1.Investigation and analysis on the improvement of drug instructions based on the medication needs of parents of pediatric patients
Yilu WANG ; Rong DUAN ; Bin HAN ; Hengjie YUAN ; Zhengxiang LI
China Pharmacy 2025;36(22):2845-2849
OBJECTIVE To analyze the medication needs of parents of pediatric children in our hospital regarding drug instructions, and explore improvement strategies, thereby providing a basis for clinically guiding the rational use of drugs in pediatric patients. METHODS A self-designed questionnaire was used to randomly select the parents of pediatric patients in the pediatric outpatient and emergency departments of our hospital from July 1st to September 30th, 2024. A randomized face-to-face survey was conducted regarding their willingness to read drug instructions, their current understanding status, and their needs. The survey results were then statistically analyzed. RESULTS A total of 300 questionnaires were distributed in this survey, and 299 valid questionnaires were recovered, with an effective recovery rate of 99.7%. Before medication, the parents who “always” and “often” read the drug instructions in detail accounted for 39.1% (117 respondents) and 35.1% (105 respondents), respectively. Statistically significant differences were observed in the willingness to read drug instructions among respondents with varying educational levels and occupations (P<0.05). Among the 299 respondents, only 48 people (16.1%)“ fully understood” the drug instructions, and the average understanding score of all the respondents was (3.77±0.83) points. The stronger the respondents’ willingness to read drug instructions, the higher their understanding scores of drug instructions (P<0.05). A total of 256 respondents thought that drug instructions were of great help to themselves, and the average helpfulness rating score of all the respondents was (4.28±0.78) points. Under the conditions of varying ages, educational levels, occupations, and willingness to read drug instructions, statistically significant differences were observed in the scores representing the degree of helpfulness of drug instructions to the respondents (P<0.05). Respondents paid the most attention to content in drug instructions such as “dosage and administration method”,“ adverse reactions”, and “indications and therapeutic categories”. The most difficult sections for them to understand included “chemical structure and properties”, “pharmacological and toxicological effects” , and “pharmacokinetics”, etc. The demographic characteristics of the respondents were not significantly associated with the content areas of drug instructions they most desired to see improved (P>0.05). Most respondents (86.0%) hoped to improve the instructions mainly by “simplifying professional terms to make them more accessible”. Others included “highlighting key information” (60.5%) and “providing more detailed medication guidance” (49.2%), etc. CONCLUSIONS Parents of pediatric patients in our hospital have a high demand for drug instructions but low comprehension. The pharmacy department should make targeted improvements to drug instructions based on parents’ actual needs, helping them accurately obtain medication knowledge and reduce potential medication safety risks.
2.Construction of NK cell-conditional Cd226 knockout mice and preliminary investigation of their role in ulcerative colitis.
Jianchun LYU ; Zichan GUO ; Yazhen WANG ; Ziyan CHEN ; Zhengxiang ZHANG ; Lihua CHEN
Chinese Journal of Cellular and Molecular Immunology 2025;41(6):488-494
Objective To generate and characterize natural killer cell (NK cell)-conditional Cd226 gene knockout mice using Cre-loxP technology, and to explore the role of CD226 on NK cells in alleviating intestinal inflammation in a murine model of ulcerative colitis (UC). Methods NK cell-conditional Cd226 gene knockout mice were generated by crossing loxP-flanked Cd226 mice with Ncr1-Cre mice via the Cre-loxP system. Polymerase chain reaction (PCR) and agarose gel electrophoresis were used for genotyping. A UC model was established by dextran sulfate sodium (DSS) induction. Flow cytometry was performed to analyze CD226 expression levels on NK cells and the infiltration of related immune cells in colon tissues. Hematoxylin-eosin (HE) staining was performed to assess the degree of colonic inflammation. Results DNA gel electrophoresis and flow cytometry confirmed the successful generation of NK cell-specific Cd226 knockout mice. After conditional knockout of Cd226 in NK cells, inflammation in the UC mouse model was alleviated. Flow cytometry results showed a reduced proportion of NK cells in peripheral blood and the colon lamina propria, while HE staining demonstrated attenuated inflammatory responses. Conclusion Specific knockout of Cd226 in NK cells mitigates intestinal inflammation in UC mice by reducing NK cell numbers and inhibiting their pro-inflammatory functions.
