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 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.

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 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 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 reduce dispensing errors in pharmacy intravenous admixture service （PIVAS） of children’s hospitals. METHODS The risk of dispensing procedures in our PIVAS was identified by applying failure mode and effect analysis （FMEA） model. Potential failure modes that might lead to dispensing errors in each link were determined， and failure causes were analyzed. The severity， incidence and detection degree of potential failure modes were quantitatively scored， and their risk priority number （RPN） was calculated to screen failure modes that needed to be improved in priority； the corresponding improvement measures were developed by 6S management method from six aspects， namely， finishing （seiri）， rectifying （seiton）， sweeping （seiso）， sanitation （seiketsu）， literacy （shitsuke） and safety. The effect of intervention before and after rectification was evaluated. RESULTS Based on the RPN， 32 potential failure modes were selected， of which a total of 18 critical failure modes that needed to be improved in priority. After implementing corresponding measures according to 6S management method， the RPN of 18 critical failure modes decreased. The total RPN decreased from 497 to 142 with a decrease rate of 71.43%. The error rates of 15 critical failure modes were significantly lower than before implementation （P＜0.05）. CONCLUSIONS Applying FMEA model and 6S management method to the risk control of all aspects of PIVAS workflow can effectively reduce the risk of PIVAS dispensing errors and ensure the safety of children’s intravenous medication.

Objective:To compare the imaging quality and metabolic quantitative parameters of pulmonary nodules between Q. Flex whole information five-dimensional (5D) and conventional three-dimensional (3D) PET/CT imaging for clinical evaluation.Methods:Fifty-four patients (30 males, 24 females, age: 60(42, 75) years; 78 solid pulmonary nodules (maximum diameter≤3 cm) with abnormal uptake of 18F-FDG) from Tianjin Cancer Hospital Airport Hospital between June 2022 and August 2022 were enrolled in this retrospective study. All patients underwent 5D scanning and 3D, 5D reconstruction. Image quality scores, signal-to-noise ratio (SNR), SUV max, SUV mean and metabolic tumor volume (MTV) of pulmonary nodules of 5D group and 3D group were evaluated and compared with χ2 test and Wilcoxon signed rank test. Correlation of quantitative parameters between 2 groups were analyzed by using Spearman rank correlation analysis. Results:Thirty-five of 78(45%) pulmonary nodules with image quality score≥4 were found in 5D group, which were more than those in 3D group (22/78(28%); χ2=4.67, P=0.031). Meanwhile, SNR, SUV max, SUV mean, and MTV were significantly positively correlated between the 2 groups ( rs values: 0.86, 0.86, 0.85, and 0.95, all P<0.001). SNR, SUV max and SUV mean of pulmonary nodules in 5D group were significantly higher than those in 3D group, which were 37.46(18.42, 62.00) vs 32.72(16.97, 54.76) ( z=-4.07, P<0.001), 9.71(5.48, 13.82) vs 8.96(4.82, 12.63) ( z=-3.05, P<0.001) and 6.30(3.39, 8.94) vs 5.61(2.99, 7.63)( z=-4.07, P<0.001) respectively. MTV of pulmonary nodules in 5D group was significantly lower than that in 3D group, which was 1.72(0.66, 2.74) cm 3vs 1.98(1.06, 4.63) cm 3 ( z=-7.13, P<0.001). Quantitative parameters of lower lung field and nodules with maximum diameters of >10 mm and ≤20 mm based on 5D scanning changed most significantly compared with those based on 3D scanning ( z values: from -5.23 to -2.48, all P<0.05). Conclusion:Q. Flex 5D PET significantly improves the quantitative accuracy of SUV and MTV of pulmonary nodules, and the improvement of image quality is substantial without increasing the radiation dose, which has clinical practical value.