Objective:To investigate the efficacy and safety of protein A immunoadsorption (PAIA) combined with rituximab (RTX) in highly sensitized patients who underwent haplo-hematopoietic stem cell transplantation (haplo-HSCT) .Methods:The clinical data of 56 highly sensitized patients treated with PAIA and RTX before haplo-HSCT at the First Affiliated Hospital of Soochow University and Soochow Hopes Hematonosis Hospital between March 2021 and June 2023 were retrospectively analyzed. The number of human leukocyte antigen (HLA) antibody types and the mean fluorescence intensity (MFI), humoral immunity, adverse reactions during adsorption, and survival within 100 days before and after adsorption were measured.Results:After receiving the PAIA treatment, the median MFI of patients containing only HLA Ⅰ antibodies decreased from 7 859 (3 209-12 444) to 3 719 (0-8 275) ( P<0.001), and the median MFI of HLA Ⅰ+Ⅱ antibodies decreased from 5 476 (1 977-12 382) to 3 714 (0-11 074) ( P=0.035). The median MFI of patients with positive anti-donor-specific antibodies decreased from 8 779 (2 697-18 659) to 4 524 (0–15 989) ( P<0.001). The number of HLA-A, B, C, DR, and DQ antibodies in all patients decreased after the PAIA treatment, and the differences were statistically significant (A, B, C, DR: P<0.001, DQ: P<0.01). The humoral immune monitoring before and after the PAIA treatment showed a significant decrease in the number of IgG and complement C3 ( P<0.001 and P=0.002, respectively). Forty-four patients underwent HLA antibody monitoring after transplantation, and the overall MFI and number of antibody types decreased. However, five patients developed new antibodies with low MFI, and nine patients continued to have high MFI. The overall survival, disease-free survival, non-recurrent mortality, and cumulative recurrence rates at 100 days post-transplantation were 83.8%, 80.2%, 16.1%, and 4.5%, respectively. Conclusions:The combination of PAIA and RTX has a certain therapeutic effect and good safety in the desensitization treatment of highly sensitive patients before haplo-HSCT.

Objective: Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment. Methods: A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454). Results: Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease. Conclusion We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.

Objective: Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment. Methods: A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454). Results: Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease. Conclusion We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.

Objective: Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment. Methods: A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454). Results: Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease. Conclusion We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.

Objective: Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment. Methods: A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454). Results: Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease. Conclusion We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.

Objective: Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment. Methods: A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454). Results: Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease. Conclusion We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.

AIM: To observe the immunomodulatory effect of 1, 25(OH)

Objective To get well-informed of the current status of emergency training in primary hospitals in Sichuan Province and to find weaknesses in the system in order to provide scientific basis for emergency knowledge and skills training.Methods A stratified random cluster sampling method as adopted and an anonymous questionnaire survey method was conducted to investigate the basic circumstances of the current training and the training needs of 1 000 emergency medical staff in 9 regions throughout Sichuan Province.Results The scope of the survey covered emergency doctors,nurses and technicians in hospitals of Grade Ⅱ,Grade Ⅲ and below.A total of 1 000 surveys were sent out and 983 were recovered.The questionnaire completion rate was 98.3％.The respondents mainly worked for more than 10 years,most of which with Bachelor degree,junior and intermediate titles.Results of the survey showed,63.1％ Most respondents have only one or two training opportunities per year.The training methods are mainly continuing education (59.0％,580 trips),training organized within the unit (58.5％,575 trips),and training organized by health administrative units (39.3％,386 trips).The main contents of the training are:basic professional skills learning (66.7％,655 trips),basic professional theoretical study (59.2％,582 trips),and new emergency technology (42.5％,418 trips),only 32.0％ of the respondents believe that these methods meet the practical needs.The main factors that influence participation in the training were:not be arranged by employer (36.2％,356 trips);the training was different from actual work (31.6％,311 trips);no replacement for work so they couldn't join training (29.8％,293 trips).The survey showed that the most desirable way of training is:practical application (60.1％,591 trips) and the most desirable training content is:emergency first aid knowledge (73.7％,724 trips).There were significant differences in case discussion,technical observation,academic lectures,special study trainingand learning methods in hospitals of different levels (P＜0.05),but there was no significant difference in the choice of professional practice methods (P＞0.05),and the selection of training contents was in emergency first aid knowledge,general medical knowledge and prevention and treatment of chronic diseases.There was no statistical difference in the selection of training contents of knowledge,infectious disease knowledge and department management knowledge (P＞0.05).There were significant differences in the choice of nursing knowledge training (P＜0.05).Conclusion The current situation showed a lack of first-aid knowledge and skills training for emergency personnel in Sichuan Province.The present situation of skill training can't satisfy the need of their desire to participate in training.It is urgent to develop a standardized,systematic and scientific training mode to improve the emergency first aid ability of primary medical and emergency personnel.

A sensitive and selective method for the determination of imidafenacin in human plasma using liquid chromatography combined with mass spectrometry was established, and was applied to the pharmacokinetic and bioequivalence studies of imidafenacin in healthy Chinese volunteers. After the liquid-liquid extraction pretreatment, samples were separated by UPLC on BEH C8(2. 1 mm×50 mm, 1. 7 μm)column with mobile phase 2 mmol/L ammonium acetate solution with 0. 2% acetic acid and acetonitrile using gradient elution. The mass instrument was operated in the positive ion mode, and the monitored transition was set at m/z 320. 2→238. 1 and m/z 330. 2→248. 2 for imidafenacin and IS(imidafenacin-d10), respectively. In the single-dose, double cycle, self-crossover clinical trial, 24 healthy Chinese volunteers received 0. 1 mg reference or test imidafenacin tablet orally under fasting condition. Drug concentration in plasma was determined by this method and the pharmacokinetic parameters were calculated by DAS 3. 2. 8 software. The linear range of the analysis method is 10. 0 pg/mL to 1 000 pg/mL. The extraction recoveries of the low medium and high concentration samples were 84. 0%, 88. 0% and 90. 0%, respectively. The matrix effects of low medium and high concentration samples were 105%, 100% and 101%, respectively. The pharmacokinetic parameters of imidafenacin for the reference and test tablets were as follows: cmax 524. 8 pg/mL vs 612. 6 pg/mL, tmax 1. 250 h vs 1. 063 h, AUC0-∞ 2 229 pg ·h/mL vs 2 466 pg ·h/mL. The reference and test tablets of imidafenacin were bioequivalent. This method proved to be rapid and accurate for the pharmacokinetic and bioequivalence studies of imidafenacin.

Experiment of pharmacy will inevitably cause a waste of resources and environmental pollution. Therefore, it is necessary to explore some green teaching method in the experiment of pharma-ceutics. Based on the long-term teaching experience, this paper took the preparation of yiyuan powder, the cold fever granules and tables, and subing dropping as examples to compare the differences between the traditional teaching method and the green teaching method in the aspects of improving the basic operating skills, saving materials and reagents and using the micro experiments. The results showed that compared with the conventional teaching, green teaching method in pharmaceutics experiment process can significantly reduce the reagent and the amount of raw materials, so as to enables students to cultivate green, energy saving, environmental awareness while mastering the pharmaceutical theory and technology.