Objective To mine and analyze cutaneous adverse drug event(ADE)of eight antibody-drug conjugates(ADC),and to ensure the safe clinical use of ADC drugs.Methods The data was obtained from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)for the period from the third quarter of 2011 to the fourth quarter of 2023.The cutaneous ADE associated with 8 eight ADC drugs were identified through the process of specification and standardization of nomenclature.The potential ADE signals were detected using the reporting odds ratio and Bayesian confidence propagation neural network methods.Results A total of 124 234 ADE reports were identified with the 8 ADC drugs as the first suspected drugs,including 5 184 reports of cutaneous ADEs adverse reactions,involving 3 225 patients.A total of 72 preferred term signals were detected for the 8 ADC drugs.The highest number of signals were detected for enfortumab vedotin,followed by ado-trastuzumab emtansine and brentuximab vedotin.Except for detrolizumab,the first-day incidence of cutaneous ADEs associated with the remaining 7 ADC drugs was less than 30％.The median time of occurrence for the 7 drugs,excluding brentuximab vedotin,was within one course of treatment(21 d).Conclusion The risks of cutaneous ADEs was variable with ADC drugs,occurs early in treatment and poses a potential life-threatening danger.Therefore,clinical vigilance and close monitoring of skin conditions are essential during ADC drug use.

Objective To conduct data mining of asthma-inducing medications in underage populations based on the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,so as to provide reference for the clinical application of related medications.Methods Adverse drug event(ADE)reports from the first quarter of 2013 to the fourth quarter of 2022 in the FAERS database were collected and screened for reports of asthma adverse events in the this population(under 18 years old),which were categorized into infants,toddlers,children,and adolescents according to different age groups,and were subjected to medication signal mining by using the reporting odds ratio method,the composite standardized method,and the information component method.Results A total of 1 915 reports were obtained after screening,involving 1 042(54.41％)males and 831(43.39％)females;the highest percentage of the reporting population was between 12 and under 18 years old,with a total of 762(39.79％);60.78％of the reports were reported by health professionals;and the results of the clinical referrals showed that serious adverse events occurred in 85.90％of the cases.306 suspected drugs were screened,52 drugs were determined to be valid signals,and 1 044 adverse events were reported,of which 16 drug inserts did not mention the risk of asthma,in order of elosulfatase alpha,canakinumab,tobramycin,vancomycin,ceftriaxone,cetirizine,phenylephrine,imiglucerase,cefuroxime,betamethasone,atropine,tadalafil,riscovastatin,cyclophosphamide,octreotide,and omeprazole.Conclusion The FAERS database was mined for adverse drug event signals and evaluated using the proportional disequilibrium method to identify 16 medicines that may trigger pharmacogenetic asthma and are not documented in the specification,which can be used to provide a good early warning for the clinic.At the same time,focusing on special populations,strengthening the assessment of lung function before medication and monitoring during and after medication,timely interventions were taken to reduce the harm of drug-derived adverse reactions and ensure the safe use of medication.

Objective Based on the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,data mining was conducted on hematological adverse events related to antibody drug conjugates(ADC),providing reference for the safe use of ADC drugs in clinical practice.Methods The report data from the third quarter of 2011 to the fourth quarter of 2022 were retrieved from the FAERS database.After data cleaning such as deduplication and name standardization,extract hematological adverse events related to ADC,and use report odds ratio method and the information component method for signal detection.Results A total of 101 610 adverse event reports were extracted,with 8 ADC drugs as the primary suspected drugs,and 5 768 ADC related hematological adverse event reports.Among them,3 423 cases of agranulocytosis were involved,and the signal intensity from strong to weak were sacituzumab govitecan(SG),gemtuzumab ozogamicin(GO),brentuximab vedotin(BV),polatuzumab vedotin(PV),enfortumab vedotin(EV),trastuzumab deruxtecan(TD),inotuzumab ozogamicin(IO)and ado-trastuzumab emtansine(TDM-1).There were 2 327 cases hematopoietic cell deficiency,with signals ranging from strong to weak were IO,SG,BV,EV,PV,TD,TDM-1,and GO.Report with clinical outcome of death of ADC drug related hematological adverse events included BV 179(16.84％),TDM-1 102(13.01％),TD 88(27.08％),GO 12(16.90％),IO 8(11.59％),EV 54(24.32％),PV 22(27.16％),and SG 84(21.05％).Adverse event time analysis showed that the number of events on the first day of TD,IO,and SG medication accounts for ≥ 40％of the total number of cases.The median time of hematological adverse events in TD,GO,IO,EV,PV,and SG was within one treatment course(21 days).Conclusion Attention should be paid to the risk of ADC drug-related hematological adverse event,during the clinical medication process,blood cell count changes should be closely monitored,and any abnormalities should be promptly diagnosed and treated.

