This article reports a case of extensive ocular inflammation following zoledronic acid infusion for the treatment of osteoporosis. The patient developed pain, eyelid edema, conjunctival congestion, and decreased vision in the right eye one day after receiving intravenous zoledronic acid, and was diagnosed with uveitis, scleritis, and periorbital soft tissue inflammation. The patient′s symptoms were evaluated using the clinical activity score(CAS). After high-dose corticosteroid pulse therapy combined with other comprehensive treatments, the symptoms improved markedly. This article reviews the incidence, clinical features, potential mechanisms, management, and prognosis of ocular adverse reactions induced by zoledronic acid, and highlights the importance of early recognition and timely treatment of ocular inflammation after zoledronic acid therapy.

Objective To explore the identification of adverse reactions of type 1 diabetes during lung cancer treat-ment with cardonilimab and the pharmaceutical monitoring of patient's blood glucose management,and to accumulate ex-perience for the prevention,treatment,and pharmaceutical services of related diseases.Methods The clinical pharmacist assisted doctors in judging adverse drug reactions and identifying suspicious drugs in a patient with lung cancer who devel-oped type 1 diabetes.At the same time,the clinical pharmacist provided suggestions for clinical treatment by referring to clinical evidence,and providing medication education,pharmaceutical care,and long-term follow-up for the patient's blood glucose management.Results After intensive insulin therapy and dietary control,the patient's high glucose symptoms were relieved,and the blood glucose gradually stabilized.The patient continued to be challenged using cardonilimab immu-notherapy,and the condition was stable.Conclusions Clinical pharmacists assist physicians in identifying adverse drug reactions on time and participate in the full process management of patient medication.They play an active therapeutic role in the medical team and reflect the value of pharmaceutical services.

This article reports a case of extensive ocular inflammation following zoledronic acid infusion for the treatment of osteoporosis. The patient developed pain, eyelid edema, conjunctival congestion, and decreased vision in the right eye one day after receiving intravenous zoledronic acid, and was diagnosed with uveitis, scleritis, and periorbital soft tissue inflammation. The patient′s symptoms were evaluated using the clinical activity score(CAS). After high-dose corticosteroid pulse therapy combined with other comprehensive treatments, the symptoms improved markedly. This article reviews the incidence, clinical features, potential mechanisms, management, and prognosis of ocular adverse reactions induced by zoledronic acid, and highlights the importance of early recognition and timely treatment of ocular inflammation after zoledronic acid therapy.

Objective To explore the identification of adverse reactions of type 1 diabetes during lung cancer treat-ment with cardonilimab and the pharmaceutical monitoring of patient's blood glucose management,and to accumulate ex-perience for the prevention,treatment,and pharmaceutical services of related diseases.Methods The clinical pharmacist assisted doctors in judging adverse drug reactions and identifying suspicious drugs in a patient with lung cancer who devel-oped type 1 diabetes.At the same time,the clinical pharmacist provided suggestions for clinical treatment by referring to clinical evidence,and providing medication education,pharmaceutical care,and long-term follow-up for the patient's blood glucose management.Results After intensive insulin therapy and dietary control,the patient's high glucose symptoms were relieved,and the blood glucose gradually stabilized.The patient continued to be challenged using cardonilimab immu-notherapy,and the condition was stable.Conclusions Clinical pharmacists assist physicians in identifying adverse drug reactions on time and participate in the full process management of patient medication.They play an active therapeutic role in the medical team and reflect the value of pharmaceutical services.

Objective:To investigate urinary pH distribution and its influencing factors in gout patients, to provide insights for individualized treatment.Methods:This is a retrospective study. The gout patients in the Gout Outpatient Department of the Affiliated Hospital of Qingdao University from September 2019 to August 2021 were collected. Clinical data were collected and relevant indicators were measured. The patients were divided into different groups according to urinary pH. Clinical characteristics and factors related to urinary pH were compared among the groups. SPSS 23.0 software was used.Results:A total of 2 553 patients were enrolled. There were significant statistical differences in age, body mass index, triglyceride, alanine aminotransferase(ALT), blood urea nitrogen, serum creatinine, estimated glomerular filtration rate(eGFR), blood uric acid, urinary uric acid/creatinine ratio, fraction excretion of uric acid(FEUA) among groups with different urinary pH( F were 5.114, 4.772, 7.170, 4.721, 13.603, 2.812, 3.422, 22.834, 18.230, 26.332, all P<0.05). Urinary uric acid and FEUA in acute group were higher than those in remission group( Z were -2.295, -3.528, both P<0.05). After adjusting for gender, age, eGFR, logistics regression analysis showed that body mass index, triglyceride, total cholesterol, ALT, blood uric acid, and blood urea nitrogen were still risk factors. Multivariate logistic regression analysis showed that triglyceride, blood uric acid, and blood urea nitrogen were independent risk factors associated with acid urine. Linear correlation analysis showed that urinary pH was negatively correlated with body mass index, triglyceride, total cholesterol, blood uric acid, fasting glucose, blood urea nitrogen, ALT( r were -0.079, -0.106, -0.051, -0.186, -0.040, -0.122, -0.051, all P<0.05), but positively correlated with eGFR( r=0.058, P=0.003). Conclusion:The overall urine pH levels in patients with primary gout are below normal reference. Several metabolic components are related to it. Triglyceride, blood uric acid, and blood urea nitrogen are independent risk factors of acidic urine. In clinical practice, attention should be paid to timely alkalization of urine to prevent complications.

