Previous studies have reported elevated cardiac troponin T (cTnT) in patients with inclusion body myositis due to skeletal myopathy. Although the trends of cTnT have been reported in some cases, the onset of elevation has barely been reported. In this case, elevated cTnT in a patient diagnosed with inclusion body myositis is discussed. The routine laboratory tests of a 68-year-old male patient showed a positive cTnT test. Eight months later, he developed symptoms of myasthenia gravis. Subsequently, after a series of examinations, the patient was diagnosed with inclusion body myositis. Despite a transient decrease in cTnT levels following intravenous immunoglobulin treatment, the levels rapidly rebounded and continued to rise, suggesting continued progression of skeletal muscle damage in inclusion body myositis. It was concluded that the elevated cTnT was due to re-expression of cTnT in the damaged skeletal muscles of inclusion body myositis. This suggests that dynamic monitoring of cTnT levels in inclusion body myositis patients may predict the progression of myositis and promote timely treatment.

Previous studies have reported elevated cardiac troponin T (cTnT) in patients with inclusion body myositis due to skeletal myopathy. Although the trends of cTnT have been reported in some cases, the onset of elevation has barely been reported. In this case, elevated cTnT in a patient diagnosed with inclusion body myositis is discussed. The routine laboratory tests of a 68-year-old male patient showed a positive cTnT test. Eight months later, he developed symptoms of myasthenia gravis. Subsequently, after a series of examinations, the patient was diagnosed with inclusion body myositis. Despite a transient decrease in cTnT levels following intravenous immunoglobulin treatment, the levels rapidly rebounded and continued to rise, suggesting continued progression of skeletal muscle damage in inclusion body myositis. It was concluded that the elevated cTnT was due to re-expression of cTnT in the damaged skeletal muscles of inclusion body myositis. This suggests that dynamic monitoring of cTnT levels in inclusion body myositis patients may predict the progression of myositis and promote timely treatment.

The corneal epithelium, an essential refractive interface, plays an integral role in the corneal healing after corneal refractive surgery. All existing corneal refractive surgeries entail a degree of corneal epithelial remodeling; however, excessive epithelial remodeling precipitates adverse outcomes on the refractive correction efficacy of such surgeries. This review summarizes the application of corneal epithelial remodeling in the corneal refractive surgery, and more comprehensively investigates the influencing factors of perioperative epithelial remodeling after corneal refractive surgery, with a view to augmenting the safety, efficacy, predictability, and stability of corneal refractive surgical outcomes.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Donation related vasovagal reaction(DRVR) is the most common adverse reaction during blood donation. It is very important for blood banks to identify, treat and prevent DRVR accurately. At present, it is generally believed that psychological factors are the first major inducement of DRVR. Applied muscle tension (AMT) and salt supplementation have been proved to be effective interventions for vasovagal response; the identification methods of high-risk groups such as State Trait Anxiety Inventory, Medical Fear Inventory and Blood Donor Response Scale have been relatively mature, but the utilization rate is relatively low in China. In this paper, the main clinical manifestations, pathogenesis, research methods, related factors, management and prevention measures of DRVR, as well as the identification of high-risk groups before blood donation are reviewed.

Under the background of deepening the medical and health system reform, it is necessary to explore the measures of fine and rational drug use management and strengthen the rational drug use. Through giving full play to the management functions of pharmacy administration and pharmacotherapeutics committee, formulating the performance evaluation index system of pharmacy affairs in the hospital, adhering to the prescription doctor′s advice review and prescription pre audit, continuing to carry out drug dynamic monitoring, implementing standardized-path antimicrobial drug management, the hospital implemented refined and rational drug use management. Before and after the management, the average drug cost, prescription unqualified rate, auxiliary drug amount and antibacterial drugs related indicators were significantly improved, suggesting that fine pharmacy management could promote the rational use of drugs in the whole hospital, promote the transformation of pharmacists′ work, and control the unreasonable growth of drug costs.

