Objective:To explore the characteristics of portal vein thrombosis (PVT) formation in patients with hepatitis B cirrhosis and its effect on long-term prognosis.Methods:The clinical data of a cohort of patients with hepatitis B cirrhosis who visited Beijing Youan Hospital from May 2009 to August 2020 were retrospectively analyzed. Enhanced CT examination was used as the standard for diagnosing PVT and its classification. Patients with hepatitis B cirrhosis without PVT at baseline were selected as the research subjects. According to whether PVT was formed during the follow-up period, they were divided into the PVT and control groups including 99 and 168 patients in the PVT and control groups with a follow-up time of 52.0 (46.7, 57.3) months. The changes in baseline and endpoint clinical indicators of the two groups were compared. Kaplan-Meier survival curve, log-rank test, and Cox regression were used to analyze the effect of PVT on prognosis.Results:In the PVT group, 28.28% (28/99) of patients underwent splenectomy, and 74.75% (74/99) did not receive anticoagulation therapy. The main portal vein thrombosis, portal vein branch thrombosis, and thrombosis in both groups accounted for 34.34% (34/99), 23.23% (23/99), and 15.15% (15/99), respectively. The splenic vein or superior mesenteric vein accounted for 27.27% (27/99). PVT was stable in 63.27% (63/99), progressed in 31.31% (31/99), and relieved in 5.05% (5/99) during the follow-up period. The white blood cell, hemoglobin, and platelet counts were all decreased in the PVT group compared with the baseline ( P<0.05). The international normalized ratio (INR) [1.28 (1.14, 1.39) vs. 1.33 (1.19, 1.46), P=0.041] and spleen length [(163.84±30.68) mm vs. (177.26±32.61) mm, P<0.001] was increased compared with the baseline. The proportion of gastroesophageal variceal bleeding was higher in the PVT group than in the control group (57.0% vs. 28.7%, P<0.001), and the constituent ratio of hepatic encephalopathy was not statistically significantly different ( P>0.05). The proportion of patients with ascites in the control group decreased (63.1% vs. 41.7%, P<0.001), while the proportion of patients with ascites in the PVT group was not statistically significantly different ( P>0.05). The incidence of composite clinical endpoint events in the PVT and the control group was 21.21% (21/99) and 4.17% (7/168), respectively ( P＜0.05). The incidence of composite clinical endpoint events in PVT patients without anticoagulation and anticoagulation treatment was 25.68% (19/74) and 8.00% (2/25), respectively ( P=0.062). Cox regression analysis found that PVT formation was an independent risk factor for liver-related adverse events in patients with hepatitis B cirrhosis ( HR=9.36, 95% CI: 3.65～24.02, P=0.001). Conclusions:The presence of PVT in patients with hepatitis B cirrhosis is assoliated with worse prognosis. The formation of PVT is closely related to the increased risk of liver-related adverse prognosis in patients with hepatitis B cirrhosis.

Objective To analyze the involvement of pharmacists in the pharmaceutical care of olfacatumumab in the treatment of elderly patients with refractory anti-metabotropic glutamate receptor 5(mGluR5)encephalitis and to provide a reference for the treatment and pharmaceutical care of patients with refractory autoimmune encephalitis(AE).Methods An 81-year-old patient with anti-mGluR5 encephalitis who had poor first-line immunotherapy effect.The key points of pharmaceutical care were determined according to the patient's condition and the characteristics of therapeutic drugs.The drug selection,administration mode,drug interaction,adverse reactions,and precautions of ofatumumab were put forward.At the same time,the patients and their families were given medication guidance and discharge education,and regular follow-up was carried out.Results With the cooperation of doctors,the patient was provided with whole-process pharmaceutical care,and the patient's condition was improved,and the patient's condition was good so far.Conclusion Clinical pharmacists pay attention to the effectiveness and safety of the treatment with ofatumumab by carrying out individualized pharmaceutical care for this patient,which fully reflects the value of clinical pharmacists and provides a reference for the treatment and pharmaceutical care of refractory AE patients.

