OBJECTIVE To excavate the adverse drug event （ADE） signals of three third-generation tetracycline antibiotics （tigecycline， omadacycline， eravacycline） based on FDA adverse event reporting system （FAERS）， and to provide reference for the safe use of them. METHODS The ADE reports of tigecycline， omadacycline and eravacycline from the first quarter of 2005 to the second quarter of 2023 were retrieved from FAERS database. The ADE signals of 3 kinds of drugs were mined by the method of reporting odds ratio method and the proportional reporting ratio method. RESULTS Totally 2 538 ADE reports with tigecycline， omadacycline and eravacycline as the primary suspected drugs were obtained， including 2 135 tigecycline ADE reports， 349 omadacycline ADE reports and 54 eravacycline ADE reports. A total of 131 ADE positive signals of tigecycline were mined， involving 19 system organ classes （SOCs）， mainly concentrated in investigations， hepatobiliary system， blood and lymphatic system， and gastrointestinal system， etc； the preferred terminologies （PT） with intense signal were hypofibrinogenaemia and blood fibrinogen decreased. Fourteen ADE signals were not mentioned in the drug instruction， such as renal failure， acute kidney injury and hemorrhage. Totally 24 ADE positive signals of omadacycline were mined， involving 6 SOCs， mainly concentrated in the gastrointestinal system and various examinations； the PTs with intense signals were tooth discoloration， jet-like vomiting and loose feces， etc. ADE signals were not mentioned in the drug instructions， included lip swelling， gastroesophageal reflux disease， eosinophilia， skin discoloration， feces softening， and night sweats. Five ADE positive signals of eravacycline were mined， involving 4 SOCs， mainly concentrated in various examinations， gastrointestinal system， etc. The most intense ADE signals were blood fibrinogen decreased and hypofibrinogenaemia. CONCLUSIONS ADE of the gastrointestinal system are mostly identified in the three third-generation tetracycline antibiotics， especially pancreatitis caused by tigecycline and gastroesophageal reflux disease caused by oral administration of omadacycline. The liver function， renal function （for tigecycline） and coagulation function （for tigecycline， eravacycline） should be monitored biyiliang@hotmail.com regularly during medication， so as to prevent the occurrence of serious ADE.

Background and purpose:Colorectal carcinoma(CRC)is a common malignant tumor with incidence and mortality rates second only to gastric cancer and esophageal cancer among digestive system malignancies.Increasing evidence suggests that immune cells play a significant role in the occurrence and development of CRC.The aim of this study was to construct a prognostic model related to immune cell-associated genes to predict the prognosis of CRC patients and enable precise management.Methods:Single-cell RNA sequencing(scRNA-seq)and bulk RNA sequencing(RNA-seq)data,along with clinical information for colorectal cancer,were downloaded from the Gene Expression Omnibus(GEO)and The Cancer Genome Atlas(TCGA)databases.Differential genes of immune cell subtypes were extracted,and genes related to prognosis were screened in TCGA data using Cox regression and LASSO regression,with external validation using GSE39582 and GSE41258.The prognostic model was used to analyze chemotherapy drug sensitivity,assess immunotherapy efficacy,analyze pathways related to risk scores,and perform clinical correlation analysis.Finally,the expression levels of model genes were validated in 10 fresh frozen CRC tissues with post-operative pathological examination and cell lines using real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR)and immunohistochemistry.All samples were approved by the Fudan University Shanghai Cancer Center Ethics Committee(No.050432-4-2108*).Results:We defined 16 cell clusters based on the scRNA-seq dataset(GSE161277)and labeled these clusters as different cell types using the R package celldex.Differential analysis of immune cell subtypes yielded 374 differentially expressed genes.Using univariate Cox and LASSO analyses,we constructed a 9-gene risk prognostic model in CRC.This risk model exhibited reliable prognostic prediction performance and played an important role in predicting anti-tumor drug sensitivity,immunotherapy efficacy,potential molecular mechanisms,and clinical characteristics.Patients with high-risk scores had a lower probability of benefiting from immunotherapy.Conclusion:We constructed a 9-gene risk prognostic model based on the heterogeneity of immune cells in the CRC tumor microenvironment,which predicted the survival and treatment outcomes of CRC patients.

