenous administration (90. 53％), and mainly occurred 2-＜7 d after medication (23. 00％). Top 3 drug categories in the list of ADR were platinum antineoplastic drugs (25. 63％), plant-derived antineoplastic drugs and its derivative (24. 42％) and anti-metabolism drugs (18. 50％). Male patients mainly suffered from lung cancer, colorectal cancer and gastric cancer; female patients mainly suffered from breast cancer, lung cancer and colorectal cancer. Systems/organs involved in ADR were gastrointestinal system, hematological system and systemic damage. Main clinical manifestations were nausea, vomiting, myelosuppression, skin rash and fever. Totally 92. 57％ of ADR cases were cured and recovered after treatment, and 5 cases died. CONCLUSIONS: Antineoplastic drugs have high incidence of ADR with serious damage. Clinic should strengthen the monitoring of key population and key drugs so as to reduce the occurrence of ADR.

Objective To prepare a gelatin hydrogel crosslinked by genipin and loaded with silver sulfadiazine(AgSD) nanoparticles,and test its in vitro anti-bacterial activities and in vivo wound healing enhancing properties. Methods The suspension of AgSD nanoparticles and coarse powder,hydrogels loaded with AgSD nanoparticles and coarse powder were prepared,respectively, and blank gels were used as control. The diameters of inhibition zone of sensitive bacteria were measured;The biocompatibility to L929 cells was studied by MTT method and relative growth rates of the cells were determined. The minimum inhibitory concentration (MIC)and minimum bactericidal concentration(MBC)of 3 sensitive bacteria were tested;DeepⅡdegree scald co-aureus infection mice model was established and the healing index of treatment by drug-loaded hydrogel dressing was calculated within 3 weeks. The collagen deposition was studied after sirius red staining and pathological manifestations were observed after HE staining. Results Compared with AgSD coarse powder,the antibacterial property of AgSD nanoparticles obviously improved in inhibition zone and MIC, MBC experiments. Better biocompatibility and antibacterial property were revealed for AgSD nanoparticles gel group compared with AgSD cream group in MTT assay and inhibition zone studies;Healing index increased significantly since the second week in AgSD nanoparticles gel group compared with staph group,AgSD cream group and AgSD coarse powder gel group in wound-healing experi-ment(P<0.05). Compared with those control groups,nanocrystal gel group had more content of typeⅠcollagen and total collagen, and higher pathology scores(P<0.05). Conclusion AgSD nanocrystal loaded gelatin hydrogel has good antibacterial activity in vitro and high quality healing enhancing property in vivo.

Objective To prepare a silver sulfadiazine(AgSD)-nanocrystal loaded hydrogel with gelatin as the main raw mate-rial,genipin as crosslinker,and test its physicochemical property and drug release characteristics. Methods AgSD-nanocrystal was prepared by ball milling,the particle size and polydispersity index were determined,the solubility was studied by an ultra perfor-mance liquid chromatography(UPLC)method and the microstructure was observed with transmission electron microscope(TEM);drug loaded gelatin hydrogel in different crosslinking degrees were prepared,the dissolution rate was studied in the same way as AgSD-nanocrystal and the possible dissolution mechanism was analyzed by fitting curves;the microstructure was observed by scanning elec-tron microscope(SEM). After 6 weeks,with the same method,all the above mentioned properties of drug loaded hydrogel and AgSD-nanocrystal suspension were determined repeatedly,and at the same time their stability was tested. Results After nanocrystalliza-tion,the polydispersity index of AgSD was 0.211,the mean particle size was about 267.8 nm,the dissolution rate greatly increased within 6 hours compared with that of AgSD bulk powder. There was a negative correlation between dissolution rate and crosslinking de-gree,and the nanoparticle gel's curve was higher than that of the bulk. In terms of stability,AgSD-nanocrystal in hydrogel was almost in the original state in SEM,while those in suspention had an increasing particle size and decreasing dissolution rate. Conclusion The stability and dissolution of the new drug loaded hydrogel are good,and its data can be used as reference for relevant study.