Objective To analyze the involvement of pharmacists in the pharmaceutical care of olfacatumumab in the treatment of elderly patients with refractory anti-metabotropic glutamate receptor 5(mGluR5)encephalitis and to provide a reference for the treatment and pharmaceutical care of patients with refractory autoimmune encephalitis(AE).Methods An 81-year-old patient with anti-mGluR5 encephalitis who had poor first-line immunotherapy effect.The key points of pharmaceutical care were determined according to the patient's condition and the characteristics of therapeutic drugs.The drug selection,administration mode,drug interaction,adverse reactions,and precautions of ofatumumab were put forward.At the same time,the patients and their families were given medication guidance and discharge education,and regular follow-up was carried out.Results With the cooperation of doctors,the patient was provided with whole-process pharmaceutical care,and the patient's condition was improved,and the patient's condition was good so far.Conclusion Clinical pharmacists pay attention to the effectiveness and safety of the treatment with ofatumumab by carrying out individualized pharmaceutical care for this patient,which fully reflects the value of clinical pharmacists and provides a reference for the treatment and pharmaceutical care of refractory AE patients.

Objective:To explore the characteristics of portal vein thrombosis (PVT) formation in patients with hepatitis B cirrhosis and its effect on long-term prognosis.Methods:The clinical data of a cohort of patients with hepatitis B cirrhosis who visited Beijing Youan Hospital from May 2009 to August 2020 were retrospectively analyzed. Enhanced CT examination was used as the standard for diagnosing PVT and its classification. Patients with hepatitis B cirrhosis without PVT at baseline were selected as the research subjects. According to whether PVT was formed during the follow-up period, they were divided into the PVT and control groups including 99 and 168 patients in the PVT and control groups with a follow-up time of 52.0 (46.7, 57.3) months. The changes in baseline and endpoint clinical indicators of the two groups were compared. Kaplan-Meier survival curve, log-rank test, and Cox regression were used to analyze the effect of PVT on prognosis.Results:In the PVT group, 28.28% (28/99) of patients underwent splenectomy, and 74.75% (74/99) did not receive anticoagulation therapy. The main portal vein thrombosis, portal vein branch thrombosis, and thrombosis in both groups accounted for 34.34% (34/99), 23.23% (23/99), and 15.15% (15/99), respectively. The splenic vein or superior mesenteric vein accounted for 27.27% (27/99). PVT was stable in 63.27% (63/99), progressed in 31.31% (31/99), and relieved in 5.05% (5/99) during the follow-up period. The white blood cell, hemoglobin, and platelet counts were all decreased in the PVT group compared with the baseline ( P<0.05). The international normalized ratio (INR) [1.28 (1.14, 1.39) vs. 1.33 (1.19, 1.46), P=0.041] and spleen length [(163.84±30.68) mm vs. (177.26±32.61) mm, P<0.001] was increased compared with the baseline. The proportion of gastroesophageal variceal bleeding was higher in the PVT group than in the control group (57.0% vs. 28.7%, P<0.001), and the constituent ratio of hepatic encephalopathy was not statistically significantly different ( P>0.05). The proportion of patients with ascites in the control group decreased (63.1% vs. 41.7%, P<0.001), while the proportion of patients with ascites in the PVT group was not statistically significantly different ( P>0.05). The incidence of composite clinical endpoint events in the PVT and the control group was 21.21% (21/99) and 4.17% (7/168), respectively ( P＜0.05). The incidence of composite clinical endpoint events in PVT patients without anticoagulation and anticoagulation treatment was 25.68% (19/74) and 8.00% (2/25), respectively ( P=0.062). Cox regression analysis found that PVT formation was an independent risk factor for liver-related adverse events in patients with hepatitis B cirrhosis ( HR=9.36, 95% CI: 3.65～24.02, P=0.001). Conclusions:The presence of PVT in patients with hepatitis B cirrhosis is assoliated with worse prognosis. The formation of PVT is closely related to the increased risk of liver-related adverse prognosis in patients with hepatitis B cirrhosis.