Objective To compile nursing guidelines for diabetic patients undergoing ultrasound-guided islet transplantation through percutaneous portal vein puncture and catheterisation,providing valuable insights for the care of such patients during the surgical procedure.Methods Between December 2017 to September 2023,a total of 27 patients underwent 44 surgical procedures for ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation at our hospital.Nursing assistance was provided preoperatively,intraoperatively and postoperatively for all the procedures.Results All 27 patients who had undergone 44 surgical procedures successfully went through the ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation.Among the 44 surgical procedures,3(6.8%)resulted in upper abdominal and liver area pain,nausea and vomiting during surgery,8(18.2%)had transient increase of portal vein pressure during transplantation,and 6(13.6%)encountered active bleeding following the removal of the portal vein catheters.None of the patients developed delayed portal vein bleeding or complication such as portal vein thrombosis after the surgery.Conclusions Nursing interventions play a crucial role in ensuring the successful outcomes of ultrasound-guided islet transplantation.Following measures are the keys and they play an important roles in ensuring the smooth completion of ultrasound-guided islet transplantation:preoperatively,carefully assess the condition of recipients and provide them with psychological supports and patient education.Intraoperatively,closely monitor the vital signs,portal vein pressure and blood glucose as well as to prevent complications.Postoperatively,implement the nursing measures to prevent the recipients from postoperative bleeding of portal vein.

Clinical data of 15 primary central nervous system lymphoma (PCNSL) children aged ≤18 years admitted to our hospital between May 2013 to May 2023 were retrospectively analyzed. Our goal was to summarize the clinical features of children and investigate the therapeutic effect of a high-dose methotrexate (HD-MTX) based chemotherapy regimen on this disease. The male-to-female ratio was 2.7∶1, and the median age was 7.2 (2.3-16.4) years at diagnosis. The initial clinical symptoms were primarily cranial hypertension, with imaging findings revealing multiple lesions. Pediatric PCNSL with normal immune function has a favorable prognosis with HD-MTX-based chemotherapy. Patients with a stable disease can be treated with minimal or no maintenance. HD-MTX-based chemotherapy remains effective when the disease progresses or recurs after an initial course of non-HD-MTX-based chemotherapy.

Objective To investigate the effect and mechanism of Rougan Huaxian particle on hepatic fibrosis.Methods SD rats were divided into normal group,model group,normal saline control group,Rougan Huaxian particle low,middle,high dose group,Rougan Huaxian particle middle dose+3-MA group.Liver fibrosis model was induced by intraperitoneal injection of CCl4.Rougan Huaxian particle was administered with low,middle and high dose(2.5 mg·kg-1,5 mg·kg-1,10 mg·kg-1)and 3-MA(15 mg·kg-1)respectively.The expression of miR-135a,FOXO1,PINK1,Parkin,LC3 II,Smad2,p-Smad2,TGF-β1,NF-κB p65,p-NF-κB p65,α-SMA,Collagen I,Collagen III,TNF-α and the content of ROS were detected by Real-time PCR,Western Blot and ELISA.Results The expression of miR-135a,α-SMA,Collagen I,Collagen III,p-Smad2,TGF-β1,p-NF-κB p65,TNF-α and ROS in model group were significantly up-regulated(P<0.05),and the expression of FOXO1,PINK1,Parkin,LC3 II were significantly down-regulated(P<0.05).The middle and high dose of Rougan Huaxian particle could significantly inhibit the expression of miR-135a,α-SMA,Collagen I,Collagen III,p-Smad2,TGF-β1,p-NF-κb p65,TNF-α and ROS,and up-regulate the expression of FOXO1,PINK1,Parkin,LC3 II(P<0.05).The expression of miR-135a,α-SMA,Collagen Ⅰ,Collagen Ⅲ,p-Smad2,TGF-β1,p-NF-κB p65 and TNF-α and the production of ROS were significantly inhibited in the medium and high dose groups.Up-regulated expression of FOXO1,PINK1,Parkin and LC3Ⅱ(P<0.05).The effect of Rougan Huaxian Particle in middle dose group was stronger than that in low dose group(P<0.05),and there was no significant difference between middle and high dose groups.Mitophagy inhibitor(3-MA)could significantly inhibit the efficacy of rougan Huaxian particle(P<0.05).Conclusion Ruugan Huaxian granules can inhibit liver fibrosis,and its mechanism is related to the inhibition of miR-135a expression,activation of FOXO1/PINK1 pathway,promotion of mitochondrial autophagy,inhibition of oxidative stress response,and inhibition of TGF-β1/Smad2 activation.

