OBJECTIVE To standardize the management of patients’ self-carried medicines dispensed by Pharmacy Intravenous Admixture Services （PIVAS） of our hospital， improve the quality of medical care， and ensure the safety of patients’ medication. METHODS Based on evidence-based methodology， the research literature of domestic medical institutions on the management of patients’ self-carried medicines was systematically searched and analyzed， and the data on the use of patients’ self- carried medicines in our hospital from February to April 2023 were extracted based on our hospital’s information system. A fishbone diagram of the difficulties in constructing patients’ self-carried medicines within PIVAS of our hospital was drawn through brainstorming， thereby establishing a refined whole-process management system for patients’ self-carried medicines in PIVAS. The effectiveness of the system was evaluated through the indicators， including dispensing volume， error rate， and so on. RESULTS & CONCLUSIONS A total of 15 papers were included， covering descriptive studies on the reasons for the use of patients’ self- carried medicines， current status of their use， management system， management methods， management suggestions. There were 12 clinical departments in our hospital with a high proportion of patients using self-carried medicines， among which the pediatric neurology department had the most use of patients’ self-carried medicines， accounting for 10.65%. In terms of dosage form， injectable drugs accounted for 13.68%， all of anticancer drug were uniformly dispensed by our hospital’s PIVAS. PIVAS in our hospital had successfully constructed the management system for dispensing patients’ self-carried medicines， which included the processes of drug reception and preservation， medical document retention， doctor’s order review， drug placement， dispensing， review and transportation. After the implementation of the system， from May 2023 to October 2024， our hospital’s PIVAS dispensed 654 bags of patients’ self-carried medicines in total，with a monthly average of 36 bags. Zero error management 5）；was realized for all patients’ self-carried medicines. The system operates stably and effectively， thereby ensuring the high-quality dispensing of patients’ self-carried medicines in PIVAS of our hospital.

Objective Based on the analysis of the results of retesting of blood donors with human immunodeficiency virus(HIV)serological single-reagent reactivity,the rationality and practical effect of the existing retesting strategy were discussed.Methods HIV serological single-reagent reactivity blood donors in Wenzhou from January to December 2023 were selected as the study objects,and were confirmed by Wenzhou Center for Disease Control and Prevention(CDC)and returning test to confirm whether they could be returnee.Differences in return rates were analyzed by the basic data of blood donors and the S/CO value of HIV serological test during screening.Results Among the 374 HIV serological single-reagent reactivity blood donors,55 were confirmed by CDC with uncertain HIV antibodies,319 met the criteria for return,and 84 actively applied for return.78 showed no reactivity through self-test and return test and were allowed to return to the team.Four showed HIV serological reactivity,one showed HIV nucleic acid testing(NAT)test reactivity,permanent shielding.One showed the reactivity of anti-HIV chemiluminescence immunoassay test,and the HIV NAT test was noreactivity,and continued to be screened to participate in the next round of return.There were statistically significant differences in the permissible return rate of blood donors with different ages,blood types and blood donation times(P<0.05).There was no significant difference in the allowed return rate of blood donors with different S/CO values during screening(χ2=1.898,P=0.168).Conclusion Reasonable return procedures can effectively reduce the loss of blood donors and ensure the safety of blood for clinical use.

Objective:To analyze the demographic characteristics of positive syphilis screening test results among unpaid blood donors in Wenzhou and to provide a theoretical basis for recalling donors who have received false positive results in their syphilis screening tests.Methods:A retrospective study was conducted on the demographic characteristics of 746 unpaid blood donors in Wenzhou who tested positive for syphilis from March 2020 to September 2022. Donors with positive single-test results received targeted notifications, health inquiries, and general examinations. With their consent, these donors were allowed to re-enter the blood donation process.Results:A total of 296 898 blood donor samples were tested, resulting in the identification of 746 positive cases of syphilis antibodies, yielding a positivity rate of 0.3%. Among the positive cases, most were males aged between 35 and 45 years, with blood types A and O. They generally had an education level of junior high school or lower and were primarily first-time donors. Specifically, males accounted for 53.6% of the positive cases, while individuals aged 35 to 45 years made up 34.0% of the positive cases. Blood types A and O comprised 30.2% and 36.9% of the positive cases, respectively. Additionally, individuals with an education level of junior high school or below accounted for 43.7% of the positive cases, and first-time donors constituted 81.6%. A total of 14 cases were recalled, of which 11 were successfully contacted. Among the cases that underwent testing with the enzyme-linked immunosorbent assay, 85.7% (12/14) tested negative for syphilis antibodies, resulting in a recall success rate of 78.6% (11/14).Conclusions:To prevent the transmission of syphilis through blood transfusions, blood donation centers should prioritize recruiting donors from low-risk populations and encourage regular blood donation. Furthermore, these centers should implement a comprehensive and effective recall program to reduce the loss of qualified blood donors and enhance blood safety.

