Objective:To apply combined serological diagnostic methods for anti-BP180-type and anti-laminin 332 (Ln332) -type mucous membrane pemphigoid (MMP), and to summarize their clinical and immunoserological characteristics.Methods:A retrospective analysis was conducted on the data from 52 patients clinically suspected of having MMP at the Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2017 to February 2022. Serum samples were collected, and combined serological tests, including indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting, were performed to analyze the immunoserological and clinical characteristics of the patients. The Fisher′s exact test was used to compare the lesion occurrence rates between groups.Results:Among the 52 patients clinically suspected of MMP, 32 (61.5%) were diagnosed with anti-BP180-type MMP, 10 (19.2%) with anti-Ln332-type MMP, and 4 (7.7%) with anti-BP180- and anti-Ln332-type MMP due to the presence of both anti-BP180 and anti-Ln332 antibodies; 2 tested positive for IgG on the epidermal side of salt-split skin, but no target antigens were identified by serological tests, and they were diagnosed with MMP (subtype pending) ; 4 tested negative by immunoserological tests. Ocular involvement was observed in 6 out of 10 patients with anti-Ln332-type MMP, whereas only 6 out of 32 anti-BP180-type MMP patients (18.8%) had ocular symptoms, and there was a significant difference in the occurrence rate of ocular involvement between the two groups ( P = 0.02) ; the occurrence rates of nasal involvement and multi-mucosal involvement were significantly higher in the anti-Ln332-type MMP patients (50%[5/10], 90%[9/10], respectively) than in the anti-BP180-type MMP patients (0, 25%[8/32], respectively, both P < 0.001). Scar formation occurred in 6 out of 10 anti-Ln332-type MMP patients, but occurred in only 6 out of 32 anti-BP180-type patients (18.8%, P = 0.02) . Conclusion:The combination of indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting could effectively identify anti-BP180 and anti-Ln332 autoantibodies in MMP patients, with BP180 being the most common target antigen; compared with anti-BP180-type MMP, anti-Ln332-type MMP appeared to be more frequently involve the ocular and nasal mucosae, associated with the involvement of multiple mucosal sites, carrying a higher risk of scar formation.

To standardize the management of medication errors in medical institutions,the Pharmaceutical Specialized Committee of the Chinese Hospital Association led the formulation of the Pharmacy Management—Adverse Drug Reaction Manage-ment—Medication Error Management.The formulation process referred to national regulations,policies,books,and consensus on medication error management.This article described the development process of this standard and provided an in-depth analysis of its key contents.It aimed to guide and inform medical institutions,helping them thoroughly understand and master the requirements for medication error management.The article enhanced the management of medication errors and ensured the safety and effective-ness of medication.

To standardize the management of adverse drug reactions in medical institutions and ensure medicine safety,based on relevant national regulations,normative documents,international and domestic adverse drug reaction management guide-lines,and expert opinions,the Chinese Hospital Association Pharmaceutical Specialized Committee led the development of the ad-verse drug reaction management standard.This article elaborated on the formulation process of this standard and provides an in-depth analysis of its key contents.It aimed to offer guidance and reference for medical personnel,helping them to thoroughly under-stand and master the management requirements of adverse drug reactions,thereby enhancing the management level of adverse drug reactions and ensuring the safe use of medications for patients.

