OBJECTIVE To analyze the medication needs of parents of pediatric children in our hospital regarding drug instructions， and explore improvement strategies， thereby providing a basis for clinically guiding the rational use of drugs in pediatric patients. METHODS A self-designed questionnaire was used to randomly select the parents of pediatric patients in the pediatric outpatient and emergency departments of our hospital from July 1st to September 30th， 2024. A randomized face-to-face survey was conducted regarding their willingness to read drug instructions， their current understanding status， and their needs. The survey results were then statistically analyzed. RESULTS A total of 300 questionnaires were distributed in this survey， and 299 valid questionnaires were recovered， with an effective recovery rate of 99.7%. Before medication， the parents who “always” and “often” read the drug instructions in detail accounted for 39.1% （117 respondents） and 35.1% （105 respondents）， respectively. Statistically significant differences were observed in the willingness to read drug instructions among respondents with varying educational levels and occupations （P＜0.05）. Among the 299 respondents， only 48 people （16.1%）“ fully understood” the drug instructions， and the average understanding score of all the respondents was （3.77±0.83） points. The stronger the respondents’ willingness to read drug instructions， the higher their understanding scores of drug instructions （P＜0.05）. A total of 256 respondents thought that drug instructions were of great help to themselves， and the average helpfulness rating score of all the respondents was （4.28±0.78） points. Under the conditions of varying ages， educational levels， occupations， and willingness to read drug instructions， statistically significant differences were observed in the scores representing the degree of helpfulness of drug instructions to the respondents （P＜0.05）. Respondents paid the most attention to content in drug instructions such as “dosage and administration method”，“ adverse reactions”， and “indications and therapeutic categories”. The most difficult sections for them to understand included “chemical structure and properties”， “pharmacological and toxicological effects” ， and “pharmacokinetics”， etc. The demographic characteristics of the respondents were not significantly associated with the content areas of drug instructions they most desired to see improved （P＞0.05）. Most respondents （86.0%） hoped to improve the instructions mainly by “simplifying professional terms to make them more accessible”. Others included “highlighting key information” （60.5%） and “providing more detailed medication guidance” （49.2%）， etc. CONCLUSIONS Parents of pediatric patients in our hospital have a high demand for drug instructions but low comprehension. The pharmacy department should make targeted improvements to drug instructions based on parents’ actual needs， helping them accurately obtain medication knowledge and reduce potential medication safety risks.

Objective: To understand the mortality and probability of premature death due to malignant tumors, cardio-cerebrovascular diseases, diabetes and chronic respiratory diseases in Taizhou City, Zhejiang Province, so as to provide the basis for the improvement of chronic diseases prevention and control strategies. Methods: The death data of the four chronic diseases among local residents in Taizhou City from 2019 to 2022 were collected through Taizhou Chronic Disease Information Management System, and the crude mortality, standardized mortality (standardized by the data of the seventh national population census in 2020) and probability of premature death were calculated. The trends in mortality and probability of premature death were analyzed using annual percent change (APC). The attainment of probability of premature death due to the four chronic diseases were evaluated using the target values and predicted values in 2025 and 2030. Results: There were 119 899 deaths from the four chronic diseases in Taizhou City from 2019 to 2022, with the crude mortality of 494.48/105 and the standardized mortality of 410.68/105, which was no significant changing trend (APC=4.680% and -2.795%, both P>0.05). The probability of premature death decreased from 10.39% to 8.69% (APC=-6.027%, P<0.05). The crude mortality and standardized mortality in males were higher than those in females (562.13/105 vs. 424.08/105; 461.67/105 vs. 353.81/105; both P<0.05). The crude mortality and standardized mortality in rural areas were higher than those in urban areas (499.65/105 vs. 480.52/105; 429.20/105 vs. 365.68/105; both P<0.05). The probability of premature death in women and rural residents showed downward trends (APC=-8.210% and -7.558%, both P<0.05) from 2019 to 2022. The standardized mortality and probability of premature death due to malignant tumors showed downward trends (APC=-6.090% and -8.019%, both P<0.05). The crude mortality of diabetes showed an upward trend (APC=18.654%, P<0.05). The predicted values for probability of premature death due to due to the four chronic diseases in 2025 and 2030 were 7.27% and 5.40%, respectively, and were lower than the target values of 10.02% and 8.77%. Conclusions From 2019 to 2022, there was no significant trends in the mortality of four chronic diseases in Taizhou City, with rural men being the key population for prevention and control. The probability of premature death showed a downward trend, and it was expected to achieve the target in 2025 and 2030.

