A 66-year-old male patient received abrocitinib 100 mg once daily orally for atopic dermatitis. After 3 and a half months, the patient′s condition was significantly improved and the dose of abrocitinib was reduced to 100 mg once every 2 days orally. After 35 days of continuous medication, the patient developed a sense of stuffiness in both ears, occasional tinnitus, and hearing loss. According to specialized examinations in otolaryngology, the sudden deafness was diagnosed, which was considered to be related to abrocitinib. Abrocitinib was stopped. After 38 days of treatments with nurturing nerves, improving circulation, his hearing basically returned to normal. After that, dermatitis recurred in the patient, and he received abrocitinib 100 mg once daily orally again. One month later, the patient developed hearing loss again. After 9 days of drug withdrawal, the patient′s tinnitus and other symptoms were basically relieved. Subsequently, abrocitinib was placed by dupilumab to treat atopic dermatitis in the patient. At a six-month of follow-up, symptoms such as tinnitus and hearing loss did not recur.

Objective To investigate the predictive value of serum homocysteine(HCY)and lipoprotein(a)[Lp(a)]in autologous arteriovenous fistula(AVF)failure in patients undergoing maintenance hemodialy-sis(MHD).Methods A total of 175 patients with MHD admitted to the hospital from January to December 2022 were selected as the observation group,among them,103 patients without AVF failure were selected as observation group 1,and 72 patients with AVF failure were selected as observation group 2.175 healthy indi-viduals who underwent physical examinations at the outpatient examination center of the hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the levels of HCY and Lp(a).Pearson method was used to analyze the correlation between HCY,Lp(a)with clin-ical indicators.Multivariate Logistic regression analysis was performed to analyze the influencing factors of AVF failure in MHD patients.Receiver operating characteristic(ROC)curve was plotted to analyze the pre-dictive value of serum HCY and Lp(a)for AVF failure in MHD patients.Results Compared with the control group,the serum levels of HCY and Lp(a)in observation group 1 were increased(P<0.05).Compared with the control group and observation group 1,the serum levels of HCY and Lp(a)in observation group 2 were in-creased(P<0.05).The serum levels of HCY and Lp(a)in observation group 2 were negatively correlated with ultrafiltration amount(P<0.05),and HCY and Lp(a)were positively correlated with parathyroid hor-mone(PTH),blood phosphorus(P),uric acid(UA)(P<0.05).Multivariate Logistic regression analysis showed that HCY,Lp(a),PTH,P,UA,diabetic nephropathy,duration of endovascular fistula use≥12 months,duration of puncture point compression≥30 min,and arteriovenous internal diameter<2 mm and vascular stenosis were the risk factors for AVF failure in MHD patients(P<0.05),and ultrafiltration a-mount was a protective factor for AVF failure in MHD patients(P<0.05).ROC curve results showed that the area under the curve of HCY and Lp(a)alone and in combination in the prediction of AVF failure in MHD patients were 0.822,0.820 and 0.908,respectively(Zcombination vs.HCY=3.144,Zcombination vs.Lp(a)=2.925,P<0.05).Conclusion The serum levels of HCY and Lp(a)in MHD patients with AVF failure are increased.They are the influencing factors of AVF failure in MHD patients,and the value of the combination of the two for pre-dicting AVF failure in MHD patients is relatively high.

Objective:To analyze the clinical manifestations and fundus multimodal imaging features of patients with acute Vogt-Koyanagi-Harada (VKH) syndrome, and provide a reference for early diagnosis of VKH syndrome.Methods:Retrospective analysis was performed on the clinical data and related examinations including spectral-domain optical coherence tomography (SD-OCT), fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) of patients diagnosed with acute VKH syndrome in the Ophthalmology Department of the Beijing Friendship Hospital from January 2017 to December 2022.Results:A total of 17 patients (34 eyes) with acute VKH syndrome were included. SD-OCT showed exudative retinal detachment in all 34 eyes with punctate hyperreflective signals; 26 eyes had choroidal folds, and 14 patients (28 eyes) had " septum-like" structures under the neuroepithelium. FFA early images showed late retinal fluorescence pooling in a multi-lake pattern in all 34 eyes. ICGA was performed in 15 patients (30 eyes), with early images showing hyperfluorescence of choroidal vessels in all 30 eyes; 26 eyes had scattered hypofluorescent lesions in the fundus. Mid-to-late images showed blurred boundaries of choroidal vessels in 28 eyes.Conclusions:Patients with acute VKH syndrome have characteristic manifestations in SD-OCT, FFA, and ICGA. Fundus multimodal imaging can provide important references for the diagnosis of VKH syndrome.