Objective:To apply combined serological diagnostic methods for anti-BP180-type and anti-laminin 332 (Ln332) -type mucous membrane pemphigoid (MMP), and to summarize their clinical and immunoserological characteristics.Methods:A retrospective analysis was conducted on the data from 52 patients clinically suspected of having MMP at the Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2017 to February 2022. Serum samples were collected, and combined serological tests, including indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting, were performed to analyze the immunoserological and clinical characteristics of the patients. The Fisher′s exact test was used to compare the lesion occurrence rates between groups.Results:Among the 52 patients clinically suspected of MMP, 32 (61.5%) were diagnosed with anti-BP180-type MMP, 10 (19.2%) with anti-Ln332-type MMP, and 4 (7.7%) with anti-BP180- and anti-Ln332-type MMP due to the presence of both anti-BP180 and anti-Ln332 antibodies; 2 tested positive for IgG on the epidermal side of salt-split skin, but no target antigens were identified by serological tests, and they were diagnosed with MMP (subtype pending) ; 4 tested negative by immunoserological tests. Ocular involvement was observed in 6 out of 10 patients with anti-Ln332-type MMP, whereas only 6 out of 32 anti-BP180-type MMP patients (18.8%) had ocular symptoms, and there was a significant difference in the occurrence rate of ocular involvement between the two groups ( P = 0.02) ; the occurrence rates of nasal involvement and multi-mucosal involvement were significantly higher in the anti-Ln332-type MMP patients (50%[5/10], 90%[9/10], respectively) than in the anti-BP180-type MMP patients (0, 25%[8/32], respectively, both P < 0.001). Scar formation occurred in 6 out of 10 anti-Ln332-type MMP patients, but occurred in only 6 out of 32 anti-BP180-type patients (18.8%, P = 0.02) . Conclusion:The combination of indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting could effectively identify anti-BP180 and anti-Ln332 autoantibodies in MMP patients, with BP180 being the most common target antigen; compared with anti-BP180-type MMP, anti-Ln332-type MMP appeared to be more frequently involve the ocular and nasal mucosae, associated with the involvement of multiple mucosal sites, carrying a higher risk of scar formation.

Objective:To explore the need for parental involvement in treatment decision-making for children with type 1 diabetes mellitus, so as to provide basis for medical and nursing staff to formulate targeted intervention strategies.Methods:This was a qualitative study. From April to May 2024, 15 parents of children with type 1 diabetes mellitus admitted to the Department of Endocrine Genetics and Metabolism at Children's Hospital of Soochow University were selected as research subjects for face-to-face semi-structured interviews. Inductive content analysis was used for data analysis.Results:Among the 15 children patients, there were 4 males and 11 females, with an age of (37.61±5.93) years old. Four themes were extracted, including the need for decision-making involvement and expression, the need for diversity decision-making information, the need for multi-channel decision-making communication and the need for diversified decision-making support.Conclusions:Medical and nursing staff should pay attention to decision-making needs of the parents of children with type 1 diabetes when they participate in treatment decision-making, and improve their parents' decision-making self-efficacy and promote their decision-making involvement by adopting diversified decision-making aids and effective decision-making communication.

To standardize the management of medication errors in medical institutions,the Pharmaceutical Specialized Committee of the Chinese Hospital Association led the formulation of the Pharmacy Management—Adverse Drug Reaction Manage-ment—Medication Error Management.The formulation process referred to national regulations,policies,books,and consensus on medication error management.This article described the development process of this standard and provided an in-depth analysis of its key contents.It aimed to guide and inform medical institutions,helping them thoroughly understand and master the requirements for medication error management.The article enhanced the management of medication errors and ensured the safety and effective-ness of medication.

To standardize the management of adverse drug reactions in medical institutions and ensure medicine safety,based on relevant national regulations,normative documents,international and domestic adverse drug reaction management guide-lines,and expert opinions,the Chinese Hospital Association Pharmaceutical Specialized Committee led the development of the ad-verse drug reaction management standard.This article elaborated on the formulation process of this standard and provides an in-depth analysis of its key contents.It aimed to offer guidance and reference for medical personnel,helping them to thoroughly under-stand and master the management requirements of adverse drug reactions,thereby enhancing the management level of adverse drug reactions and ensuring the safe use of medications for patients.

Objective:To explore the need for parental involvement in treatment decision-making for children with type 1 diabetes mellitus, so as to provide basis for medical and nursing staff to formulate targeted intervention strategies.Methods:This was a qualitative study. From April to May 2024, 15 parents of children with type 1 diabetes mellitus admitted to the Department of Endocrine Genetics and Metabolism at Children's Hospital of Soochow University were selected as research subjects for face-to-face semi-structured interviews. Inductive content analysis was used for data analysis.Results:Among the 15 children patients, there were 4 males and 11 females, with an age of (37.61±5.93) years old. Four themes were extracted, including the need for decision-making involvement and expression, the need for diversity decision-making information, the need for multi-channel decision-making communication and the need for diversified decision-making support.Conclusions:Medical and nursing staff should pay attention to decision-making needs of the parents of children with type 1 diabetes when they participate in treatment decision-making, and improve their parents' decision-making self-efficacy and promote their decision-making involvement by adopting diversified decision-making aids and effective decision-making communication.