Animals
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Colitis, Ulcerative/pathology*
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Killer Cells, Natural/metabolism*
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Mice, Knockout
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T Lineage-Specific Activation Antigen 1
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Antigens, Differentiation, T-Lymphocyte/genetics*
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Mice
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Disease Models, Animal
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Mice, Inbred C57BL
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Male
3.Pharmacovigilance Signal Mining and Analysis of Ustekinumab versus Upadacitinib for Inflammatory Bowel Disease Based on the FAERS Database
Dong XIE ; Yu WANG ; Haojia LIN ; Qiuyue TU ; Hetong ZHANG ; Huizhen LI ; Qinghua YI ; Zhengxiang LI ; Hengjie YUAN ; Xiaocang CAO
Medical Journal of Peking Union Medical College Hospital 2025;16(6):1376-1383
To analyze potential adverse drug events(ADEs) associated with ustekinumab and upadacitinib in the treatment of inflammatory bowel disease(IBD) based on an international authoritative database, thereby providing evidence for clinical medication safety. Data were extracted from the Food and Drug Administration Adverse Event Reporting System(FAERS) database using OpenVigil 2.1. ADE reports were collected for ustekinumab(from Q3 2017 to Q1 2025) and upadacitinib(from Q3 2019 to Q1 2025), where each drug was identified as the primary suspected medication for IBD. Signal detection and statistical analysis were performed using the reporting odds ratio(ROR) and proportional reporting ratio(PRR) methods. A total of 3648 ADE reports for ustekinumab and 3812 for upadacitinib, with each as the primary suspected drug in IBD treatment, were retrieved. Using the ROR-PRR combined detection method, relevant ADE signals were identified. High-frequency ADEs associated with ustekinumab included hypersensitivity reactions, various infections, and brain fog, while those associated with upadacitinib included acne, flatulence, and herpes zoster. System organ class(SOC) analysis of positive signals indicated that both drugs commonly caused ADEs in categories such as Infections and infestations, Gastrointestinal disorders, Nervous system disorders, Skin and subcutaneous tissue disorders, and Respiratory, thoracic, and mediastinal disorders. Among these, Infections and infestations were the most frequent SOC, involving preferred terms such as Escherichia sepsis and Pneumococcal pneumonia. Ustekinumab and upadacitinib exhibit distinct safety profiles in the treatment of IBD. In addition to known ADEs described in the prescribing information, ustekinumab requires close monitoring for hypersensitivity reactions, opportunistic infections, and potential neurological risks. For upadacitinib, attention should be paid to risks of acne, herpes zoster, hypercholesterolemia, and thrombotic events. These findings provide important safety information to support individualized clinical decision-making in IBD management.
4.Signal mining and analysis of adverse events of sacituzumab govitecan
Yilu WANG ; Ke ZHANG ; Zhengxiang LI
China Pharmacy 2024;35(20):2527-2532
OBJECTIVE To mine the adverse drug event (ADE) signals of sacituzumab govitecan and provide a reference for its clinical safety application. METHODS The data of sacituzumab govitecan-related ADE reports were collected from the FDA Adverse Event Reporting System (FAERS) database from April 1, 2020 to April 30, 2024. The reporting odds ratio(ROR) method, the United Kingdom Medicines and Healthcare Products Regulatory Agency comprehensive standard method (MHRA) and Bayesian confidence propagation neural network (BCPNN) method were used for data mining. Systematic organ classification (SOC) and preferred term (PT) in the ADE terminology set of version 27.0 of the Medical Dictionary for Regulatory Activities (MedDRA) were used for data classification and statistics. RESULTS A total of 753 ADE reports were obtained for sacituzumab govitecan, including 46 ADE signals, involving 12 SOCs, and 13 new suspicious ADE signals not recorded in the instructions. Top 5 PTs in terms of occurrence frequency were disease progression, death, diarrhea, off label use and inappropriate schedule of product administration. Top 5 PTs in terms of signal strength were febrile bone marrow aplasia, neutropenic colitis, disease progression, pulmonary sepsis, general physical condition abnormal. New ADE not recorded in the drug instructions included neutropenic sepsis, hepatic cytolysis, meningitis, aplasia, etc. CONCLUSIONS When using sacituzumab govitecan in clinical practice, special attention should be paid to ADE with highly reported cases and strong signal intensity, such as febrile neutropenia, febrile bone marrow aplasia, weight fluctuations, colitis. We should also be alert to new suspected ADE such as neutropenic sepsis, hepatic cytolysis, meningitis, and aplasia to ensure patient medication safety.