Objective:To analyze the demographic characteristics of positive syphilis screening test results among unpaid blood donors in Wenzhou and to provide a theoretical basis for recalling donors who have received false positive results in their syphilis screening tests.Methods:A retrospective study was conducted on the demographic characteristics of 746 unpaid blood donors in Wenzhou who tested positive for syphilis from March 2020 to September 2022. Donors with positive single-test results received targeted notifications, health inquiries, and general examinations. With their consent, these donors were allowed to re-enter the blood donation process.Results:A total of 296 898 blood donor samples were tested, resulting in the identification of 746 positive cases of syphilis antibodies, yielding a positivity rate of 0.3%. Among the positive cases, most were males aged between 35 and 45 years, with blood types A and O. They generally had an education level of junior high school or lower and were primarily first-time donors. Specifically, males accounted for 53.6% of the positive cases, while individuals aged 35 to 45 years made up 34.0% of the positive cases. Blood types A and O comprised 30.2% and 36.9% of the positive cases, respectively. Additionally, individuals with an education level of junior high school or below accounted for 43.7% of the positive cases, and first-time donors constituted 81.6%. A total of 14 cases were recalled, of which 11 were successfully contacted. Among the cases that underwent testing with the enzyme-linked immunosorbent assay, 85.7% (12/14) tested negative for syphilis antibodies, resulting in a recall success rate of 78.6% (11/14).Conclusions:To prevent the transmission of syphilis through blood transfusions, blood donation centers should prioritize recruiting donors from low-risk populations and encourage regular blood donation. Furthermore, these centers should implement a comprehensive and effective recall program to reduce the loss of qualified blood donors and enhance blood safety.

INTRODUCTION: Lecanemab has shown promise in treating early Alzheimer's disease (AD), but its safety and efficacy in Chinese populations remain unexplored. This study aimed to evaluate the safety and 6-month clinical outcomes of lecanemab in Chinese patients with mild cognitive impairment (MCI) or mild AD. METHODS: In this single-arm, real-world study, participants with MCI due to AD or mild AD received biweekly intravenous lecanemab (10 mg/kg). The study was conducted at Hainan Branch, Ruijin Hospital Shanghai Jiao Tong University School of Medicine. Patient enrollment and baseline assessments commenced in November 2023. Safety assessments included monitoring for amyloid-related imaging abnormalities (ARIA) and other adverse events. Clinical and biomarker changes from baseline to 6 months were evaluated using cognitive scales (mini-mental state examination [MMSE], montreal cognitive assessment [MoCA], clinical dementia rating-sum of boxes [CDR-SB]), plasma biomarker analysis, and advanced neuroimaging. RESULTS: A total of 64 patients were enrolled in this ongoing real-world study. Safety analysis revealed predominantly mild adverse events, with infusion-related reactions (20.3%, 13/64) being the most common. Of these, 69.2% (9/13) occurred during the initial infusion and 84.6% (11/13) did not recur. ARIA-H (microhemorrhages/superficial siderosis) and ARIA-E (edema/effusion) were observed in 9.4% (6/64) and 3.1% (2/64) of participants, respectively, with only two symptomatic cases (one ARIA-E presenting with headache and one ARIA-H with visual disturbances). After 6 months of treatment, cognitive scores remained stable compared to baseline (MMSE: 22.33 ± 5.58 vs . 21.27 ± 4.30, P = 0.733; MoCA: 16.38 ± 6.67 vs . 15.90 ± 4.78, P = 0.785; CDR-SB: 2.30 ± 1.65 vs . 3.16 ± 1.72, P = 0.357), while significantly increasing plasma amyloid-β 42 (Aβ42) (+21.42%) and Aβ40 (+23.53%) levels compared to baseline. CONCLUSIONS: Lecanemab demonstrated a favorable safety profile in Chinese patients with early AD. Cognitive stability and biomarker changes over 6 months suggest potential efficacy, though high dropout rates and absence of a control group warrant cautious interpretation. These findings provide preliminary real-world evidence for lecanemab's use in China, supporting further investigation in larger controlled studies. REGISTRATION ClinicalTrials.gov , NCT07034222.
Humans ; Alzheimer Disease/drug therapy* ; Male ; Female ; Aged ; Middle Aged ; Cognitive Dysfunction/drug therapy* ; Aged, 80 and over ; Amyloid beta-Peptides/metabolism* ; Biomarkers ; East Asian People