Pulmonary fibrosis is a difficult to treat fibrotic disease with multiple triggering factors and complex pathogenesis. It is characterized by diffuse inflammatory damage, tissue structure destruction, and persistent fibrosis, resulting in irreversible damage to lung function. The Hippo signaling pathway is involved in regulating various biological processes such as cell proliferation, differentiation, migration, apoptosis, and is closely related to the occurrence of pulmonary fibrosis. In order to further explore the mechanism of pulmonary fibrosis, this paper comprehensively analyzes the Hippo signaling pathway and its cellular and pathological imbalance related to pulmonary fibrosis, revealing the influence of Hippo signaling pathway in pulmonary fibrosis and its possible mechanism of action, which is expected to provide new targets and strategies for the prevention and treatment of pulmonary fibrosis.

Pulmonary fibrosis is a difficult to treat fibrotic disease with multiple triggering factors and complex pathogenesis. It is characterized by diffuse inflammatory damage, tissue structure destruction, and persistent fibrosis, resulting in irreversible damage to lung function. The Hippo signaling pathway is involved in regulating various biological processes such as cell proliferation, differentiation, migration, apoptosis, and is closely related to the occurrence of pulmonary fibrosis. In order to further explore the mechanism of pulmonary fibrosis, this paper comprehensively analyzes the Hippo signaling pathway and its cellular and pathological imbalance related to pulmonary fibrosis, revealing the influence of Hippo signaling pathway in pulmonary fibrosis and its possible mechanism of action, which is expected to provide new targets and strategies for the prevention and treatment of pulmonary fibrosis.

Objective:To explore the status of microsatellite instability (MSI) and its relationship with clinicopathological characteristics of patients with endometrial carcinoma.Methods:The clinical data of 365 patients with endometrial carcinoma who received surgery in Shanxi Province Cancer Hospital between January 2020 and December 2021 were retrospectively analyzed. Immunohistochemistry was used to detect the expressions of 4 DNA mismatch repair (MMR) proteins (MLH1, MSH2, MHS6, and PMS2), estrogen receptor (ER), progesterone receptor (PR), and p53 mutant protein in postoperative cancer tissue samples from 365 patients with endometrial carcinoma. All patients were divided into MSI group (1 or more non-expression of MMR protein) and microsatellite stability (MSS) group (4 proteins were all expressed), and the clinicopathological characteristics of patients in both groups were compared. φ efficient was used to analyze the correlation of MSI with ER, PR, p53 mutant protein expressions. Results:There were 72 cases (19.7%) in MSI group and 293 cases (80.3%) in MSS group; and the age of all patients was (53±19) years (21-83 years). There were statistically significant differences in the proportion of MSI patients in endometrial carcinoma patients with different age [>50 years vs. ≤50 years: 22.1% (61/276) vs. 12.4% (11/89)], tumor diameter [≤2 cm vs. > 2 cm: 25.9% (30/116) vs. 16.8% (42/249)], International Federation of Gynecology and Obstetrics (FIGO) staging [stage Ⅲ-Ⅳ vs. stage Ⅰ-Ⅱ: 31.1% (14/45) vs. 18.1% (58/320)], histological type [type Ⅰ vs. type Ⅱ: 21.7% (71/327) vs. 2.6% (1/38)] (all P < 0.05). There were no statistically significant differences in the proportion of MSI patients with different depth of invasion, degree of differentiation, lymph node metastasis, vascular involvement, and lesion location (all P > 0.05). Among 327 cases of type Ⅰendometrial carcinoma, 1 case was mucinous adenocarcinoma (MSS status), and the other 326 cases were endometrioid adenocarcinoma. Of the 72 patients with MSI, 71 cases were endometrioid carcinoma and the other was 1 of 3 mixed carcinomas in type Ⅱ endometrial carcinoma. There was a negative correlation between MSI and mutant p53 ( φ coefficient was -0.11, P = 0.031), and φ coefficient of the correlation of MSI with ER and PR was -0.03 and -0.06, while there were no statistically significant differences ( P value was 0.578 and 0.255, respectively). Conclusions:Endometrioid adenocarcinoma is the main type of endometrial cancer patients with MSI. MSI in endometrial cancer is correlated with age, FIGO staging, tumor diameter and histological type of patients, while negatively correlated with mutant p53.