5.Expression of CD226 in the small intestinal group 3 innate lymphoid cells (ILC3) in mice.
Lu YANG ; Jingchang MA ; Yitian LIU ; Tingting WANG ; Yuling WANG ; Ran ZHUANG ; Zhengxiang ZHANG
Chinese Journal of Cellular and Molecular Immunology 2024;40(1):1-6
Objective To observe the expression of adhesion molecule CD226 on the small intestinal group 3 innate lymphoid cells (ILC3) in mice. Methods The bioinformatics was used to analyze the expression of CD226 on murine ILCs. Small intestinal mucosal lamina propria lymphocytes (LPL) were isolated from wild-type C57BL/6J mice, and the expression of CD226 on ILC1 and ILC3 was detected by flow cytometry. A mouse model of dextran sulfate sodium (DSS)-induced colitis was constructed to observe the changes in the expression of CD226 on ILC3. Results Both ILC1 and ILC3 in the mice small intestine expressed CD226 molecules; the proportion of ILC3 was reduced, while the expression level of CD226 on ILC3 was increased in the colitis model. Conclusion CD226 is expressed on the small intestines of mice, and although the proportion of ILC3 decreases in the DSS-induced colitis, the expression of CD226 on ILC3 increases.
Animals
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Mice
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Colitis/chemically induced*
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Immunity, Innate
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Intestine, Small
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Lymphocytes
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Mice, Inbred C57BL
6.Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults (version 2023)
Fan FAN ; Junfeng FENG ; Xin CHEN ; Kaiwei HAN ; Xianjian HUANG ; Chuntao LI ; Ziyuan LIU ; Chunlong ZHONG ; Ligang CHEN ; Wenjin CHEN ; Bin DONG ; Jixin DUAN ; Wenhua FANG ; Guang FENG ; Guoyi GAO ; Liang GAO ; Chunhua HANG ; Lijin HE ; Lijun HOU ; Qibing HUANG ; Jiyao JIANG ; Rongcai JIANG ; Shengyong LAN ; Lihong LI ; Jinfang LIU ; Zhixiong LIU ; Zhengxiang LUO ; Rongjun QIAN ; Binghui QIU ; Hongtao QU ; Guangzhi SHI ; Kai SHU ; Haiying SUN ; Xiaoou SUN ; Ning WANG ; Qinghua WANG ; Yuhai WANG ; Junji WEI ; Xiangpin WEI ; Lixin XU ; Chaohua YANG ; Hua YANG ; Likun YANG ; Xiaofeng YANG ; Renhe YU ; Yongming ZHANG ; Weiping ZHAO
Chinese Journal of Trauma 2023;39(9):769-779
Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.
