This paper summarizes Professor WANG Xiuxia's clinical experience in treating hyperprolactinemia using the liver soothing therapy. Professor WANG identifies liver qi stagnation and rebellious chong qi （冲气） as the core pathomechanisms of hyperprolactinemia. Furthermore， liver qi stagnation may transform into fire or lead to pathological changes such as spleen deficiency with phlegm obstruction or kidney deficiency with essence depletion. The treatment strategy centers on soothing the liver， with a modified version of Qinggan Jieyu Decoction （清肝解郁汤） as the base formula. Depending on different syndrome patterns such as liver stagnation transforming into fire， liver stagnation with spleen deficiency， or liver stagnation with kidney deficiency， heat clearing， spleen strengthening， or kidney tonifying herbs are added accordingly. In addition， three paired herb combinations are commonly used for symptom specific treatment， Danggui （Angelica sinensis） with Chuanxiong （Ligusticum chuanxiong）， Zelan （Lycopus lucidus） with Yimucao （Leonurus japonicus） ， and Jiegeng （Platycodon grandiflorus） with Zisu （Perilla frutescens）.

INTRODUCTION: Lecanemab has shown promise in treating early Alzheimer's disease (AD), but its safety and efficacy in Chinese populations remain unexplored. This study aimed to evaluate the safety and 6-month clinical outcomes of lecanemab in Chinese patients with mild cognitive impairment (MCI) or mild AD. METHODS: In this single-arm, real-world study, participants with MCI due to AD or mild AD received biweekly intravenous lecanemab (10 mg/kg). The study was conducted at Hainan Branch, Ruijin Hospital Shanghai Jiao Tong University School of Medicine. Patient enrollment and baseline assessments commenced in November 2023. Safety assessments included monitoring for amyloid-related imaging abnormalities (ARIA) and other adverse events. Clinical and biomarker changes from baseline to 6 months were evaluated using cognitive scales (mini-mental state examination [MMSE], montreal cognitive assessment [MoCA], clinical dementia rating-sum of boxes [CDR-SB]), plasma biomarker analysis, and advanced neuroimaging. RESULTS: A total of 64 patients were enrolled in this ongoing real-world study. Safety analysis revealed predominantly mild adverse events, with infusion-related reactions (20.3%, 13/64) being the most common. Of these, 69.2% (9/13) occurred during the initial infusion and 84.6% (11/13) did not recur. ARIA-H (microhemorrhages/superficial siderosis) and ARIA-E (edema/effusion) were observed in 9.4% (6/64) and 3.1% (2/64) of participants, respectively, with only two symptomatic cases (one ARIA-E presenting with headache and one ARIA-H with visual disturbances). After 6 months of treatment, cognitive scores remained stable compared to baseline (MMSE: 22.33 ± 5.58 vs . 21.27 ± 4.30, P = 0.733; MoCA: 16.38 ± 6.67 vs . 15.90 ± 4.78, P = 0.785; CDR-SB: 2.30 ± 1.65 vs . 3.16 ± 1.72, P = 0.357), while significantly increasing plasma amyloid-β 42 (Aβ42) (+21.42%) and Aβ40 (+23.53%) levels compared to baseline. CONCLUSIONS: Lecanemab demonstrated a favorable safety profile in Chinese patients with early AD. Cognitive stability and biomarker changes over 6 months suggest potential efficacy, though high dropout rates and absence of a control group warrant cautious interpretation. These findings provide preliminary real-world evidence for lecanemab's use in China, supporting further investigation in larger controlled studies. REGISTRATION ClinicalTrials.gov , NCT07034222.
Humans ; Alzheimer Disease/drug therapy* ; Male ; Female ; Aged ; Middle Aged ; Cognitive Dysfunction/drug therapy* ; Aged, 80 and over ; Amyloid beta-Peptides/metabolism* ; Biomarkers ; East Asian People