Objective:To mine the risk signals of adverse events of limaprost and provide reference for safe use of the drug.Methods:US FDA Public Data Open Project (OpenFDA) platform was searched, and the adverse event (AE) reports on limaprost from January 1, 2004 to October 1, 2023 were collected. AEs were classified and standardized according to the system organ class (SOC) and preferred terms (PT) of Medical Dictionary for Regulatory Activities version 25.1. The reporting odds ratio (ROR) method was used to mine the risk signal of limaprost. An AE with reports ≥3, ROR ≥2 and the lower limit of the 95% confidence interval ( CI)>1 was defined as a risk signal, which was analyzed descriptively. Results:A total of 1 618 AE reports with limaprost as the primary suspect drug were collected, 69 risk signals were identified, involving 17 SOCs. Of the 69 PTs, 10 were recorded in the drug instructions including hepatic function abnormal, red blood cell count decreased, drug eruption, blood pressure decreased, liver disorder, platelet count decreased, anaemia, haemoglobin decreased, pyrexia, and decreased appetite. The other 59 risk signals were not recorded in the drug instructions. The top 10 PTs in signal intensity were scleroderma, tumour haemorrhage, brain natriuretic peptide increased, inappropriate antidiuretic hormone secretion, colitis microscopic, large intestine perforation, cardiac failure acute, depressive symptom, cardiac failure chronic, pulmonary alveolar haemorrhage. The risk signals with more than 10 reports were inappropriate antidiuretic hormone secretion, interstitial lung disease, renal impairment, cardiac failure, pneumonia, fall, etc.Conclusion:In addition to the AEs recorded in the instructions, limaprost may also cause serious adverse reactions such as tumour haemorrhage, brain natriuretic peptide increased, and inappropriate antidiuretic hormone secretion, which are not recorded in the instructions and have a poor prognosis.

Objective:To mine the risk signals of adverse events of limaprost and provide reference for safe use of the drug.Methods:US FDA Public Data Open Project (OpenFDA) platform was searched, and the adverse event (AE) reports on limaprost from January 1, 2004 to October 1, 2023 were collected. AEs were classified and standardized according to the system organ class (SOC) and preferred terms (PT) of Medical Dictionary for Regulatory Activities version 25.1. The reporting odds ratio (ROR) method was used to mine the risk signal of limaprost. An AE with reports ≥3, ROR ≥2 and the lower limit of the 95% confidence interval ( CI)>1 was defined as a risk signal, which was analyzed descriptively. Results:A total of 1 618 AE reports with limaprost as the primary suspect drug were collected, 69 risk signals were identified, involving 17 SOCs. Of the 69 PTs, 10 were recorded in the drug instructions including hepatic function abnormal, red blood cell count decreased, drug eruption, blood pressure decreased, liver disorder, platelet count decreased, anaemia, haemoglobin decreased, pyrexia, and decreased appetite. The other 59 risk signals were not recorded in the drug instructions. The top 10 PTs in signal intensity were scleroderma, tumour haemorrhage, brain natriuretic peptide increased, inappropriate antidiuretic hormone secretion, colitis microscopic, large intestine perforation, cardiac failure acute, depressive symptom, cardiac failure chronic, pulmonary alveolar haemorrhage. The risk signals with more than 10 reports were inappropriate antidiuretic hormone secretion, interstitial lung disease, renal impairment, cardiac failure, pneumonia, fall, etc.Conclusion:In addition to the AEs recorded in the instructions, limaprost may also cause serious adverse reactions such as tumour haemorrhage, brain natriuretic peptide increased, and inappropriate antidiuretic hormone secretion, which are not recorded in the instructions and have a poor prognosis.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