7.Monitoring results of plague vector fleas in Yulong ,Yunnan Province from 2019 to 2021
Yuqiong LI ; Fahong WANG ; Zongti SHAO ; Ennian PU ; Jian WANG ; Meiqi LIU ; Pan CHENG ; Zhengxiang LIU
Shanghai Journal of Preventive Medicine 2023;35(9):879-884
ObjectiveTo analyze the community structure and dynamics of parasitic fleas on the body surface of host animals and nested fleas in different seasons in the natural foci of wild rat plague in Yulong County,Yunnan Province, to explore the relationship between seasonal fluctuation of fleas and the prevalence of plague among animals, so as to provide evidence for plague prevention and control in the natural foci. MethodsNanxi Village, Huangshan Town, the core area of plague epidemic in Yulong County, was selected as the monitoring sample area in December 2019 (winter), August 2020(summer), October 2020(autumn) and March 2021(spring). Host animals were captured by rattrap at night and rat nests were excavated for collecting parasitic fleas on host animals and rat nest fleas in different seasons. Excel 2010 and SPSS 26.0 software were used to analyze the data, and Chi square test was used to compare the rate. Community ecological indicators were used to analyze the community structure and species diversity of the host animals and their parasitic fleas. ResultsA total of 355 vector fleas were captured, belonging to 7 species of 5 genera in 2 families. 441 small animals were captured and 138 rat body fleas were detected with the flea infection rate of 14.51% and the flea index 0.31. 96 effective rat holes were excavated and 217 fleas were detected with the flea infection rate of 35.42% and the flea index 2.26. Among the four seasons, the flea infection rates of rat body and rat nests were higher in summer and winter, showing a significant difference in general (χ2=15.851, P<0.01; χ2=16.398, P<0.01). The dominant species of flea community were Ctenophthalmus quadratus, Stenischia humilis, Neopsylla specialis and Frontopsylla spadix, with a dominance index of 0.434, 0.254, 0.180 and 0.110, respectively. The diversity and evenness of rat body fleas showed a distribution characteristic of decreasing, increasing and then decreasing again with season changes, and both were the highest in spring, while the ecological dominance showed an opposite trend. The diversity and evenness of rat nest fleas showed a distribution characteristic of increasing first and then decreasing in summer, autumn and winter, with the highest in autumn, while the ecological dominance was diametrically opposite. ConclusionThe fleas community structure is relatively stable in Yulong County, but the number of species in the community is unevenly distributed by seasons, and the status of dominant species is prominent. Local authorities should carry out timely preventive deratization and depulization measures according to the results of daily monitoring, so as to effectively avoid the prevalence and spread of plague among animals in plague foci.
8.Efficacy and safety of three minimally invasive endoscopic procedures for the treatment of internal hemorrhoids
Mei XIAO ; Huiqun WANG ; Yong JIA ; Banghai ZHENG ; Chao XU ; Song WANG ; Kaiguang ZHANG ; Mingli ZHANG ; Yue YU ; Zhengxiang WU
Chinese Journal of Digestive Endoscopy 2023;40(3):224-228
In order to evaluate the safety and effectiveness of endoscopic hemorrhoids treatment, a retrospective analysis was conducted on data of 166 patients with grade I to Ⅲ hemorrhoids who underwent endoscopic treatment in the First Affiliated Hospital of University of Science and Technology of China from January 2018 to June 2020 with complete follow-up data. There were 35 cases in the simple sclerotherapy group, 104 cases in the simple ligation group, and 27 cases in the ligation combined sclerotherapy group. The results showed that, no serious complications occurred in the 3 groups after surgery. In the simple ligation group and the ligation combined with sclerotherapy group, the incidence of postoperative anal pain [35.6% (37/104) and 33.3% (9/27), respectively,] and anal pendant distension [70.2% (73/104) and 70.4% (19/27), respectively] were higher, but symptoms could be tolerated or relieved after simple treatment. The satisfaction of patients in the 3 groups was all more than 90% before discharge, and the degree of operation acceptance was more than 95%. The effective rate of the 3 groups was above 90.0% at 3 months after surgery, At 12 months after surgery, the effective rate of the simple sclerotherapy group was the lowest [74.3% (26/35)], and the effective rate of the other two groups was still above 85.0%. In conclusion, minimally invasive treatment for internal hemorrhoids under endoscopy is safe and effective with effective improvement of symptoms, high postoperative satisfaction of patients and high degree of acceptance.