Objective:To analyze the research hotspots and frontier trends in skin adverse reactions caused by epidermal growth factor receptor inhibitors(EGFRIs)in the treatment of lung cancer.Methods:CiteSpace software was used to visually analyze the literature on skin adverse reactions caused by EGFRIs in the treatment of lung cancer in the three databases of CNKI,WANFANG and VIP from the establishment of the database to October 30,2023.The literature was analyzed from the aspects of annual publication volume,funding,journals,authors,keywords,etc.Results:A total of 663 Chinese literature were obtained,with national funding projects accounting for 9.20%.A total of 312 journals were involved,with the highest publication volume being the Chinese Journal of Lung Cancer,accounting for 2.71%.The China-Japan Friendship Hospital and the Beijing University of Chinese Medicine were the top two research institutions in terms of the number of published papers,and they had a close cooperation relationship.The top three authors in terms of publication volume were CUI Huijuan with 18 articles,PENG Yanmei with 11 articles,and ZHANG Xu with 9 articles.Research hotspots focus on EGFRIs related rash,gefitinib,and clinical efficacy.Frontier trends focused on the clinical observation,research progress,and traditional Chinese medicine of skin adverse reactions caused by EGFRIs drugs.Conclusions:The research on skin adverse reactions caused by EGFRIs in the treatment of lung cancer has great development prospects.Authors and institutions can further form a stronger collaborative network to promote interdisciplinary communication,and jointly promote research and development in this field.

Based on the analysis of heart rate variability(HRV),a prediction method for paroxysmal atrial fibrillation(PAF)attacks is proposed.A new adaptive filtering technique is used for smoothing and coarse graining of HRV,followed by entropy-based quantification of HRV complexity at multiple adaptive scales.After the features are normalized by Min-Max,feature subsets are selected by sequential forward selection method,and then input to support vector machine to identify HRV types and predict PAF attacks.Through 5-fold cross-validation on a set of 50 HRV sequences each lasting 5 minutes,the optimal prediction results are obtained:98%accuracy,100%sensitivity,96%specificity,demonstrating excellent performance.In addition,the experiment shows significant changes(P<0.05)in the complexity eigenvalues of HRV far away from and close to PAF at different frequency bands,reflecting alterations in nervous system regulation of cardiac rhythm and a decline in the ability to adapt to external environmental changes such as stress regulation.

Crizotinib is a multi-target small molecule tyrosine kinase inhibitor, which can act on anaplastic lymphoma kinase (ALK), cellular-mesenchymal to epithelial transition factor and c-ros oncogene 1 (ROS1). It is mainly used in patients with ALK/ROS1-positive advanced non-small cell lung cancer. Liver injury is one of the most common adverse reactions of crizotinib. The typical symptom of crizotinib-induced liver injury is asymptomatic aminotransferase elevation, and fatal liver failure can occur in very few patients. The mechanism is mainly related to mitochondrial-mediated apoptosis, excessive autophagy, oxidative stress, and anaphylaxis. The risk factors involved are history of liver diseases, hepatitis B virus infection, combined use of immune checkpoint inhibitors or H 2-antagonist/proton pump inhibitor, gene polymorphisms of signal transducer and activator of transcription 1 and cytochrome P450. It is very important to assess liver function comprehensively before treatment, and strengthen the therapeutic drug monitoring during treatment. Measures such as temporary (reduce the dose when re-use) or permanent discontinuation should be taken when necessary.