Objective:To explore the occurrence and risk factors of bleeding events in acute coronary syndromes (ACS) patients treated with ticagrelor combined with aspirin.Methods:The study subjects were selected from ACS patients who were admitted to Beijing Anzhen Hospital, Capital Medical University from January to December 2017 and treated with ticagrelor and aspirin (aspirin 100 mg/d, ticagrelor 180 mg/d). Medical records of the patients who met the inclusion criteria(at age>18 years, with medication duration ≥ 1 year, and with complete follow-up records) were collected and retrospectively analyzed. The patients were divided into bleeding group and non-bleeding group according to whether there were bleeding events within 1 year. Baseline clinical characteristics such as gender, age, type of ACS, comorbidities, combined drugs, history of percutaneous coronary intervention, routine blood parameters, liver and kidney function, and etc. in patients between 2 groups were compared. The risk factors of bleeding events were analyzed using logistic regression method and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 180 patients were entered in the analysis, including 135 males and 58 females, aged (57±10) years, with the range of 31 to 81 years. There were 39 patients in the bleeding group and 141 patients in the non-bleeding group, and the incidence of bleeding events was 21.7%. None of the differences in gender distribution, age, comorbidities, history of percutaneous coronary intervention or combined drugs in patients between the 2 groups were statistically significant (all P>0.05). The platelet count of patients in the bleeding group was significantly lower than that in the non-bleeding group [(197±49) ×10 9/L vs. (220±60) ×10 9/L, t=2.254, P=0.025]. The shortest time from medication to the onset of bleeding of the 39 patients in the bleeding group was 14 days and the longest one was 12 months. The cumulative incidences of bleeding events at 3, 6, and 12 months of medication were 12.2% (22/180), 18.3% (33/180), and 21.7% (39/180), respectively. All bleeding events were minor bleeding, and the skin mucous ecchymosis had the highest incidence, which was 15.0% (27/180), followed by gingival bleeding or nosebleed, which was 7.2% (13/180). The incidence of fundus hemorrhage was 1.7% (3/180) and incidences of gastrointestinal bleeding and hematuria were both 0.6% (1/180). Multivariate logistic regression analysis showed that low platelet count was an independent risk factor for bleeding events [ OR=0.991, 95 %CI: 0.984-0.999, P=0.020]. Conclusions:ACS patients have a relative high risk of bleeding events when treated with ticagrelor combined with aspirin, but most of them were minor. For ACS patients with low platelet counts, this anti-platelet regimen should be used with caution and drug monitoring should be done in the whole course.

Objective:To explore the occurrence and risk factors of bleeding events in acute coronary syndromes (ACS) patients treated with ticagrelor combined with aspirin.Methods:The study subjects were selected from ACS patients who were admitted to Beijing Anzhen Hospital, Capital Medical University from January to December 2017 and treated with ticagrelor and aspirin (aspirin 100 mg/d, ticagrelor 180 mg/d). Medical records of the patients who met the inclusion criteria(at age>18 years, with medication duration ≥ 1 year, and with complete follow-up records) were collected and retrospectively analyzed. The patients were divided into bleeding group and non-bleeding group according to whether there were bleeding events within 1 year. Baseline clinical characteristics such as gender, age, type of ACS, comorbidities, combined drugs, history of percutaneous coronary intervention, routine blood parameters, liver and kidney function, and etc. in patients between 2 groups were compared. The risk factors of bleeding events were analyzed using logistic regression method and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 180 patients were entered in the analysis, including 135 males and 58 females, aged (57±10) years, with the range of 31 to 81 years. There were 39 patients in the bleeding group and 141 patients in the non-bleeding group, and the incidence of bleeding events was 21.7%. None of the differences in gender distribution, age, comorbidities, history of percutaneous coronary intervention or combined drugs in patients between the 2 groups were statistically significant (all P>0.05). The platelet count of patients in the bleeding group was significantly lower than that in the non-bleeding group [(197±49) ×10 9/L vs. (220±60) ×10 9/L, t=2.254, P=0.025]. The shortest time from medication to the onset of bleeding of the 39 patients in the bleeding group was 14 days and the longest one was 12 months. The cumulative incidences of bleeding events at 3, 6, and 12 months of medication were 12.2% (22/180), 18.3% (33/180), and 21.7% (39/180), respectively. All bleeding events were minor bleeding, and the skin mucous ecchymosis had the highest incidence, which was 15.0% (27/180), followed by gingival bleeding or nosebleed, which was 7.2% (13/180). The incidence of fundus hemorrhage was 1.7% (3/180) and incidences of gastrointestinal bleeding and hematuria were both 0.6% (1/180). Multivariate logistic regression analysis showed that low platelet count was an independent risk factor for bleeding events [ OR=0.991, 95 %CI: 0.984-0.999, P=0.020]. Conclusions:ACS patients have a relative high risk of bleeding events when treated with ticagrelor combined with aspirin, but most of them were minor. For ACS patients with low platelet counts, this anti-platelet regimen should be used with caution and drug monitoring should be done in the whole course.