Objective:To investigate the clinical characteristics and risk factors of multiple tophi among gout patients.Methods:Gout patients treated at Affiliated Hospital of Qingdao University from September 2017 to September 2021 were included retrospectively. According to the number of tophi, the patients were divided into the multiple tophi group, the single tophi group and the non-tophi group. Clinical data were collected, biochemical indices and urine pH value were determined. One- way ANOVA or Chi-square test was used to compare groups, and multivariate logistic regression was used to analyze the risk factors. Results:The age, disease course, blood pressure, serum uric acid, urea nitrogen, and the rate of family history, smoking, drinking, gout attacks≥2 twice per year, hypertension, cardio-cerebrovascular diseases, kidney stones in the multiple tophi group were significantly higher than those in the single tophi group and the non-tophi group. The glomerular filtration rate, urine pH value and the rate of regular exercise were significantly lower than those of single tophi group and non-tophi group. In the multiple tophi group, 245 cases(44.46%) were involved in the interphalangeal joint or metacarpophalangeal joint, 212 cases(38.47%) were involved in other joints of the upper limb, which was second only to the first metatarsophalangeal joint(349 cases, 63.33%). Logistic regression analysis showed that the course of disease, urea nitrogen, serum uric acid, positive family history, drinking, gout attacks ≥twice per year and hypertension were the risk factors for multiple tophi in gout patients. Conclusion:Patients with a long disease course, elevated uric acid, high urea nitrogen, positive family history, alcohol consumption, frequent gout flare and hypertension are more likely to develop multiple tophi.

Objective:To analyze the clinical characteristics and risk factors of impaired liver and renal function in hospitalized patients with gout.Methods:A total of 494 hospitalized patients with confirmed gout were selected and divided into four groups according to liver and renal function, control(Con), impaired liver function (ILF), impaired renal function (IRF), and both function impaired (ILRF) group. Multivariate logistic regression was used to analyze the risk factors related with impaired liver and renal function.Results:Compared to Con group, ILF group were younger with shorter gout duration, higher body mass index, waist circumference, homeostasis model assessment for insulin resistance (HOMA-IR), serum uric acid, low density lipoprotein-cholesterol (LDL-C), total cholesterol, triglycerides, C reactive protein, higher prevalence of dyslipidemia, obesity, fatty liver, and monosodium urate crystal (MSU) deposition (all P<0.05). IRF group were older and with higher serum uric acid, serum creatinine, C reactive protein, and hypertension, MSU deposition prevalence, with lower prevalence of fatty liver (all P<0.05). Compared to ILF group, IRF group were older, with longer gout duration, lower level of body mass index, waist circumference, HOMA-IR, LDL-C, total cholesterol, triglycerides, lower prevalence of obesity, fatty liver, and higher prevalence of hypertension and type 2 diabetes (all P<0.05). The univariate logistic regression analysis showed that age( OR=0.941, 95% CI 0.906-0.977, P<0.001), serum uric acid ( OR=1.002, 95% CI 1.000-1.005, P=0.043), HOMA-IR ( OR=1.147, 95% CI 1.024-1.285, P=0.018), and MSU deposition ( OR=1.959, 95% CI 1.154-3.326, P=0.013) were the independent risk factors of impaired liver function, while the independent risk factors of impaired renal function were age ( OR=1.104, 95% CI 1.048-1.162, P<0.001), serum uric acid ( OR=1.007, 95% CI 1.004-1.010, P<0.001), and MSU deposition ( OR=2.393, 95% CI 1.191-4.805, P=0.014). Conclusions:Serum uric acid and MSU deposition are the common independent risk factors for impaired liver and renal function in patients with gout. Younger patients with insulin resistance are susceptible to impaired liver function, older patients with hypertension and diabetes are susceptible to impaired renal function.