Objective:To investigate the feasibility and effectiveness of 3D ultrasound technique in diagnosing uterine arteriovenous fistula(UAVF),and compare it with two-dimensional color Doppler ultrasound(2D-CDUS).Methods:A total of fifty patients with suspected uterine arteriovenous fistula(UAVF)who received examination in the Department of Ultrasound,Baoding Maternal and Child Health Care Hospital from November 2023 to September 2024 were selected,and they were divided into control group and observation group by the random number table method,with 25 cases in each group.The control group received 2D-CDUS examination,while the observation group received the examination of three-dimensional transvaginal ultrasound(3D-TVS).The results of the ultrasound examinations were recorded,and the diagnostic indicators of the ultrasound examinations were calculated.The result of contrast enhanced ultrasound(CEUS)to conduct comparison and analysis,and the receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic value of the two kinds of diagnostic methods.Results:There were no statistically significant differences in the positive rate and UAVF type after 2D-CDUS,3D-TVS and CEUS examinations between control group and observation group(P>0.05).There were no statistically significant difference in the sensitivity,specificity,accuracy and positive predictive value between the control group with 2D-CDUS examination and the observation group with 3D-TVS examination(P>0.05).The negative predictive value of 3D-TVS was 83.33%,which was higher than that of 2D-CDUS,and the difference was statistically significant(x2=7.481,P<0.05).Conclusion:The 3D-TVS technique shows a favorably negative predictive value in diagnosing UAVF,which can effectively make up for deficiencies of 2D-CDUS.It has the feasibility and effectiveness of clinical diagnosis,and provides a more comprehensive assessment method for early diagnosis for UAVF.

Objective:To analyze the spatiotemporal correlation between the surveillance data of influenza in students reported by medical institutions and school absenteeism due to illness, and evaluate the application of Bayesian Structural Time Series model (BSTS) in the prediction of school influenza epidemic.Methods:A total of 13 schools in Dapeng new district of Shenzhen were selected. The incidence data of influenza in schools in Shenzhen from January 1, 2015 to December 31, 2019 were collected from China Disease Control and Prevention Information System and the illness related school absentence data during this period were collected from Shenzhen Student Health Surveillance System, and the spatiotemporal correlation between the data from two systems was analyzed and compared. BSTS was used to make long-term predictions of the monthly incidence of influenza in students in 2019 and short-term predictions of the weekly incidence of influenza in week 1-8 and week 45-52 of 2019 by using the data from two systems.Results:There was a temporal correlation between the data from China Disease Control and Prevention Information System and the data from Shenzhen Student Health Surveillance System ( r=0.93, P<0.001), and the lag of the former one was 1 day ( r=0.73, P<0.001). Influenza outbreaks were randomly distributed in different schools in Shenzhen, and there was no spatial correlation. The root mean square error ( RMSE) and mean absolute error ( MAE) were 0.35 and 0.28, respectively, in the long-term prediction, and the RMSE was 0.33 and 0.34, and the MAE was 0.26 and 0.28, respectively, in the short-term predictions of week 1-8 and week 45-52 of 2019, respectively, showing good prediction accuracy and fitting effect. Conclusion:By analyzing the data from China Disease Control and Prevention Information System and Shenzhen Student Health Surveillance System with BSTS, the dynamics of the school influenza epidemic can be accurately predicted, and effective technical support can be provided for the early warning and prevention and control of influenza epidemic.

Objective:To explore the application value of three-dimensional ultrasound(3D-US)combined with two-dimensional trans vaginal sonography(2D-TVS)in diagnosing uterine arteriovenous fistula(UAVF).Methods:A total of 36 patients with suspected UAVF who admitted to Baoding Maternal and Child Health Care Hospital from January 2024 to December 2024 were retrospective selected.All of them underwent 3D-US,2D-TVS and combined examinations of 3D-US and 2D-TVS.The gynecological intravenous contrast-enhanced ultrasound was used as the"gold standard"to compare and analyze the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 3D-US,2D-TVS and the combined examination of them.The diagnostic efficacies of the three diagnostic methods were calculated by the four-grid table method and the analysis of the receiver operating characteristic(ROC)curve.The detection rates of 2D-TVS and combined examination of 2D-TVS and 3D-US for UAVF imaging signs were compared.Results:In 36 patients,gold standard confirmed 26 positive cases and 10 negative cases.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 2D-TVS examination were respectively 69.23%,80.00%,72.22%,90.00%and 50.00%.These indicators of 3D-US examinations were respectively 84.62%,90.00%,86.11%,95.65%and 69.23%.These indicators of the combined examination were respectively 92.31%,90.00%,91.67%,96.00%and 81.82%.There were not statistically significant differences in these indicators among the three diagnostic methods(P>0.05).However,the sensitivity,accuracy rate of the combined examination were respectively higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.457,4.600,P<0.05).The detection rates of the sings included lake-like,multicolored Mosaic and blood flow spectrum of high-speed low-resistance in UAVF images of the combined examination were all higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.000,4.431,4.600,P<0.05).Conclusion:The combination of 3D-US and 2D-TVS can significantly improve the diagnostic sensitivity,accuracy and detection rate of imaging signs in the diagnosis for UAVF,which has important clinical application value.

