Objective:To explore the effect of vitamin D supplement on chronic musculoskeletal pain (CMP) in patients with ankylosing spondylitis (AS) through a cohort study and provide evidence for optimizing vitamin D supplement strategies in AS management.Methods:Based on the large-scale prospective cohort of the UK Biobank, a total of 1 497 middle-aged and older patients diagnosed with AS were included. Patients were categorized into three groups according to their baseline vitamin supplements usage: non-vitamin supplement group ( n=978), vitamin D supplement group ( n=65), and other vitamin supplements group ( n=454). The occurrence of CMP was obtained by baseline pain survey and follow-up data from 2019—2020 and 2022—2023. A generalized linear mixed model (GLMM) was used to analyze the association between vitamin D supplement and CMP occurrence, with odds ratio ( OR) and its 95% confidence intervals ( CI) calculated. To verify robustness of the study findings, propensity score matching was employed to match participants in the vitamin D supplementation group with those in the non-vitamin supplement group and the other vitamin supplements group for sensitivity analysis. Results:After adjusting for confounding factors such as demographic characteristics, lifestyle, and co-morbidities, GLMM analysis did not find significant association between vitamin D supplement and the risk of CMP occurrence in AS patients [ OR(95% CI)=0.85(0.48, 1.48), P=0.555]. However, GLMM analysis indicated that male AS patients had a lower likelihood of developing CMP compared to female patients [ OR(95% CI)=0.69(0.56, 0.86), P<0.001]. Additionally, current smoking [ OR(95% CI)=1.46(1.06, 2.03), P=0.022] and poorer overall health status-categorized as general [ OR(95% CI)=2.32(1.85, 2.90)] or poor [ OR(95% CI)=2.31(1.68, 3.18), P<0.001] were associated with an increased risk of CMP occurrence. In the sensitivity analysis, no significant association was observed between vitamin D supplement and CMP. Conclusion:Vitamin D supplement does not reduce the risk of CMP occurrence in middle-aged and old AS patients. However, female, smoking, and poor overall health status are identified as risk factors for CMP in AS patients. Future research should focus on large-scale real-world studies, particularly in younger AS populations, to further investigate the relationship between vitamin D supplement and CMP, thereby providing more targeted intervention strategies.

Objective To explore the risk factors and construct a predictive model for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis.Methods A total of 142 patients with hepatitis B cirrhosis admitted to the Second Affiliated Hospital of Shandong First Medical University from January 2023 to December 2024 were selected as subjects.Patients with first occurrence of gastrointestinal bleeding were classified as bleeding group(n=52),while patients without such history were devided into no bleeding group(n=90).Baseline data between groups were compared,and potential risk factors for the first occurrence of upper gastrointestinal bleeding in patients with hepatitis B cirrhosis were analyzed.Results Grade C liver function classification,low red blood cell count(RBC),thrombocytopenia,prolonged fibrinogen concentration,serum albumin,prothrombin activity,and prothrombin time,high international standardized ratio,widened main portal vein diameter,and severe esophageal/gastric varices were the risk factors for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis(P＜0.05).Multivariate Logistic analysis demonstrated that RBC,portal vein diameter,and severe esophageal/gastric varices were independent risk factors for gastrointestinal bleeding in hepatitis B cirrhosis patients.Conclusion When RBC＜3.25×109/L,portal vein diameter＞14.5 mm and severe esophageal varices are present,the combined diagnosis has a high predictive value for the risk of first upper gastrointestinal bleeding in hepatitis B cirrhosis patients.

As a new type of high-risk packaging container, prefilled syringes are more widely used, and concerns regarding their effectiveness, stability and safety in clinical use have become prominent increasingly. However, the leachable substances from prefilled syringes may cause harm to humans in different degrees. Therefore, this paper reviews the research progress of leachable substances in prefilled syringes, which is not only of great significance for the quality control of prefilled syringe products, but also contributes to the healthy development of the industry.
Syringes ; Drug Packaging ; Quality Control