Crizotinib is a multi-target small molecule tyrosine kinase inhibitor, which can act on anaplastic lymphoma kinase (ALK), cellular-mesenchymal to epithelial transition factor and c-ros oncogene 1 (ROS1). It is mainly used in patients with ALK/ROS1-positive advanced non-small cell lung cancer. Liver injury is one of the most common adverse reactions of crizotinib. The typical symptom of crizotinib-induced liver injury is asymptomatic aminotransferase elevation, and fatal liver failure can occur in very few patients. The mechanism is mainly related to mitochondrial-mediated apoptosis, excessive autophagy, oxidative stress, and anaphylaxis. The risk factors involved are history of liver diseases, hepatitis B virus infection, combined use of immune checkpoint inhibitors or H 2-antagonist/proton pump inhibitor, gene polymorphisms of signal transducer and activator of transcription 1 and cytochrome P450. It is very important to assess liver function comprehensively before treatment, and strengthen the therapeutic drug monitoring during treatment. Measures such as temporary (reduce the dose when re-use) or permanent discontinuation should be taken when necessary.

Objective To study the effect of serotonergic efferent projection of the dorsal rophe nucleus (DRN) on the activity of substantia nigro pars compacta (SNc) and ventral tegmenta area (VTA) dopaminergic neurons after lesioning of the DRN by the neurotoxin 5,7-drhydroxytryptamine (5,7-DHT) in rot. Methods The changes in the firing rote and firing pattern of SNc and VTA dopaminergic neurons were observed with extrocellular recording in control and the lesioned rats. Results The results showed that the mean firing rotes of the fast-firing dopaminergic neurons of the SNc in control and the lesioned rots were (5.34±0. 13 ) Hz (n = 23 ) and ( 7.13±0. 49 ) Hz (n=37), respectively. The mean firing rote of the fast-firing dopaminergic neurons of the SNc in the lesioned rats was significantly increased when compared to that of control rots (P<0.01), while the mean firing rote of the slow-firing dopaminergic neurons of the SNc did not change. The mean firing rotes of dopaminergic neurons of the VTA in control and the lesioned rots were (5.27±0. 38)Hz (n=35) and (3.6±0.2)Hz (n=52), respectively. Lesioning of the DRN induced a significant decrease in the mean firing rote of dopaminergic neurons of the VTA. The firing pattern of SNc and VTA dopaminergic neurons changed towards a more bursting or irrgular firing after the lesioning. Conlusion These data suggest that the serotonergic efferent projections of the DRN significantly affect the activity of SNe and VTA dopaminergic neurons.

Objective To study the changes in neuronal activity of the zone incerta (ZI) following the unilateral lesion of the nigrostriatal pathway. Methods Eiectrophysiological recordings of ZI neurons were made in normal rats and in two groups of rats at different time intervals after injection of 6-hydrodopamine (6-OHDA) into the pars compacta of snbstantia nigra by extracellular recording in vivo. Results The results showed a significant increase in the mean firing rate of ZI during the second and fourth weeks after 6-OHDA lesion [-n=32, (3.6±2. 2)Hz, P<0.001; n=35, (9.3±6.6)Hz, P<0. 001, respectively] compared to that of normal rats [n=39, (9.2±5.2)Hz]. However, no significant change was observed between two groups of 6-OHDA-lesioned rats. With regard to firing pattern, 7.7%(3/39) of ZI neurons discharged regularly, 82.1% (32/39) irregularly and 10. 3% (4/39) in bursts in normal rats. During the second week after 6-OHDA lesion, the regular, irregular and bursting firing neurons recorded in the ZI were 9.4% (3/32), 59. 4% (19/32) and 31.3% (10/32), and during fourth week, the regular, irregular and bursting firing neurons were 14.3% (5/35), 57.1% (20/35) and 28. 6% (10/35), respectively. The firing pattern of the neurons in the three different groups did not change significantly. Conclusion These results suggest that the firing rate of ZI neurons in 6-OHDA-lesioned rats is increased significantly, which may contribute to the pathophysiology of Parkinson's disease.