Objective:To explore the application value of high-resolution temporal bone CT and DW-MRI fusion technology in achieving precise diagnosis and anatomical localization of middle ear cholesteatoma during endoscopic surgery. Methods:Eighteen patients initially diagnosed with middle ear cholesteatoma in the Department of Otolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, from January to June 2024 were enrolled.Preoperative high-resolution temporal bone CT and DW-MRI were performed, and rtStation software was used for image fusion to construct CT-MRI fused images. The involvement of cholesteatoma in six anatomical subregions of the temporal bone was evaluated. Using surgical pathology as the gold standard, and combining surgical videos and anatomical records, the sensitivity, specificity, and accuracy of pure CT, pure DW-MRI, and CT-MRI fused images in evaluating middle ear cholesteatoma lesions were compared. Results:A total of 18 patients were included, and 17 cases were pathologically confirmed as middle ear cholesteatoma postoperatively. The sensitivity of the preoperative of preoperative CT was 100%, but the specificity was only 44.44%, with an overall accuracy of 72.22%; the sensitivity and specificity of DW-MRI evaluation were 81.46% and 85.19%, the accuracy was 83.33%, respectively. In contrast, the sensitivity and specificity of CT-MRI fusion image to the spatial localization of cholesteatoma were higher than that of DW-MRI alone（92.59% vs 81.46%; 98.15% vs 85.19%）, and the diagnostic accuracy was also significantly improved（95.37% vs 83.33%）. The Kappa values for the agreement between HRCT, DW-MRI, and CT-MRI segmentation localization and pathological results were 0.444, 0.667, and 0.907 respectively. The chi-square paired t-test confirmed statistically significant diagnostic differences between groups（P<0.001）. Results demonstrated that CT-MRI significantly outperformed HRCT and DW-MRI in diagnostic efficacy for segmental localization of primary posterior congenital middle ear cholesteatoma. Conclusion:High-resolution temporal bone CT combined with DW-MRI fusion technology demonstrates higher sensitivity, specificity, and accuracy in the diagnosis and spatial localization of middle ear cholesteatoma than single imaging modalities. It can provide more precise evaluation of lesion scope for endoscopic surgery, showing important clinical application value.
Humans ; Cholesteatoma, Middle Ear/diagnostic imaging* ; Tomography, X-Ray Computed ; Temporal Bone/diagnostic imaging* ; Diffusion Magnetic Resonance Imaging ; Female ; Male ; Adult ; Sensitivity and Specificity ; Middle Aged ; Endoscopy

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Objective Based on the analysis of the results of retesting of blood donors with human immunodeficiency virus(HIV)serological single-reagent reactivity,the rationality and practical effect of the existing retesting strategy were discussed.Methods HIV serological single-reagent reactivity blood donors in Wenzhou from January to December 2023 were selected as the study objects,and were confirmed by Wenzhou Center for Disease Control and Prevention(CDC)and returning test to confirm whether they could be returnee.Differences in return rates were analyzed by the basic data of blood donors and the S/CO value of HIV serological test during screening.Results Among the 374 HIV serological single-reagent reactivity blood donors,55 were confirmed by CDC with uncertain HIV antibodies,319 met the criteria for return,and 84 actively applied for return.78 showed no reactivity through self-test and return test and were allowed to return to the team.Four showed HIV serological reactivity,one showed HIV nucleic acid testing(NAT)test reactivity,permanent shielding.One showed the reactivity of anti-HIV chemiluminescence immunoassay test,and the HIV NAT test was noreactivity,and continued to be screened to participate in the next round of return.There were statistically significant differences in the permissible return rate of blood donors with different ages,blood types and blood donation times(P<0.05).There was no significant difference in the allowed return rate of blood donors with different S/CO values during screening(χ2=1.898,P=0.168).Conclusion Reasonable return procedures can effectively reduce the loss of blood donors and ensure the safety of blood for clinical use.