Objective:To evaluate the efficacy and safety of brentuximab vedotin (BV) combined with rituximab and attenuated chemotherapy in the treatment of children with classic Hodgkin lymphoma (cHL).Methods:A prospective, non-randomized, risk-assigned study. Clinical data (including age, gender, B symptoms, bulky disease, CD30 and Epstein-Barr virus-encoded RNA(EBER) expression, clinical stage, risk stratification, etc.) of 28 intermediate to high-risk cHL children diagnosed and treated at Beijing Children′s Hospital Affiliated to Capital Medical University from October 2022 to May 2024 were collected. Immuno-targeted combined with attenuated chemotherapy was administered based on risk stratification and early treatment response. The patients were followed up until May 1st, 2024. The infusion reactions and adverse reactions after treatment were recorded.Results:In all 28 patients, there were 22 males and 6 females, the age was 12 (5,16) years, 16 cases (57%) presented with bulky disease and 10 cases (36%) with B symptoms. The most common pathological type was nodular sclerosis (14 cases, 50%). There were 7 cases of stage Ⅱ, 14 cases of stage Ⅲ and 7 cases of stage Ⅳ according to the Ann Arbor staging system. There were 5 cases in the intermediate-risk group and 23 cases in the high-risk group. EBER was positive in 20 cases (71%) and negative in 6 cases (21%), and CD30 antigen was expressed in tumor cells of all enrolled children. Treatment duration: 5 cases (18%) received 4 courses of treatment, 21 cases (75%) received 6 courses of treatment, and 2 cases (7%) received 8 courses of treatment, 25 cases (89%) achieved complete metabolism response (CMR) through early assessment after 2 courses of chemotherapy. The CMR rates were 100% in intermediate-risk group and 87% (20/23) in high-risk group, respectively. Four patients (14%) finally received residual field radiotherapy. Toxicities included grade Ⅰ-Ⅱ myelosuppression, early infusion reaction and mild peripheral neuropathy, only one case of grade 3 adverse events was recorded and did not affect sequential treatment. At the end of treatment and 3 months of follow-up, the levels of IgA, IgG and IgM were all decreased compared with the baseline before chemotherapy, and the total B cell count began to be lower than the level before chemotherapy at the early stage of treatment (after 2 courses). The total B cell count monitored during treatment was 50 (0, 101)×10 6/L and was 12 (0, 25)×10 6/L at the end of treatment. The follow-up time was 6 (3, 13) months, all 28 children had event-free survival and all achieved complete remission. At 6 and 9 months of follow-up, IgA, IgG, IgM and total B cell counts returned to pre-chemotherapy baseline levels, respectively. Conclusion:BV combined with rituximab attenuated chemotherapy has demonstrated efficacy and a tolerable safety profile in the treatment of cHL in children, and significantly reduce radiation rate.