OBJECTIVE To mine the adverse drug event （ADE） signals of sacituzumab govitecan and provide a reference for its clinical safety application. METHODS The data of sacituzumab govitecan-related ADE reports were collected from the FDA Adverse Event Reporting System （FAERS） database from April 1， 2020 to April 30， 2024. The reporting odds ratio（ROR） method， the United Kingdom Medicines and Healthcare Products Regulatory Agency comprehensive standard method （MHRA） and Bayesian confidence propagation neural network （BCPNN） method were used for data mining. Systematic organ classification （SOC） and preferred term （PT） in the ADE terminology set of version 27.0 of the Medical Dictionary for Regulatory Activities （MedDRA） were used for data classification and statistics. RESULTS A total of 753 ADE reports were obtained for sacituzumab govitecan， including 46 ADE signals， involving 12 SOCs， and 13 new suspicious ADE signals not recorded in the instructions. Top 5 PTs in terms of occurrence frequency were disease progression， death， diarrhea， off label use and inappropriate schedule of product administration. Top 5 PTs in terms of signal strength were febrile bone marrow aplasia， neutropenic colitis， disease progression， pulmonary sepsis， general physical condition abnormal. New ADE not recorded in the drug instructions included neutropenic sepsis， hepatic cytolysis， meningitis， aplasia， etc. CONCLUSIONS When using sacituzumab govitecan in clinical practice， special attention should be paid to ADE with highly reported cases and strong signal intensity， such as febrile neutropenia， febrile bone marrow aplasia， weight fluctuations， colitis. We should also be alert to new suspected ADE such as neutropenic sepsis， hepatic cytolysis， meningitis， and aplasia to ensure patient medication safety.

Lymphoedema of lower extremities,chronic and progressive,will severely deteriorate the quality of life of patients as it progresses.Thus,early diagnosis and treatment to delay the progress of the disease is conducive to improving the prognosis of patients.At present,common techniques for the diagnosis of lower limb lymphedema,whose advantages and disadvantages vary,cannot be applied to individual case comprehensively.CEUS has the advantages of non-invasion,convenience,real-time,and good repeatability for this disease.CEUS can enhance the image of lymph in lymphatics,and has a high sensitivity to superficial lymphatics,gradually applied in lymphedema of lower limbs.This article reviews the application of CEUS in lower limb lymphedema.

Objectives:To evaluate the coronary microcirculatory function in patients with hypertrophic cardiomyopathy(HCM). Methods:Patients who diagnosed with HCM and underwent the measurement of index of microcirculatory resistance(IMR)using pressure-sensing guide wire from November 2021 to April 2023 were prospectively included.Coronary microcirculatory dysfunction(CMD)was defined as IMR≥25 U and patients were grouped accordingly to compare the clinical characteristics. Results:A total of 25 HCM patients were included.Mean age was(58.4±13.3)years,18 were men and mean body mass index was(26.7±3.6)kg/m2.Coronary microcirculatory function was successfully evaluated in all patients and the mean value of IMR was(30.5±15.3)U.There were 15 patients with CMD.Baseline clinical characteristics,laboratory examinations and medications were simialr between patients with and without CMD.The maximal left ventricular wall was significant thicker in patients with CMD compared with that in patients without CMD([20.2±2.8]mm vs.[16.9±2.3]mm,P=0.005).There was no significant difference in other echocardiographic parameters between two groups(all P>0.05).In the range of IMR value less than 50 U(n=22),there was a significant linear positive correlation between maximal left ventricular wall thickness and IMR(r=0.423,P=0.049).There was no significant difference in coronary flow reserve and fractional flow reserve between two groups. Conclusions:The severity of CMD is positively correlated with left ventricular wall thickness in HCM patients.

Chronic aortic stenosis and regurgitation can cause left ventricular remodeling.Whether these changes are reversible and their reversibility after valve replacement are the main determinants affecting the timing and prognosis of surgery.Imaging techniques are commonly used to evaluate myocardial structure and function,in which echocardiography and enhanced CT are helpful to evaluate artificial flap function and monitor left ventricular deformation,while cardiac MR and PET/CT are helpful to identify the progression and regression of postoperative cardiac fibrosis.The combined application of these new techniques can improve clinical outcomes by early diagnosis and non-invasive detection of postoperative left ventricular reverse remodeling.This paper reviews the evaluation and application of multi-modal imaging techniques for left ventricular reverse remodeling after aortic valve replacement.

