Objective To investigate predictive value of soluble growth stimulation-expressed gene 2 protein (sST2), cardiac troponin T (cTnT), and creatine kinase-myocardial band (CK-MB) for steroid resistance and prognosis in patients with immune checkpoint inhibitor-associated myocarditis (ICIAM). Methods A total of 28 patients with ICIAM were prospectively enrolled from March 2023 to February 2024 at Zhongshan Hospital, Fudan University. All participants were divided into the steroid-resistant ICIAM (srICIAM) group and the non-srICIAM group. Baseline serum levels of sST2, cTnT and CK-MB were detected prior to treatment initiation. ROC curve analysis was applied to evaluate the predictive value of these biomarkers, and Kaplan-Meier survival analysis was performed to explore the relationship between sST2 and all-cause mortality. Results Baseline sST2, cTnT, and CK-MB levels were significantly higher in the srICIAM group (n＝15) than in the non-srICIAM group (n＝13, P＜0.05). Combination of cTnT and sST2 improved predictive performance for srICIAM (AUC＝0.857, sensitivity 0.714, specificity 1.000). After 6 months of follow-up, the high sST2 group had a significantly higher all-cause mortality than the low sST2 group (P＝0.016). Conclusions The combination of sST2 and cTnT could effectively predict srICIAM, and elevated sST2 is associated with increased higher all-cause mortality in ICIAM patients, providing a basis for early risk stratification and treatment optimization.

Objective To observe the usage of antiasthmatic drugs and seek problems of following the guidelines of asthma and COPD prevention & treatment in community hospitals.Methods The prescribed quantity in 2013 of antiasthmatic drugs was recorded for 5 community hospitals in a district of Shanghai.Basing on the defined daily dose (DDD),the dosing frequency of drugs (DDDs) and the percentages of each category of drugs were calculated.Then comparisons were made with the data of a grade Ⅱ hospital and a grade Ⅲ hospital in the same district.Results Among three level hospitals,no significant difference existed in the percentages of oral antiasthmatic drugs.But the major category of oral drugs at grades Ⅱ-Ⅲ hospitals was leukotriene receptor antagonist whereas only oral theophylline and oral β2-receptor agonists were available at community hospitals.Among inhaled drugs,inhaled corticosteroids (ICS) dominated at grades Ⅱ-Ⅲ hospitals.But at community hospitals,inhaled short-acting beta-agonists (SABA) predominated.Among inhalants,dry powder inhaler (DPI) dominated at grades Ⅱ-Ⅲ hospitals and metered dose inhaler (MDI) at community hospitals.Conclusions The usage of antiasthmatics at community hospitals is not consistent with the guidelines.Optimizing drug purchasing at hospitals,strengthening continued medical education,modifying the medication concept of patients and boosting the production of domestic inhalants should be urgently undertaken.

Objective To compale the physical and chemical parameters of three market available medi-an/long chain fat emulsions.Methods The quality properties were determined and compared according to the fat emulsion injection quality standards in the Chinese Pharmacopeia Convention,the United States Pharmacopeia Con-vention,and the National Standard.Results Products A:the pH value was between 8.2-8.3;the particles with a size larger than 1 μm were 1.23%-1.53% and no particles were larger than 5 μm;the mean particle size was 0.246-0.256μm;the acid value was 0.2;the peroxide and methoxyl aniline values were 0 and 0.9-1.4;the he-molysis phosphatide was 0.6-0.9 g/L. The contents of fat,glycerin,and triglycerides were more than 97% of the labeled amounts;the content of phosphorus was 0.46-0.49 g/L. Products B:the pH value was between 8.2;the partocles with a size larger than 1 μm were 0.81%-1.62% and no particles were larger than 5 μm;the mean parti-cle size was 0.239-0.241 μm;the acid value was 0.4-0.5;the peroxide and methoxyl aniline values were 0 and 0.8-1.4;the hemolysis phosphatide was 0.2-0.6 g/L. The contents of fat,glycerin,and triglycerides were more than 94% of the labeled amounts;the content of phosphorus was 0.42 g/L. Products C:the pH value was between 7.7-8.1;the particles with a size larger than 1 μm were 0.42%-0.86% and no particles were larger than 5 μm;the mean particle size was 0.249-0.262 μm;the acid value was 0.3-0.4;the peroxide and methoxyl aniline values were 0 and 1.8-2.9;the hemolysis phosphatide was 0.5-0.8 g/L. The contents of fat,glycerin,and triglycerides were mole than 96% of the labeled amounts;the content of phosphoms was 0.44-0.46 g/L. Conclusion All properties of the median/long chain fat emulsions produced by the three manufacturers met the National Standard.