Objective:To investigate clinical, immunoserological, and therapeutic characteristics of patients with linear IgA bullous dermatosis (LABD) .Methods:Clinical data were collected from patients with LABD in Hospital of Dermatology, Chinese Academy of Medical Sciences from 2016 to 2023, and their clinical, immunoserological, and therapeutic characteristics were retrospectively analyzed.Results:Twenty-six patients were included, comprising 12 males and 14 females, with a median age ( Q1, Q3) of 32 (11, 48) years. Among the 26 patients, 12 (46.2%) presented with annular erythema and blisters, while 14 (53.8%) with atypical lesions (erythema and blisters not in an annular arrangement). Direct immunofluorescence assay yielded positive results in 14 out of 19 patients (73.7%). Indirect immunofluorescence on salt-split skin showed IgA with or without IgG deposited in the epidermis of the salt-split skin in 53.8% (14/26) of the patients. The positive rate of IgA antibody detected by Western blot analysis was 88.5% (23/26). Western blot analysis with epidermal extracts as substrates showed that 18 patients (69.2%) had serum IgA recognizing the linear IgA bullous dermatosis autoantigen LAD-1 with a relative molecular weight of 120 000, of whom 4 (15.4%) also had IgA recognizing BP180; in 1 case (3.8%), the serum IgA could recognize a protein with a relative molecular weight of about 170 000 in the epidermal extracts; another 1 (3.8%) had IgA recognizing BP230 and a protein with a relative molecular weight of 140 000 in the epidermal extracts at the same time; additionally, the serum IgA recognizing type Ⅶ collagen with a relative molecular weight of 290 000 in the dermal extracts was detected in 1 case (3.8%). Among 23 patients receiving dapsone treatment, 21 well responded, 1 showed poor response, and 1 was intolerant; in addition, the latter two patients could not achieve complete remission by tofacitinib. Minocycline, colchicine, and sulfasalazine were effective in another 3 patients. Conclusions:In this study, LABD mainly occurred in middle-age individuals, and LAD-1 was determined to be a major autoantigen. Western blot analysis showed an increased positive rate of IgA antibody compared with immunofluorescence assay, and could be an important means of differential diagnosis. Although the LABD patients responded well to dapsone, it is still necessary to explore other safe and effective medications.

To report the first case of cutaneous chronic active Epstein-Barr virus disease manifesting as persistent erythema multiforme in China. The 12-year-old female patient presented with recurrent erythema and blisters all over the body, accompanied by oral erosions for more than 5 months. Skin examination showed dark erythema scattered on the right upper eyelid and cheeks, as well as erosions and blisters arising in the dark erythema on the lower jaw; broad bean- to pigeon egg-sized blisters with clear fluids arising in erythema were scattered on the back, buttocks, and limbs, and some manifested as atypical targetoid lesions; there was a mung bean-sized erosion on the mucosa of the lower lip and the right buccal region each; the patient also presented with moon face and multiple striae atrophicae on the lower limbs. Histopathological examination of the skin lesions on the lower limb revealed basket-weave hyperkeratosis, epidermal necrosis, liquefaction degeneration of basal cells with subepidermal blister formation, and perivascular lymphocytic infiltration in the superficial dermis; direct immunofluorescence assay showed negative staining for IgG, IgM, IgA, and complement C3 among epidermal cells and at the basement membrane zone; enzyme-linked immunosorbent assay showed negative staining for serum antibodies against desmoglein 1/3 (Dsg1/3), BP180, and type Ⅶ collagen; immunohistochemical examination demonstrated partial positive staining for CD3, CD4, CD5, CD8, CD56, granzyme B, and Epstein-Barr virus-encoded RNA, positive staining for Ki67 (> 70%), but negative staining for CD20. The Epstein-Barr virus DNA level was measured to be 1.97 × 10 6 IU/ml in whole blood samples and 2.65 × 10 7 IU/ml in blister fluid samples. No mutation sites with functional significance were identified by whole-exome sequencing. Based on these findings, a diagnosis of cutaneous chronic active Epstein-Barr virus disease manifesting as persistent erythema multiforme was made. The patient was treated with methylprednisolone at a dose of 40 mg/d, intravenous drips of ganciclovir at 200 mg twice daily, etc., and discharged after improvement.