Objective:To analyze the clinical manifestations and fundus multimodal imaging features of patients with acute Vogt-Koyanagi-Harada (VKH) syndrome, and provide a reference for early diagnosis of VKH syndrome.Methods:Retrospective analysis was performed on the clinical data and related examinations including spectral-domain optical coherence tomography (SD-OCT), fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) of patients diagnosed with acute VKH syndrome in the Ophthalmology Department of the Beijing Friendship Hospital from January 2017 to December 2022.Results:A total of 17 patients (34 eyes) with acute VKH syndrome were included. SD-OCT showed exudative retinal detachment in all 34 eyes with punctate hyperreflective signals; 26 eyes had choroidal folds, and 14 patients (28 eyes) had " septum-like" structures under the neuroepithelium. FFA early images showed late retinal fluorescence pooling in a multi-lake pattern in all 34 eyes. ICGA was performed in 15 patients (30 eyes), with early images showing hyperfluorescence of choroidal vessels in all 30 eyes; 26 eyes had scattered hypofluorescent lesions in the fundus. Mid-to-late images showed blurred boundaries of choroidal vessels in 28 eyes.Conclusions:Patients with acute VKH syndrome have characteristic manifestations in SD-OCT, FFA, and ICGA. Fundus multimodal imaging can provide important references for the diagnosis of VKH syndrome.

A 66-year-old male patient received abrocitinib 100 mg once daily orally for atopic dermatitis. After 3 and a half months, the patient′s condition was significantly improved and the dose of abrocitinib was reduced to 100 mg once every 2 days orally. After 35 days of continuous medication, the patient developed a sense of stuffiness in both ears, occasional tinnitus, and hearing loss. According to specialized examinations in otolaryngology, the sudden deafness was diagnosed, which was considered to be related to abrocitinib. Abrocitinib was stopped. After 38 days of treatments with nurturing nerves, improving circulation, his hearing basically returned to normal. After that, dermatitis recurred in the patient, and he received abrocitinib 100 mg once daily orally again. One month later, the patient developed hearing loss again. After 9 days of drug withdrawal, the patient′s tinnitus and other symptoms were basically relieved. Subsequently, abrocitinib was placed by dupilumab to treat atopic dermatitis in the patient. At a six-month of follow-up, symptoms such as tinnitus and hearing loss did not recur.

