Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

Objective To analyze the prevalence status,influencing factors,and differences among different school age groups of myopia in children and adolescents in Ningxia Hui Autonomous Region.Methods From September to De-cember 2019,inYinchuan,Wuzhong,Shizuishan,Guyuan and Zhongwei of Ningxia,8 primary schools,6 junior high schools,6 senior high schools and 4 universities were randomly selected by stratified cluster random sampling.Five classes were se-lected from each grade of primary school,and four classes were selected from each grade of junior high school to university.All students in the selected classes were included in the study.A total of 14 211 students were selected for questionnaire sur-vey,physical examination and visual acuity measurement.The influencing factors of myopia in children of different grades were analyzed using the least absolute shrinkage and selection operator(LASSO)and logistic regression,and the model with the smallest Bayesian information criterion(BIC)was selected as the optimal model.Results The detection rate of myopia in children and adolescents in Ningxia Hui Autonomous Region was 70.3％.The detection rate of myopia in girls was higher than that in boys,and that in cities was higher than that in towns,with statistically significant differences(both P＜0.001).Compared with primary school students,the detection rate of myopia in junior high school students,senior high school students and college students gradually increased,and that in the college students was the highest,with statistically signifi-cant differences among different grades(all P＜0.001).The LASSO-logistic regression analysis of the influencing factors of myopia showed that urban and rural areas,gender,age,whether or not to wear glasses at present,the number of daily break exercises,whether or not to actively participate in physical activities,and whether or not to maintain regular exercises in the past 6 months were the influencing factors of myopia in primary school students(all P＜0.05).Gender and whether or not to wear glasses at present were the influencing factors of myopia in junior high school students and senior high school students(all P＜0.05).Whether or not to wear glasses at present was the influencing factor of myopia in college students(P＜0.05).Conclusion The detection rate of myopia in children and adolescents in Ningxia Hui Autonomous Region is high,and there are significant differences in the influencing factors of myopia among different age groups of children and adolescents.Wear-ing glasses is a protective factor to control myopia.Targeted health education on vision should be provided based on the aca-demic stage of children and adolescents to enhance their awareness of health care and improve their visual health.

OBJECTIVE To provide a reference for continuing education and training of clinical pharmacists. METHODS The revision of the syllabus and the improvement of training methods of practical skills training class for clinical pharmacists in the neurology department held by Xuanwu Hospital of Capital Medical University from 2007 to 2022 was sorted to summarize its advantages and characteristics. RESULTS Training programs were developed to benefit clinical pharmacists at different levels， and the training contents were adjusted according to the training programs and the needs of trainees. Teachers with teaching experience were selected to participate in the teaching. Theory teaching was combined with practice teaching in the teaching process， and case teaching and question-based teaching methods were adopted to benefit both senior clinical pharmacists and new clinical pharmacists. In addition， the influence of the training class was expanded through online teaching， so that doctors and pharmacists could communicate and learn together on the platform of the training class. For example， when designing the training program， we replaced one common neurological disease every two years， and carried rollover study on its new progress and new ideas； clinical pharmacist skill course was reduced， drug history writing， information retrieval and test index interpretation were compressed into clinical pharmacy skill course. CONCLUSIONS The continuing education platform is established for clinical pharmacists； new knowledge and concepts that clinical pharmacists of this specialty need to be familiar with are compiled into the teaching syllabus， and the experts who are familiar with the training of clinical pharmacists are selected to explain to the students so that the students could follow the platform to constantly update their knowledge and improve the ability of clinical pharmacists to participate in the clinic work.

OBJECTIVE:To investigate related factors for valproic acid-induced fibrinogenopenia in epilepsy patients. METHODS:A retrospective survey was conducted to collect the epilepsy patients treated with routine dose of valproic acid regularly more than one week in Epilepsy Diagnosis and Treatment Center of Xuanwu Hospital,Capital Medical University during Jan. 1st,2017 to Mar. 1st,2017. The general situation,drug use (dosage of valproic acid,dosage form of valproic acid,drug combination),liver function,blood routine indexes and coagulation indexes,etc. were collected. Univariate and binary Logistic regression analysis were used to analyze the relationship of above factors with fibrinogenopenia. ROC curve was used to screen and predict the cut-off points when sensitivity and specificity of fibrinogenopenia were good. RESULTS:A total of 59 valid cases were collected,including 40 male(67.8％)and 19 female(32.2％);35 patients(59.3％)were under 14 years of age,and 24 patients (40.7％)over 14 years of age,with average age of(17.2±15.7). Of these,24 had fibrinogenopenia(40.7％). Univariate analysis showed that fibrinogenopenia was negatively correlated with age(P=0.042),but was positively correlated with dosage of valproic acid(P=0.003);fibrinogenopenia was not correlated with gender(P=0.679),dosage form of valproic acid(P=0.790)or drug combination (P=0.502). Binary Logistic regression analysis showed that dosage of valproic acid and neutrophil percentage, erythrocyte count and platelet count of patients were related risk factors of fibrinogenopenia;odds ratios of related risk factors were 1.101,0.925,0.132,0.976. ROC curve showed that the area under the ROC curve which was correlated with dosage of valproic acid was 0.766,sensitivity and specificity were 98.5％ and 54.3％;the cut-off dosage was 13.3117 mg/kg. CONCLUSIONS:The greater the dosage of valproic acid and the younger the age,the greater the possibility of the fibrinogenopenia. For patients with long-term use of valproic acid,even if the normal dosage are used,it is necessary to monitor fibrinogen changes regularly,for whom the dosage are greater than 13.3117 mg/kg,the frequency of fibrinogen monitoring should be increased.