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To explore the risk factors and construct a predictive model for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis.Methods A total of 142 patients with hepatitis B cirrhosis admitted to the Second Affiliated Hospital of Shandong First Medical University from January 2023 to December 2024 were selected as subjects.Patients with first occurrence of gastrointestinal bleeding were classified as bleeding group(n=52),while patients without such history were devided into no bleeding group(n=90).Baseline data between groups were compared,and potential risk factors for the first occurrence of upper gastrointestinal bleeding in patients with hepatitis B cirrhosis were analyzed.Results Grade C liver function classification,low red blood cell count(RBC),thrombocytopenia,prolonged fibrinogen concentration,serum albumin,prothrombin activity,and prothrombin time,high international standardized ratio,widened main portal vein diameter,and severe esophageal/gastric varices were the risk factors for the first occurrence of gastrointestinal bleeding in patients with hepatitis B cirrhosis(P＜0.05).Multivariate Logistic analysis demonstrated that RBC,portal vein diameter,and severe esophageal/gastric varices were independent risk factors for gastrointestinal bleeding in hepatitis B cirrhosis patients.Conclusion When RBC＜3.25×109/L,portal vein diameter＞14.5 mm and severe esophageal varices are present,the combined diagnosis has a high predictive value for the risk of first upper gastrointestinal bleeding in hepatitis B cirrhosis patients.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To explore the effect of vitamin D supplement on chronic musculoskeletal pain (CMP) in patients with ankylosing spondylitis (AS) through a cohort study and provide evidence for optimizing vitamin D supplement strategies in AS management.Methods:Based on the large-scale prospective cohort of the UK Biobank, a total of 1 497 middle-aged and older patients diagnosed with AS were included. Patients were categorized into three groups according to their baseline vitamin supplements usage: non-vitamin supplement group ( n=978), vitamin D supplement group ( n=65), and other vitamin supplements group ( n=454). The occurrence of CMP was obtained by baseline pain survey and follow-up data from 2019—2020 and 2022—2023. A generalized linear mixed model (GLMM) was used to analyze the association between vitamin D supplement and CMP occurrence, with odds ratio ( OR) and its 95% confidence intervals ( CI) calculated. To verify robustness of the study findings, propensity score matching was employed to match participants in the vitamin D supplementation group with those in the non-vitamin supplement group and the other vitamin supplements group for sensitivity analysis. Results:After adjusting for confounding factors such as demographic characteristics, lifestyle, and co-morbidities, GLMM analysis did not find significant association between vitamin D supplement and the risk of CMP occurrence in AS patients [ OR(95% CI)=0.85(0.48, 1.48), P=0.555]. However, GLMM analysis indicated that male AS patients had a lower likelihood of developing CMP compared to female patients [ OR(95% CI)=0.69(0.56, 0.86), P<0.001]. Additionally, current smoking [ OR(95% CI)=1.46(1.06, 2.03), P=0.022] and poorer overall health status-categorized as general [ OR(95% CI)=2.32(1.85, 2.90)] or poor [ OR(95% CI)=2.31(1.68, 3.18), P<0.001] were associated with an increased risk of CMP occurrence. In the sensitivity analysis, no significant association was observed between vitamin D supplement and CMP. Conclusion:Vitamin D supplement does not reduce the risk of CMP occurrence in middle-aged and old AS patients. However, female, smoking, and poor overall health status are identified as risk factors for CMP in AS patients. Future research should focus on large-scale real-world studies, particularly in younger AS populations, to further investigate the relationship between vitamin D supplement and CMP, thereby providing more targeted intervention strategies.

Acromicric dysplasia(AD) is a rare skeletal dysplasia characterized by severe short stature, short hands and feet, normal intelligence, mild facial dysmorphism, and radiological characteristics. The clinical data and genetic test results of one patient with AD in our hospital were analyzed, and the clinical characteristics of this case were summarized. The main manifestations of the child were short stature, short hands and feet, mild facial dysmorphism, short and stubby metacarpals and phalanges on hand X-ray. One mutation, FBN1: c.5141T>G(p.Met1714Arg), was identified in this child, the mutation is inherited from her short mother and grandfather. AD is a rare congenital skeletal dysplasia disorder associated with mutations in the FBN1 gene. It conforms to the pathogenesis of autosomal dominant genetic disease.

OBJECTIVE: To characterize the silver in chitosan antibacterial gel, and to establish a method for the determination of silver content in samples. METHODS: The silver in the samples was analysed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and single particle inductively coupled plasma mass spectrometry (SP-ICP-MS). Microwave digestion was adopted to digest the chitosan antibacterial gel, and then the content of silver was determined by flame atomic absorption spectrometry. RESULTS: The analysises showed that the particle size of silver in chitosan antibacterial gel was about 150~ 200 nm. The silver showed good linearity in the concentration range of 25~250 μg/L (y=0.000 35x+0.001 7, r=0.999 9). The recovery rate (n=9) was 98.5%. CONCLUSIONS SEM, EDS and SP-ICP-MS can be used for the characterization of silver particles in chitosan antibacterial gel. Microwave digestion-flame atomic absorption spectrophotometry method is simple, practicable, high precision and high quantitative accuracy, which is suitable for the quantitative analysis of silver in chitosan antibacterial gel.
Anti-Bacterial Agents/pharmacology* ; Chitosan/chemistry* ; Microwaves ; Particle Size ; Silver

Objective Doppler ultrasonography was used to screen the incidence of central venous catheter (CVC) thrombosis in severe patients to observe the incidences of catheter-related thrombosis (CRT) at subclavian (SC) and internal jugular (IJ) venous insertion sites, and to analyze the factors affecting the thrombosis. Methods One hundred and twenty three adult patients with IJ or SC CVC admitted to the Department of Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University from May to December 2015 were enrolled to be the research objects, they were divided into an IJCVC group (35 cases) and a SCCVC group (88 cases) according to different catheterization sites; they were divided into an operation group (85 cases) and a non-operation group (38 cases) according to whether operation was performed or not; and they were also divided into an anticoagulation group (25 cases) and a non-anticoagulation group (98 cases) according to whether anticoagulation therapy was used or not. Doppler ultrasonography was performed every day to observe the incidences of CRT during ICU stay. Results One hundred and twenty-three patients were included in this study. CRT was detected in 11 (8.9%) patients, with an incidence of 22.1 per 1 000 catheter-days. All the 11 cases with CRT were presented within 3 days after the insertion, with 9 cases (81.8%) on the first day and 2 cases (18.2%) on the third day. The incidence of CRT in SCCVC group was significantly lower than that in IJCVC group [5.7% (5/88) vs. 17.1% (6/35), P < 0.05], with the rates of 12.6 and 59.4 per 1 000 catheter-days, respectively. There were no statistical significant differences in the incidences of CRT between operation group and non-operation group [11.8% (10/85) vs. 2.6% (1/38)], and between anticoagulation group and non-anticoagulation group [8.0% (1/25) vs. 9.2% (2/98), both P > 0.05]. Conclusions The incidence of CRT at IJCVC site is estimated to be 3-times higher than that at SCCVC site, anticoagulants or surgical operation may have impacts on the incidence of CRT, although there were no statistically significant differences. The CRT usually occurs within 3 days after the catheter insertion. Frequent bedside ultrasonography in the first 3 days after catheterization can confirm the diagnosis and guide clinical treatment.