Objective To investigate the reasons for the inconsistent results between the vertical auto profile(VAP)method and bio-chemical homogeneous phase(BHP)method in detecting plasma low-density lipoprotein cholesterol(LDL-C),and provide experimen-tal basis for the accurate and quantitative detection of plasma LDL-C levels.Methods A total of 360 plasma samples from diabetes mellitus patients combined with carotid plaque admitted to the Department of Endocrinology of Ningbo Yinzhou Hospital of Traditional Chinese Medicine during January,2022 and January,2023 were collected.The LDL-C levels of these samples were detected by the VAP method and BHP method,respectively.The VAP method uses software to automatically calculate the area under the LDL-C curve after centrifugation of the sample as the LDL-C level(LDL-CVAP)and the BHP method directly detects the LDL-C level(LDL-CBHP)by the special surfactant method.360 samples were divided into the consistent group(group A)and inconsistent group(group B)ac-cording to the relative deviation between the LDL-CBHP and LDL-CVAP methods.Group B was further divided into the LDL-CBHP on the high side group(Group B1)and LDL-CBHP on the low side group(Group B2).Groups B1 and B2 were divided into B1-1,B1-2,B1-3 and B2-1 groups based on the degree of relative deviation.The percentages of samples and levels of lipoprotein a cholesterol[Lp(a)-C],intermediate-density lipoprotein cholesterol(IDL-C),Lp(a)-C and IDL-C[Lp(a)-C+IDL-C],very low-density lipo-protein cholesterol(VLDL-C),total cholesterol(TC)and total triglyceride(TG)in each group were compared.Results The LDL-CBHP levels of 360 samples were significantly higher than that of LDL-CVAP(P＜0.01).The percentage of samples in group B was significantly higher than that in group A,and that of group B1 was significantly higher than that of group B2(P＜0.05).The levels of Lp(a)-C,IDL-C and Lp(a)-C+IDL-C in groups B1-1,B1-2,and B1-3 were significantly higher than those in group A(P＜0.01).The relative deviation between LDL-CBHP and LDL-CVAP in 360 samples was significantly positively correlated with the levels of Lp(a)-C,IDL-C,and Lp(a)-C+IDL-C(P＜0.01).The maximum correlation coefficient was found in Lp(a)-C+IDL-C.Conclusion The results of plasma LDL-C in diabetes mellitus patients combined with carotid plaque detected by the BHP method are significantly different from those detected by the VAP method,which mainly shows that the results of the BHP method are on the high side.The higher the level of plasma Lp(a)-C+IDL-C,the greater the relative deviation between the BHP method and VAP method.The reason for the high results of LDL-C detected by the BHP method may be related to the fact that LDL-CBHP contains irremovable Lp(a)-C and cholesterol carried by IDL-C.The VAP method can be used as an accurate method for detecting real LDL-C without Lp(a)-C and IDL-C.

Objective To explore the relationship between glycemic instability index(GLI),peripheral blood CD4+/CD8+,neutrophil-to-lymphocyte ratio(NLR),red blood cell distribution width(RDW),neutrophil gelatinase-associated lipocalin(NGAL),and the occurrence,condition and prognosis of stroke-associated pneumonia(SAP).Methods According to the occurrence of SAP within 7 d after onset,550 patients with acute cerebral infarction were divided into the study group(129 cases with SAP)and the control group(421 cases without SAP).GLI,peripheral blood CD4+/CD8+,NLR,RDW and NGAL levels were measured.The differences in the above indicators were compared between the study group and the control group,as well as SAP patients with different conditions and prognoses.The relationship between above indicators and the occurrence,condition and prognosis of SAP was discussed.The prognostic values of each indicator and combination of indicators were analyzed.Results GLI,NLR,RDW and NGAL levels were higher in the study group,the medium to high risk group and the poor prognosis group than those in the control group,the low-risk group and the good prognosis group.CD4+/CD8+was lower than that in the corresponding group(P＜0.05).Multivariate Logistic regression analysis showed that higher GLI and NLR were independent risk factors for acute cerebral infarction complicated with SAP,and higher GLI,NLR,RDW and NGAL were independent risk factors for the medium to high risk conditions in SAP patients,while higher levels of CD4+/CD8+were protective factor for high-risk diseases in patients with concurrent SAP and SAP(P＜0.05).Higher GLI,NLR and RDW were independent risk factors for poor prognosis in patients with SAP(P＜0.05).ROC curves indicated that the AUC of the combination of GLI,NLR and RDW for evaluating poor prognosis in patients with SAP was better than that of GLI or RDW.Conclusion Changes in GLI,CD4+/CD8+and NLR are influencing factors for the occurrence of SAP.GLI,CD4+/CD8+,NLR,RDW and NGAL are influencing factors for the severity of SAP patients.GLI,NLR and RDW are associated with poor prognosis in SAP patients,and all three have certain predictive effective in predicting the prognosis of SAP patients,and NLR has the highest predictive efficacy.

A 60-year-old male patient with lumbar disc herniation and sciatica received Sanqi Shangyao 3 tablets thrice daily orally by himself. After 6 days of administration, the patient developed upper abdominal stuffy pain, nausea, vomiting, and yellowish skin. Laboratory tests showed total bilirubin (TBil) 155.2 μmol/L, direct bilirubin (DBil) 87.1 μmol/L, alanine aminotransferase (ALT) 817 U/L, aspartate aminotransferase (AST) 367 U/L, and alkaline phosphatase (ALP) 136 U/L. The concentration of γ-glutamyltransferase (GGT) was 455 U/L. The drug was stopped, liver protective treatments were given for 8 days, and the above symptoms in the patient were improved; after 38 days of treatments, laboratory tests showed TBil 27.3 μmol/L, DBil 9.3 μmol/L, ALT 46 U/L, AST 28 U/L, ALP 83 U/L, and GGT 55 U/L. The patient′s liver injury was possibly related to the aconitine contained in the Radix Aconiti Kusnezoffii and Aconitum racemulosum Franch of Sanqi Shangyao tablets.