Clinical pharmacists joined the team for treating a cerebral hemorrhage patient with hypertension. Medications were as-sessed by learning guidelines and consulting the related literature reports,and the regimen was adjusted according to the condition of the disease and drug characteristics during the whole process of pharmaceutical care. As a result, the clinical medication became more rea-sonable. The patient's blood pressure was controlled within the target range timely, and the vital signs were sufficiently stable so that the patient could be transferred to a general ward for the further treatment.

Objective To investigate the value of third generation dual-source CT in early differential diagnosis of intracranial hemorrhage and iodinated contrast medium after endovascular treatment of acute ischemic stroke (AIS).Methods Totally 78 patients with AIS underwent endovascular treatment were prospectively enrolled.Dual-energy CT (DECT) examination (80 kV/Sn150 kV) of the head was performed after treatment with a third generation dual-source CT scanner.Iodine overlay maps and virtual non-contrast images were post-processed.Taking conventional brain CT images obtained 24 48 h after AIS attack as references,the accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of DECT for identifying hemorrhage were computed respectively.Results Totally 31 patients with 53 foci of intracranial hyper-attenuation were finally enrolled.Among 53 foci,26 were correctly diagnosed as hemorrhage by DECT,23 were correctly diagnosed as iodinated contrast medium,while 1 calcification was misdiagnosed as hemorrhage combined with iodinated contrast medium,3 were misdiagnosed as contrast medium which showed delayed hemorrhagic transformation.The sensitivity,specificity and accuracy of DECT was 89.66％ (26/29),95.83％ (23/24) and 92.45％ (49/53),PPV and NPV was 96.30％ (26/27) and 88.46％ (23/26),respectively.Conclusion The third generation dual-source CT is available in early and accurate diagnosis of hemorrhagic transformation after endovascular treatment of AIS,which can help clinicians to adjust the subsequent treatment strategies in time.

A 35-year-old female patient with acute cerebral infarction received an IV infusion of azithromycin 0.5 g once daily for combination with pneumonia. About 10 minutes after completing the first infusion,scattered red miliary rash with itching appeared on the patient′s upper limbs,chest,and back. Drug eruption was considered,and dexamethasone 10 mg by an IV injection and loratadine tablets 10 mg by mouth once daily were given. On day 2 of admission,an IV infusion of etimicin sulfate 0.3 g,added into 0.9% sodium chloride injection 250 ml,was given once daily as anti-infective treatment. On day 7,with the disappearance of rash and itching,dexamethasone was replaced by prednisone tablets 30 mg orally once daily,and finally prednisone but not loratadine tablets were discontinued on day 14 through gradual reduction dose of 10 mg every 3 days. On day 15,the patient developed systemic diffuse erythema and facial and limb edema,and then an IV injection of dexamethasone 10 mg once daily was given again. On day 17,with the disappearance of erythema and reduction of edema,desquamation occurred on the patient′s face,body and limbs,which was diagnosed as exfoliative dermatitis,and topical 0.1% halcinonide solution mixed with Yumeijing moisturizer was given externally thrice daily. On day 19,the patient′s skin desquamation improved and edema subsided,and then the dose of dexamethasone was reduced to 5 mg once daily. On day 22,as the desquamation became slighter,dexamethasone was replaced by prednisone tablets 30 mg orally once daily,and the dose of prednisone was gradually reduced by 5 mg every 5 days. On day 26,all symptoms on the patient′s skin disappeared. The rash did not recur at 1 month of follow-up.

A 35-year-old female patient with acute cerebral infarction received an IV infusion of azithromycin 0.5 g once daily for combination with pneumonia. About 10 minutes after completing the first infusion,scattered red miliary rash with itching appeared on the patient′s upper limbs,chest,and back. Drug eruption was considered,and dexamethasone 10 mg by an IV injection and loratadine tablets 10 mg by mouth once daily were given. On day 2 of admission,an IV infusion of etimicin sulfate 0.3 g,added into 0.9% sodium chloride injection 250 ml,was given once daily as anti-infective treatment. On day 7,with the disappearance of rash and itching,dexamethasone was replaced by prednisone tablets 30 mg orally once daily,and finally prednisone but not loratadine tablets were discontinued on day 14 through gradual reduction dose of 10 mg every 3 days. On day 15,the patient developed systemic diffuse erythema and facial and limb edema,and then an IV injection of dexamethasone 10 mg once daily was given again. On day 17,with the disappearance of erythema and reduction of edema,desquamation occurred on the patient′s face,body and limbs,which was diagnosed as exfoliative dermatitis,and topical 0.1% halcinonide solution mixed with Yumeijing moisturizer was given externally thrice daily. On day 19,the patient′s skin desquamation improved and edema subsided,and then the dose of dexamethasone was reduced to 5 mg once daily. On day 22,as the desquamation became slighter,dexamethasone was replaced by prednisone tablets 30 mg orally once daily,and the dose of prednisone was gradually reduced by 5 mg every 5 days. On day 26,all symptoms on the patient′s skin disappeared. The rash did not recur at 1 month of follow-up.

Objective:To discuss the methods and effects of clinical pharmacists in the Chinese and western medicine pharmaceu-tical care for one myelitis patient infected by brucellosis. Methods:Taking one myelitis patient infected by brucellosis as the example, clinical pharmacists provided Chinese and western medicine pharmaceutical care through making individualized drug regimen, perform-ing drug education and so on. Results:Clinical pharmacists participated in the therapeutic process actively, and performed Chinese and western medicine pharmaceutical care. As a result, the body temperature, look,tongue coating and excrement of the patient were obvi-ously improved. Conclusion:Performing Chinese and western medicine pharmaceutical care in clinics is very important for safety and effectiveness of drugs and improvement of drug use level.