Objective To investigate the risk factors and intervention measures for surgical site infec-tion following posterolateral approach lumbar fusion surgery.Methods A total of 1 078 patients who under-went posterolateral approach lumbar fusion surgery in the department of spine surgery from January 1,2022 to December 31,2023 were included.Patient related information was collected through the real-time nosocomi-al infection monitoring system,while medical visit information was obtained via the outpatient electronic med-ical record system.Multivariate logistic regression analysis was performed to identify risk factors for surgical site infection.Results Among the 1 078 patients,34 cases(3.15%)developed surgical site infections,while 1 044 cases did not.Multivariate logistic regression analysis revealed that age,smoking,hypertension,diabetes,concurrent hospital stay,operative time,duration of postoperative antimicrobial use after initial surgery,and total antimicrobial use duration were significant risk factors for surgical site infection(P＜0.05).Among the 34 infected patients,the duration of antimicrobial use varied significantly across different infection sites(P＜0.05),with the longest duration observed in patients with deep space infections.Conclusion Targeted surveil-lance of surgical site infections should be reinforced based on these risk factors.Perioperative infection control measures must be strictly implemented to improve the scientific,precise,and standardized management of sur-gical-related nosocomial infections.

[Objective] To extract hemoglobin (Hb) from red blood cells using osmotic pressure swelling method, expected to achieve a hemoglobin dissolution rate of ≥80% and a cell membrane integrity rate of ≥70%. [Methods] Human umbilical cord blood red blood cells were used as raw materials and phosphate buffer solution was used as the swelling solution for red blood cells. A three factor three-level orthogonal experiment (n=3) was conducted to determine the optimal matching conditions for selecting the osmolality molar concentration of phosphate buffer solution, pH value of hypotonic phosphate buffer solution and volume ratio of hypotonic phosphate buffer solution to washed red blood cells. Red blood cell swelling solution samples (n=6) were prepared by the optimal matching conditions and the original process conditions. The hemoglobin dissolution rate and cell membrane integrity rate were checked. In the expanded comparative experiment, red blood cell swelling solution samples (n=6) were prepared by the optimal matching conditions and the original process conditions, which was filtered by ultrafiltration membranes. The filtration time and hemoglobin yield were checked. [Results] The optimal matching conditions for preparing red blood cell swelling solution were obtained through orthogonal experiment as follows: osmotic pressure molar concentration was 30 mOsmol/Kg, pH was 7.8, and phosphate buffer to red blood cell volume ratio was 6∶1. On the basis of the above conditions, the red blood cell swelling solution sample was compared with the original process sample: the hemoglobin dissolution rate was (82.4±1.8)% vs (78.6±3.0)% (P<0.05), and the cell membrane integrity rate was (65.8±4.0)% vs (28.7±2.3)% (P<0.05). In the expanded comparative experiment, the optimal matching conditions were compared with the original process conditions: filtration time(s) (327±9) vs (434±13) (P<0.05), and hemoglobin yield was (72.3±1.2)% vs (66.0±1.4)% (P<0.05). [Conclusion] Compared with the original preparation process, the hemoglobin extraction process which optimized through orthogonal experiments greatly reduces the cell membrane fragmentation rate and minimizes the entry of cell membrane matrix into the target solution, ensuring a slightly higher hemoglobin dissolution rate, and reducing the preparation difficulty for the subsequent cell membrane separation and further purification.