Objective:To report a large family of epileptic seizures caused by DEPDC5 gene variation, and to conduct a clinical genetic analysis on a proband in this family with both DEPDC5 gene mutation and a de novo GABRA1 gene mutation. Methods:The medical records of a family suffering from epilepsy due to a newly identified DEPDC5 gene variant were compiled from cases admitted to Hebei General Hospital in January 2024. The relevant genetic detection was carried out by sampling the peripheral blood of the family members. The whole exome sequencing techniques were employed for the identification of pathogenic mutation sites in the proband. The next generation sequencing technology was utilized for other family members to identify disease-causing mutation sites associated with the clinical phenotype of patients, and these findings were confirmed using first-generation Sanger sequencing technology. Results:The proband, who experienced seizures in early childhood and harbored two gene mutation sites, exhibited an early onset age along with significant delays in both intellectual and motor development. The primary clinical manifestations included focal seizures, myoclonus, and tonic-clonic symptoms. When compared with other family members who had the onset of epilepsy during adolescence, carried only one mutation site, and had generalized epileptic seizures and mostly accompanied by attention deficit hyperactivity disorder, the proband showed obvious clinical heterogeneity. The results of whole exome sequencing indicated that the proband had both GABRA1 c.640C>T(p.Arg214Cys) and DEPDC5 c.4348A>T(p.Lys1450 *) mutations inherited from the father. The mutation inherited from the father was reported here for the first time and had not been reported before, with the paternal mutation traceable to the proband's grandfather, while the proband's mother and grandmother were found to be devoid of the mutation. In this family, 5 patients with similar seizure phenotype all had pathogenic mutations at the same locus of the DEPDC5 gene(c.4348A>T, p.Lys1450 *), and the remaining 3 patients with seizure symptoms were not tested. Conclusions:The DEPDC5 gene mutation is the cause of the disease in this family, and the c.4348A>T is the newly discovered mutation site. The proband carries the mutation sites of both GABRA1 gene and DEPDC5 gene. The clinical manifestations of proband are significantly heterogeneous compared with those of his family members.

Objective:To observe the effects of electroacupuncture(EA)combined with Western medication on lower-limb motor function and blood circulation in patients with cerebral infarction-induced hemiplegia in the acute stage. Methods:One hundred eligible patients with acute ischemic stroke accompanied by lower-limb motor dysfunction were allocated to an observation group and a control group using the random number table method,with 50 cases in each group.The control group received routine Western medications for treatment,and the observation group received additional EA intervention.After 2-week and 4-week treatments,the improvement of lower-limb motor function was assessed using the Fugl-Meyer assessment scale for lower extremity(FMA-LE),and changes in the peak blood flow velocities of the posterior tibial(PT)and dorsalis pedis(DP)arteries on the affected side were detected using Doppler. Results:Three cases dropped out during the study,so there were 48 cases in the observation group and 49 in the control group collected for statistical analysis.The FMA-LE score and the peak blood flow velocities of PT and DP arteries increased after 2-week and 4-week treatments in both groups compared with the pre-treatment baseline(P<0.05).After 2-week treatments,the FMA-LE score and the peak blood flow velocities of PT and DP arteries showed no significant differences between the two groups(P>0.05).After 4-week treatments,compared with the control group,the FMA-LE score was higher(P<0.05),and the peak blood flow velocities of PT and DP arteries on the affected side were larger in the observation group(P<0.05). Conclusion:EA combined with Western medication can significantly improve the motor function and blood flow velocity of the affected lower limb in patients with acute cerebral infarction accompanied by hemiplegia.