ObjectiveTo compare the diagnostic accuracy of five different weighting methods of Chinese medicine syndrome and then analyze their diagnostic efficacy and characteristics， by taking Diagnostic Standard for Type 2 Diabetes Mellitus （T2DM） with Dampeness-heat Syndrome （abbreviated as diagnostic standard） as an example. MethodsData from expert questionnaire on the diagnostic standard and a cross-sectional survey of 1021 patients were collected. The comparative diagnostic test accuracy （CDTA） method was used to calculate the area under the ROC curve （AUC）， area under the PR curve （AUPR）， accuracy （ACC）， sensitivity， and specificity of five commonly used weighting methods in two categories， including knowledge-driven weighting methods （expert scoring synthesis method， analytic hierarchy process， and precedence chart method） and data-driven weighting methods （logistic regression contribution method and entropy weighting method）. ResultsAmong 1021 patients with T2DM， 389 cases were diagnosed as dampness-heat syndrome. The expert scoring synthesis method， analytic hierarchy process method， and precedence chart method were basically consistent in the weight scores of each item. The expert scoring comprehensive method， analytic hierarchy process method， and entropy weighting method have a smaller difference in the weight scores of each item， while there was larger difference in the weight scores of each item of the precedence chart method and the logistic regression contribution method. The AUC （95% CI）， AUPR， ACC， sensitivity， and specifi-city of the expert scoring synthesis method were 0.913 （0.893， 0.932）， 0.851， 0.870， 0.868 and 0.875， respectively； while those of the analytic hierarchy process method were 0.910 （0.890， 0.930）， 0.838， 0.879， 0.848 and 0.896； of the precedence chart method were 0.919 （0.900， 0.937）， 0.858， 0.875， 0.871 and 0.875； of the logistic regression contribution method were 0.867 （0.842， 0.891）， 0.792， 0.853， 0.769 and 0.898； and of the entropy weighting method were 0.895 （0.873， 0.916）， 0.820， 0.869， 0.802 and 0.908. ConclusionThe knowledge-driven weighting methods are better than the data-driven weighting methods in terms of diagnostic efficacy and reflecting expert experience.

【Objective】 To analyze the hepatitis B virus (HBV) infection data of blood donors from 18 domestic blood stations, so as to investigate the HBV infection situation of blood donors. 【Methods】 The positive rate of HBV and its distribution characteristics of regions, the percentage of HBsAg+ ELISA in first-time vs repeated blood donors, and the percentage of HBsAg-/HBV DNA+ blood donors of 18 domestic blood stations during 2017 to 2020 were collected from the Working Platform for Practice Comparison of Blood Centers, and the HBV infection among blood donors were statistically analyzed. 【Results】 From 2017 to 2020, the positive rate of HBV in blood donors among 18 domestic blood stations was 13.48/10 000-144.02/10 000, with the average HBV positive rate in eastern, central and western region at 26.14/10 000, 51.98/10 000 and 41.00/10 000, respectively. The HBsAg+ rate by ELISA among first-time and repeated blood donors was 14.55/10 000-305.39/10 000 vs 1.04/10 000-87.43/10 000 The HBsAg-/HBV DNA+ yield was 1.80/10 000-35.31/10 000. 【Conclusion】 The distribution of HBV infection in blood donors has regional characteristics, and HBV prevalence was low in repeated blood donors. HBsAg ELISA combined with HBV DNA detection can better ensure blood safety.

Humans ; Vaccines, Inactivated ; COVID-19/prevention & control* ; Vaccination ; Viral Vaccines ; Immunity ; Antibodies, Viral

This study conducted a bibliometric analysis of the literature related to the field of hemodialysis arteriovenous fistula from the Web of Science database. The current and future research hotspots and development trends in this field were visualized by sorting and interpreting the research data and drawing a visualization chart. This study suggests that there are certain academic barriers between China and developed countries, and international multicenter clinical trials should be conducted in the future with early identification of arteriovenous fistula dysfunction and emerging diagnostic tools as the academic development direction.