Objective:To explore the latent categories of sleep quality in shift nurses using latent profile analysis, and analyze the characteristics and influencing factors of each category.Methods:A convenience sampling method was used to select 1 480 shift nurses from three ClassⅢ Grade A hospitals in Fuyang city from January to February 2024. Data were collected using a general information questionnaire, Pittsburgh Sleep Quality Index, Perceived Stress Scale, and the Morningness-Eveningness Questionnaire-5. Latent profile analysis was performed to identify the latent categories of sleep quality, and multivariate logistic regression analysis was used to explore the influencing factors of different sleep quality categories. In this study, a total of 1 480 questionnaires were distributed. After excluding 28 invalid questionnaires, 1 452 valid questionnaires were retrieved, the effective recovery rate of the questionnaires was 98.11%.Results:The sleep quality of 1 452 shift nurses was classified into four latent categories: 44.5% (647/1 452) were in the "sleep impairment" category, 44.6% (648/1 452) in the "good sleep" category, 4.0% (58/1 452) in the "difficulty falling asleep-low efficiency" category, and 6.8% (99/1 452) in the "sleep disorder-medication-induced sleep" category. Multivariate logistic regression analysis revealed that perceived stress, monthly night shift frequency, sleep timing, daytime napping, and years of work experience were significant influencing factors for sleep quality ( P<0.05) . Conclusions:Sleep quality among shift nurses shows heterogeneity. Nursing managers should develop tailored management strategies and implement targeted sleep hygiene interventions based on nurses' sleep quality characteristics to improve their sleep quality.

Objective:To analyze the spatiotemporal correlation between the surveillance data of influenza in students reported by medical institutions and school absenteeism due to illness, and evaluate the application of Bayesian Structural Time Series model (BSTS) in the prediction of school influenza epidemic.Methods:A total of 13 schools in Dapeng new district of Shenzhen were selected. The incidence data of influenza in schools in Shenzhen from January 1, 2015 to December 31, 2019 were collected from China Disease Control and Prevention Information System and the illness related school absentence data during this period were collected from Shenzhen Student Health Surveillance System, and the spatiotemporal correlation between the data from two systems was analyzed and compared. BSTS was used to make long-term predictions of the monthly incidence of influenza in students in 2019 and short-term predictions of the weekly incidence of influenza in week 1-8 and week 45-52 of 2019 by using the data from two systems.Results:There was a temporal correlation between the data from China Disease Control and Prevention Information System and the data from Shenzhen Student Health Surveillance System ( r=0.93, P<0.001), and the lag of the former one was 1 day ( r=0.73, P<0.001). Influenza outbreaks were randomly distributed in different schools in Shenzhen, and there was no spatial correlation. The root mean square error ( RMSE) and mean absolute error ( MAE) were 0.35 and 0.28, respectively, in the long-term prediction, and the RMSE was 0.33 and 0.34, and the MAE was 0.26 and 0.28, respectively, in the short-term predictions of week 1-8 and week 45-52 of 2019, respectively, showing good prediction accuracy and fitting effect. Conclusion:By analyzing the data from China Disease Control and Prevention Information System and Shenzhen Student Health Surveillance System with BSTS, the dynamics of the school influenza epidemic can be accurately predicted, and effective technical support can be provided for the early warning and prevention and control of influenza epidemic.

Objective:To explore the application value of three-dimensional ultrasound(3D-US)combined with two-dimensional trans vaginal sonography(2D-TVS)in diagnosing uterine arteriovenous fistula(UAVF).Methods:A total of 36 patients with suspected UAVF who admitted to Baoding Maternal and Child Health Care Hospital from January 2024 to December 2024 were retrospective selected.All of them underwent 3D-US,2D-TVS and combined examinations of 3D-US and 2D-TVS.The gynecological intravenous contrast-enhanced ultrasound was used as the"gold standard"to compare and analyze the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 3D-US,2D-TVS and the combined examination of them.The diagnostic efficacies of the three diagnostic methods were calculated by the four-grid table method and the analysis of the receiver operating characteristic(ROC)curve.The detection rates of 2D-TVS and combined examination of 2D-TVS and 3D-US for UAVF imaging signs were compared.Results:In 36 patients,gold standard confirmed 26 positive cases and 10 negative cases.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 2D-TVS examination were respectively 69.23%,80.00%,72.22%,90.00%and 50.00%.These indicators of 3D-US examinations were respectively 84.62%,90.00%,86.11%,95.65%and 69.23%.These indicators of the combined examination were respectively 92.31%,90.00%,91.67%,96.00%and 81.82%.There were not statistically significant differences in these indicators among the three diagnostic methods(P>0.05).However,the sensitivity,accuracy rate of the combined examination were respectively higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.457,4.600,P<0.05).The detection rates of the sings included lake-like,multicolored Mosaic and blood flow spectrum of high-speed low-resistance in UAVF images of the combined examination were all higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.000,4.431,4.600,P<0.05).Conclusion:The combination of 3D-US and 2D-TVS can significantly improve the diagnostic sensitivity,accuracy and detection rate of imaging signs in the diagnosis for UAVF,which has important clinical application value.