Objective To evaluate the risk of acute kidney injury (AKI) induced by sodium glucose co-transporter 2 (SGLT2) inhibitors (canagliflozin,dapagliflozin,empagliflozin,and ertugliflozin).Methods Reports of AKI events induced by SGLT2 inhibitors and non-SGLT2 inhibitors received from January 1,2013 to September 30,2018 in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database were collected.The relationship between the drugs mentioned above and the AKI events in all patients and especially in patients with diabetes mellitus,respectively,were analyzed by the method of reporting odds ratio (ROR).Results A total of 2 949 reports of SGLT2 inhibitors-induced AKI (2.50％ of 117 843 AKI event reports in the database during the study period),and 114 894 reports of non-SGLT2 inhibitors-induced AKI were retrieved from the database.The ROR values of AKI events induced by overall SGLT2 inhibitors,canagliflozin,dapagliflozin,and empagliflozin in all patients were 4.14 (95％ CI:3.98-4.30),5.58 (95％ CI:5.35-5.83),2.62 (95％ CI:2.35-2.92),and 1.96 (95％ CI:1.76-2.19),respectively,and in patients with diabetes mellitus were 2.84 (95 ％ CI:2.71-2.98),3.90 (95 ％ CI:3.69-4.12),1.70 (95％CI:1.48-1.94),and 1.30 (95％CI:1.15-1.48),respectively.Due to the short time to market,less than 3 reports of AKI events induced by ertugliflozin were reported,thus ROR analysis was not conducted for ertugliflozin.The analyses of combined medication showed that in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 8.05 (95％ CI:7.10-9.13) when SGLT2 inhibitors were combined with diuretics,which increased by 80.90％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 6.07 (95％ CI:5.27-7.00),which increased by 92.09％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.87 (95％CI:4.89-7.04) when SGLT2 inhibitors were combined with non-steroidal anti-inflammatory drugs (NSAID),which increased by 39.43％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.66 (95％ CI:3.79-5.74),which increased by 61.25％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.60 (95％ CI:5.12-6.14) when SGLT2 inhibitors were combined with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers,which increased by 25.56％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.05 (95％ CI:3.66-4.48),which increased by 27.36％.Conclusions SGLT2 inhibitors might increase the risk of AKI and this risk was mainly from canagliflozin,suggesting that dapagliflozin and empagliflozin were relatively safe to patients.The risk of AKI might increase when SGLT2 inhibitors were combined with diuretics or NSAID.

Objective To evaluate the risk of acute kidney injury (AKI) induced by sodium glucose co-transporter 2 (SGLT2) inhibitors (canagliflozin,dapagliflozin,empagliflozin,and ertugliflozin).Methods Reports of AKI events induced by SGLT2 inhibitors and non-SGLT2 inhibitors received from January 1,2013 to September 30,2018 in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database were collected.The relationship between the drugs mentioned above and the AKI events in all patients and especially in patients with diabetes mellitus,respectively,were analyzed by the method of reporting odds ratio (ROR).Results A total of 2 949 reports of SGLT2 inhibitors-induced AKI (2.50％ of 117 843 AKI event reports in the database during the study period),and 114 894 reports of non-SGLT2 inhibitors-induced AKI were retrieved from the database.The ROR values of AKI events induced by overall SGLT2 inhibitors,canagliflozin,dapagliflozin,and empagliflozin in all patients were 4.14 (95％ CI:3.98-4.30),5.58 (95％ CI:5.35-5.83),2.62 (95％ CI:2.35-2.92),and 1.96 (95％ CI:1.76-2.19),respectively,and in patients with diabetes mellitus were 2.84 (95 ％ CI:2.71-2.98),3.90 (95 ％ CI:3.69-4.12),1.70 (95％CI:1.48-1.94),and 1.30 (95％CI:1.15-1.48),respectively.Due to the short time to market,less than 3 reports of AKI events induced by ertugliflozin were reported,thus ROR analysis was not conducted for ertugliflozin.The analyses of combined medication showed that in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 8.05 (95％ CI:7.10-9.13) when SGLT2 inhibitors were combined with diuretics,which increased by 80.90％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 6.07 (95％ CI:5.27-7.00),which increased by 92.09％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.87 (95％CI:4.89-7.04) when SGLT2 inhibitors were combined with non-steroidal anti-inflammatory drugs (NSAID),which increased by 39.43％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.66 (95％ CI:3.79-5.74),which increased by 61.25％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.60 (95％ CI:5.12-6.14) when SGLT2 inhibitors were combined with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers,which increased by 25.56％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.05 (95％ CI:3.66-4.48),which increased by 27.36％.Conclusions SGLT2 inhibitors might increase the risk of AKI and this risk was mainly from canagliflozin,suggesting that dapagliflozin and empagliflozin were relatively safe to patients.The risk of AKI might increase when SGLT2 inhibitors were combined with diuretics or NSAID.