OBJECTIVE To conduct data mining on drugs causing liver failure in underage populations based on the FDA Adverse Event Reporting System （FAERS） database， so as to provide reference for clinical use of related drugs. METHODS The data on reported adverse drug event （ADE） of liver failure in this population （under 18 years old） from the first quarter of 2013 to the third quarter of 2022 were retrieved from the FAERS database for mining and analysis； they were divided into infants（≤1 year old）， young children（＞1-＜6 years old）， children（6-＜12 years old） and adolescents（12-＜18 years old） according to the age. The reporting odds ratio （ROR）， proportional reporting ratio and Bayesian confidence propagation neural network of the proportional imbalance method were used to screen ADE signals. RESULTS A total of 1 051 ADE reports of liver failure were collected from the underage population involving 60 drugs. The highest incidence was found in adolescents （410 cases， 39.01%）， followed by young children （297 cases， 28.26%）. The instructions of 14 drugs did not mention hepatobiliary system injury and liver failure risk， including 31 cases of levetiracetam （2.95%），18 cases of metronidazole （1.71%）， 16 cases of each of topiramate and methylprednisolone （1.52% each）， 12 cases of dexamethasone （1.14%）， 11 cases of tisagenlecleucel （1.05%）， 10 cases of each of ferrous sulfate， metformin and busulfan （0.95% each）， 9 cases of propofol （0.86%）， 8 cases of onasemnogene abeparvovec （0.76%）， 5 cases of each of diphenhydramine and omeprazole （0.48% each）， 4 cases of sebeliesterase α （0.38%）， totaling 165 cases， accounting for 15.70% of the total reported cases. Metformin was contrary to the known liver safety， and E-mail：libingchemical@163.com metronidazole and levetiracetam were new risk signals， which caused more serious clinical outcomes. CONCLUSIONS Fourteen new pharmacovigilance signals which cause liver failure in the underage population are found in this study； the liver function of patients should be closely monitored when using these drugs. Among those drugs， metformin neither undergoes liver metabolism nor has been reported in the relevant literature， and the liver-related ADE caused by metformin deserves further attention. The clinical outcomes caused by metronidazole and levetiracetam are relatively serious and need to be given sufficient attention.

Objective:To mine risk signals related to tafamidis, which was a rare disease drug and newly included in the medical insurance list.Methods:The drug-related adverse event (AE) reports from the 1st quarter of 2013 to the 2nd quarter of 2022 were searched based on the US FDA Adverse Event Reporting System and AE reports with tafamidis as the primary suspect drug were extracted. The report odds ratio ( ROR) method and Bayesian confidence propagation neural network (BCPNN) method were used to detect the AE risk signals of tafamidis. A target AE with reports ≥3 and 95% confidence interval ( CI) lower limit of ROR>1 was defined as a positive signal for ROR method and the larger the ROR and its lower limit of 95% CI, the stronger the signal strength. The information component ( IC)-2 SD>0 ( SD is the standard deviation) was defined as a positive signal for BCPNN method, and the larger the IC-2 SD value, the stronger the signal. According to the preferred system organ class (SOC) and preferred term (PT) from terminology of adverse drug reactions in Medical Dictionary for Regulatory Activities, AEs were counted and classified. The risk signal with positive detection results from both ROR and BCPNN methods was determined as the AE risk signal of tafamidis and analyzed. Results:A total of 3 999 cases with tafamidis as the primary suspect drug were collected, including 2 942 males (73.6%), 688 females (17.2%), and 369 unknown cases (9.2%); 3 148 cases (78.7%) aged >65 years, 192 cases (4.8%) aged 18-65 years, 52 cases (1.3%) aged <18 years, and 607 cases (15.2%) were unknown; 1 064 patients were with cardiac amyloidosis, 872 patients with cardiac amyloidosis, 148 patients with peripheral nerve amyloidosis, and 176 with other diseases; 1 403 cases (35.1%) died. A total of 110 positive signals were screened with both ROR and BCPNN methods, involving 20 SOCs. The top 5 PTs of AE reports were dyspnea (338 cases), fatigue (301 cases), edema (167 cases), dizziness (111 cases), and fall (110 cases). The SOC involved were systemic lesions, neurological diseases, respiratory/thoracic and mediastinal diseases, examination, metabolic and nutritional diseases. The top 5 PTs ( ROR and the 95% CI lower limit) were early feeling of fullness (28.07, 11.64), lumbar spinal stenosis (26.73, 15.15), aortectasia (24.36, 9.11), hypoxia (22.64, 10.15), and cervical radiculopathy (22.13, 7.11). Four of the top 20 PTs in the AE reports were not recorded in the drug label, including dizziness, height loss, chest pain, and renal failure; 16 of the top 20 PTs in signal strength ( ROR method) were not recorded in the drug label, including lumbar spinal stenosis, aortic dilatation, physical decline, cervical radiculopathy, height reduction, carotid artery disease, hyperlipidemia, orthopnea, peripheral vein disease, benign prostatic hyperplasia, carpal tunnel syndrome, emaciation, foreign body sensation in the throat, immune thrombocytopenia, positional dizziness, and aortic atherosclerosis. Conclusion:Through data mining, it is found that early feeling of fullness, lumbar spinal stenosis, aortic dilatation, physical decline, and cervical radiculopathy may be the common adverse events of tafamidis, some risk signals are not recorded in the drug label, which should be paid attention to during the clinical use.