9.Comparison of endoscopic sclerotherapy with polycinnamol solution and foam injection in the treatment of grade II hemorrhagic internal hemorrhoids
Mei XIAO ; Xiaohui YU ; Chao XU ; Huiqun WANG ; Wei LI ; Yong JIA ; Banghai ZHENG ; Kaiguang ZHANG ; Mingli ZHANG ; Yue YU ; Zhengxiang WU
Journal of Chinese Physician 2023;25(6):819-823
Objective:To compare the efficacy and safety of endoscopic sclerotherapy with polycinnamol solution and foam in the treatment of grade II hemorrhagic internal hemorrhoids.Methods:From September 2020 to June 2021, 81 patients with grade II hemorrhagic internal hemorrhoids were collected from the Department of Gastroenterology, the First Affiliated Hospital of University of Science and Technology of China. They were randomly divided into an observation group and a control group. The observation group was injected with polycinnamol solution, and the control group was injected with polycinnamol foam. All of them were treated with endoscopic sclerotherapy. The clinical data of the two groups were compared and analyzed. The operation time, immediate hemostasis rate, incidence of postoperative complications (such as fever, pain, bleeding and Urinary retention), recurrence and rebleeding rate of the two groups were observed, and the efficacy and safety of the two groups in the treatment of grade II hemorrhagic internal hemorrhoids were compared.Results:There was no statistically significant difference in basic data between the two groups of patients (all P>0.05), indicating comparability. The surgical operation time of the observation group patients [(7.40±1.18)min] was shorter than that of the control group [(13.88±0.95)min] ( P<0.05); The injection dose of polycinnamol [(5.79±1.61)ml] in the observation group was higher than that in the control group [(4.38±1.92)ml] ( P<0.05). The immediate postoperative hemostasis rate in the observation group was the same as that in the control group (100%). The incidence of postoperative fever (7.32%), perianal pain (4.88%), bleeding (7.32%), and urinary retention (4.88%) complications in the observation group had no significant difference from that in the control group [postoperative fever (5.00%), anal pain (7.50%), bleeding (7.50%), and urinary retention (2.50%)] (all P>0.05). Two months after surgery, the rebleeding rate in the observation group (4.88%) was not significantly different from that in the control group (7.50%) ( P>0.05), but the rebleeding score in the observation group (1.21±0.63) was lower than that in the control group (2.62±0.71), with a statistically significant difference ( P<0.05). The rebleeding rate (2.44%) and the rebleeding score (2.33±1.51) in the observation group were lower than those in the control group [the rebleeding rate (12.50%) and the rebleeding score (5.54±2.42)] at 12 months after follow-up, and the differences were statistically significant ( P<0.05). Conclusions:Endoscopic sclerotherapy is effective in the treatment of grade II hemorrhagic internal hemorrhoids. There is no significant difference in the immediate and short-term hemostasis rate and the incidence of complications between two different dosage forms of sclerotherapy, namely, polycinnamol solution and foam, but the operation of the solution injection is more time-saving and the long-term recurrence rate is lower, which is worthy of clinical application.
10.Effectiveness and safety of programmed cell death-1 inhibitor in the treatment of advanced non-HBV non-HCV-related hepatocellular carcinoma
Haonan LIU ; Yuqin WANG ; Meng WU ; Tong LU ; Yang ZHAO ; Zhengxiang HAN
Journal of Clinical Hepatology 2022;38(12):2761-2766
Objective To investigate the clinical effectiveness and adverse events of domestic programmed cell death -1 (PD-1) inhibitor in the treatment of advanced non-HBV non-HCV-related hepatocellular carcinoma (NBNC-HCC). Methods A totals of 31 patients with advanced NBNC-HCC who received domestic PD-1 inhibitor in the Affiliated Hospital of Xuzhou Medical University from June 2019 to February 2022 were retrospectively enrolled and their clinicopathological data were retrieved from their medical records and analyzed, i.e., the time to disease progression (TTP), disease control rate (DCR), objective response rate (ORR), and adverse events were recorded and statistically analyzed. The Kaplan-Meier method was used for survival analysis. Results Among these 31 patients, only one achieved the complete response and four achieved the partial response, and six had the stable disease, but 20 showed a disease progression, resulting in an ORR of 16.1% and a (DCR of 35.5%. The median TTP was 7.2 months [95% confidence interval: 6.4-8.0) months]. The incidence of adverse events was 61.30% and the common adverse events were skin rash (29.03%) and hypertension (22.58%). However, there was no grade 4 adverse reactions or related death in these patients. Conclusion Advanced NBNC-HCC patients had a relative weak response to the PD-1 inhibitor although the adverse events were controllable. Future multi-center prospective clinical trials are needed to validate the data.

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