A 60-year-old male patient with lumbar disc herniation and sciatica received Sanqi Shangyao 3 tablets thrice daily orally by himself. After 6 days of administration, the patient developed upper abdominal stuffy pain, nausea, vomiting, and yellowish skin. Laboratory tests showed total bilirubin (TBil) 155.2 μmol/L, direct bilirubin (DBil) 87.1 μmol/L, alanine aminotransferase (ALT) 817 U/L, aspartate aminotransferase (AST) 367 U/L, and alkaline phosphatase (ALP) 136 U/L. The concentration of γ-glutamyltransferase (GGT) was 455 U/L. The drug was stopped, liver protective treatments were given for 8 days, and the above symptoms in the patient were improved; after 38 days of treatments, laboratory tests showed TBil 27.3 μmol/L, DBil 9.3 μmol/L, ALT 46 U/L, AST 28 U/L, ALP 83 U/L, and GGT 55 U/L. The patient′s liver injury was possibly related to the aconitine contained in the Radix Aconiti Kusnezoffii and Aconitum racemulosum Franch of Sanqi Shangyao tablets.

Objective:To investigate the clinical efficacy, safety and tolerance of different enteral nutritional therapy in the treatment of moderately severe acute pancreatitis (MSAP).Methods:From January 2018 to January 2019, 65 patients with MSAP who were hospitalized in Beijing Chao-Yang Hospital, Capital Medical University were prospectively enrolled. According to random number table, the patients were divided into the nasogastric tube enteral nutrition (NGEN) group (35 cases) and the nasojejunal tube enteral nutrition (NJEN) group (30 cases). All the patients received enteral nutrition solution through continuously pumping at a constant speed for 24 h. The two groups were compared in the relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, computed tomography severity index (CTSI) score 1 week after enteral nutrition, nutrition status, infection parameters, hospitalization time, hospitalization expenses and complications. Independent sample t test and rank sum test of two independent samples were used for statistical analysis. Results:There were no significant differences in age, gender, body mass index (BMI), CTSI score and Ranson score at admission, relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, CTSI score one week after enteral nutrition or hospitalization time between NGEN group and NJEN group (all P>0.05), and there was no death in both groups. The cost of hospitalization, catheterization time, cost of catheterization of NGEN group were all lower than those of NJEN group ((40.0±10.0) thousand yuan vs. (40.4±9.0) thousand yuan; 2.00 min (1.50 min, 2.50 min) vs. 11.50 min (9.50 min, 12.75 min); 135.42 yuan (135.42 yuan, 135.42 yuan) vs. 1 313.30 yuan (1231.20 yuan, 1 823.72 yuan)), and the differences were statistically significant ( t=2.342, Z=6.737 and 7.687, all P<0.01). The albumin levels of MSAP patients of the NGEN group at admission and 1 week after enteral nutrition were both higher than those of NJEN group ((43.5±5.1) g/L vs. (41.0±4.0) g/L, (42.1±4.1) g/L vs. (39.5±4.4) g/L), and the differences were statistically significant ( t=2.135 and 2.486, P=0.04 and 0.02), however there was no statistically significant difference in the decrease of albumin level between the two groups ( P>0.05). There were no statistically significant differences in the incidence of nutrition-related complications (abdominal distension, diarrhea, gastric retention and lumen obstruction) or the incidence of severe complications (transient organ failure and pancreatic necrosis complicated with infection) between NGEN group and NJEN group (all P>0.05). Conclusions:The efficacy and safety of NGEN are equivalent to NJEN in MSAP. Moreover, it can reduce the medical expenses of patients, and it is convenient to carry out in primary hospitals because of its easy operation.