Objective:To mine risk signals related to tafamidis, which was a rare disease drug and newly included in the medical insurance list.Methods:The drug-related adverse event (AE) reports from the 1st quarter of 2013 to the 2nd quarter of 2022 were searched based on the US FDA Adverse Event Reporting System and AE reports with tafamidis as the primary suspect drug were extracted. The report odds ratio ( ROR) method and Bayesian confidence propagation neural network (BCPNN) method were used to detect the AE risk signals of tafamidis. A target AE with reports ≥3 and 95% confidence interval ( CI) lower limit of ROR>1 was defined as a positive signal for ROR method and the larger the ROR and its lower limit of 95% CI, the stronger the signal strength. The information component ( IC)-2 SD>0 ( SD is the standard deviation) was defined as a positive signal for BCPNN method, and the larger the IC-2 SD value, the stronger the signal. According to the preferred system organ class (SOC) and preferred term (PT) from terminology of adverse drug reactions in Medical Dictionary for Regulatory Activities, AEs were counted and classified. The risk signal with positive detection results from both ROR and BCPNN methods was determined as the AE risk signal of tafamidis and analyzed. Results:A total of 3 999 cases with tafamidis as the primary suspect drug were collected, including 2 942 males (73.6%), 688 females (17.2%), and 369 unknown cases (9.2%); 3 148 cases (78.7%) aged >65 years, 192 cases (4.8%) aged 18-65 years, 52 cases (1.3%) aged <18 years, and 607 cases (15.2%) were unknown; 1 064 patients were with cardiac amyloidosis, 872 patients with cardiac amyloidosis, 148 patients with peripheral nerve amyloidosis, and 176 with other diseases; 1 403 cases (35.1%) died. A total of 110 positive signals were screened with both ROR and BCPNN methods, involving 20 SOCs. The top 5 PTs of AE reports were dyspnea (338 cases), fatigue (301 cases), edema (167 cases), dizziness (111 cases), and fall (110 cases). The SOC involved were systemic lesions, neurological diseases, respiratory/thoracic and mediastinal diseases, examination, metabolic and nutritional diseases. The top 5 PTs ( ROR and the 95% CI lower limit) were early feeling of fullness (28.07, 11.64), lumbar spinal stenosis (26.73, 15.15), aortectasia (24.36, 9.11), hypoxia (22.64, 10.15), and cervical radiculopathy (22.13, 7.11). Four of the top 20 PTs in the AE reports were not recorded in the drug label, including dizziness, height loss, chest pain, and renal failure; 16 of the top 20 PTs in signal strength ( ROR method) were not recorded in the drug label, including lumbar spinal stenosis, aortic dilatation, physical decline, cervical radiculopathy, height reduction, carotid artery disease, hyperlipidemia, orthopnea, peripheral vein disease, benign prostatic hyperplasia, carpal tunnel syndrome, emaciation, foreign body sensation in the throat, immune thrombocytopenia, positional dizziness, and aortic atherosclerosis. Conclusion:Through data mining, it is found that early feeling of fullness, lumbar spinal stenosis, aortic dilatation, physical decline, and cervical radiculopathy may be the common adverse events of tafamidis, some risk signals are not recorded in the drug label, which should be paid attention to during the clinical use.

Objective:To explore the effect of nursing interventions based on individual and family self-management theory (IFSMT) on postoperative rehabilitation of patients undergoing percutaneous transforaminal endoscopic surgery.Methods:A total of 835 patients who underwent percutaneous transforaminal endoscopic surgery in Shanxi Provincial People's Hospital from January 2018 to January 2020 were selected as research objects by the convenient sampling method. According to the random envelope method, patients were divided into the control group ( n=417) and the observation group ( n=418) according to the approximate 1∶1 standard. The control group was given routine nursing intervention, while the observation group was given nursing intervention based on IFSMT on the basis of the control group. The differences in self-management ability, postoperative recovery time, lumbar functional recovery, pain score and postoperative complication rate before and after intervention were compared between the two groups. Results:After intervention, the scores of treatment management, psychological management, life management and knowledge and skill management in the observation group were higher than those before intervention and were higher than those in the control group, and the differences were statistically significant ( P<0.01). The hospitalization days, self-care time and work recovery time of observation group were shorter than those of control group, and the differences were statistically significant ( P<0.01). After intervention, the Oswestry dysfunction index and pain score in the observation group were lower than those before intervention and lower than those in the control group. The treatment score evaluated by the Japanese Orthopedic Association was higher than that before intervention and higher than that of the control group, and the differences were statistically significant ( P<0.01). The incidence of postoperative complications in observation group was lower than that in control group, and the difference was statistically significant ( P<0.05) . Conclusions:IFSMT based nursing intervention for patients undergoing percutaneous foraminal endoscopic surgery is beneficial to postoperative rehabilitation of patients, which is worthy of clinical promotion.