Objective:To compare the clinical efficacy of laparoscopic pelvic floor three-level internal repair and stapled transanal rectum resection (STARR) in the treatment of male patients with intrarectal prolapse. Mlethds A total of 101 male patients with rectal intrarectal prolapse from Feb 2013 to Oct 2017 were enrolled into this study. Fifty-two patient in group A received laparoscopic pelvie floor three-level internal repair, and 49 patients in group B received STARR. The Wexner incontinence scale (WIS), Wexner constipation scale (WCS) score, gastrointestinal quality of life index (GIQLI) and degree of internal rectal prolapse (DIRP) were systematically evaluated before surgery and 3 months, 1 year and 3 years after surgery. Results:There were no significant differences in age, BMI, number of bowel movements(BM), WIS, WCS, GIQLI and DIRP between the two groups before surgery(all P>0.05). The WIS, WCS, GIQLI and DIRP in 3 months, 1year and 3 years after surgery in both two groups were significantly better than those before surgery ( t=20.169, 25.229, 27.278, 23.818, 23.489, 21.152, -3.550, -23.042, -22.901, 82.852, 40.915, 30.010, 11.323, 13.237, 11.452, 19.473, 18.647, 17.108, -8.791, -5.254, -5.846, 37.439, 30.598, 22.852, all P<0.001). The GIQLI in Group A was significantly better than that of group B at 1 year and 3 years after surgery ( P<0.001) but close to that in Group B at 3 months after surgery ( t=1.428, P=0.156). The WIS, WCS and DIRP in group A were significantly better than those in group B at 3 months, 1 year and 3 years after surgery, with statistical significance ( t=-8.243, -15.688, -20.193, -4.268, -4.768, -4.851, 11.329, 13.543, -5.399, -4.745, -4.598, all P<0.001). There was no signifcant difference in grade Ⅰ-Ⅲ complications between the two groups (χ 2=0.046, P=1.00). Conclusion:Laparoscopic pelvic floor three-level internal repair is more effective than transanal STARR in the treatment of male internal rectal prolapse.

Nowadays,the application of ultrasound is not only used in clinical imaging,but also extended in the study of drug delivery.Diagnostic ultrasound combined with microbubbles can effectively open the biological barriers,which can enhance the targeted delivery of drugs and be beneficial to the combination of ultrasound and disease treatment.This review summarizes the biological effects of ultrasound,the characteristics of ultrasound microbubbles and the potential ability that solving the biological barrier problems in cancer therapy by using ultrasound targeted microbubble destruction,hoping to provide some reference for the further development of therapeutic ultrasound as a safe and effective drug targeted delivery strategy.

Objective:To evaluate the application value of left ventricular pressure-strain loop (PSL) in patients with rheumatoid arthritis (RA) by the PSL.Methods:From April 2020 to June 2021, 75 RA patients(case group) and 35 healthy physical examination person(control group) were selected from the Affiliated Hospital of Inner Mongolia Medical University.According to the disease activity scores 28(DAS28) joint disease range of activity score, the patients were divided into low range of activity group (16 cases), medium range of activity group (35 cases) and high range of activity group (24 cases). Echocardiographic examinations were performed on all patients, conventional ultrasound data were collected and the left ventricular PSL technology was used to analyze the myocardial work parameters, including global work index (GWI), global constructive work (GCW), global waste work (GWW) and global work efficiency (GWE). The mean values of myocardial work index (MWI), constructive work (CW), waste work (WW) and work efficiency (WE) were calculated. The differences of myocardial work parameters between the case groups and the control group were compared, and the correlation analysis of myocardial work parameters with global longitudinal strain of left ventricle(LVGLS), left ventricular ejection fraction(LVEF) and DAS28 scores were conducted.Results:①There were no statistically significant differences of clinical data between each case group and the control group (all P>0.05). ②Compared with the control group and low disease activity group, the LVGLS of medium and high disease activity groups decreased obviously (all P<0.05). ③The GWI and GCW of the medium and high disease activity groups were significantly lower than those of the control group (all P<0.05), and there were no statistically significant differences of GWW and GWE between the case groups and the control group (all P>0.05). The mid-segment MWI, apical MWI and CW of the medium and high disease activity case groups, and the mid-segment CW of the medium disease activity case group were lower than those of the control group (all P<0.05). ④In the case group, GWI, GCW and LVEF were significantly and positively correlated ( rs1=0.253, P=0.008; rs2=0.261, P=0.024), and were significantly negatively correlated with LVGLS ( rs1=-0.525, P<0.001; rs2=0.455, P<0.001). There were no significant correlations between myocardial work parameters and DAS28 score (all P>0.05). Conclusions:PSL can early reflect to the impaired cardiac function of RA patients with moderate and high disease activity, and provide a new imaging method for clinical evaluation of the cardiac function of patients.

Objective:To evaluate the cardiac function and systolic dyssynchrony of fetuses exposed to maternal autoimmune antibodies (anti-SSA/Ro60, anti-SSA/Ro52 and anti-SSB/La) by using two-dimensional speckle tracking imaging (2D-STI).Methods:A total of 52 pregnant women with singleton pregnancy in the Affiliated Hospital of Inner Mongolia Medical University from July 2018 to November 2020 were selected. Eighteen fetuses of mothers with autoimmune antibodies were enrolled as autoimmune disease (AD) group and 34 fetuses of healthy mothers without antibodies were included as control group. Maternal baseline characteristics, fetoplacental Doppler parameters, and conventional echocardiographic data of two groups were prospectively collected. The systolic global and regional longitudinal strain of left and right ventricles (LV and RV) and the time to peak strain of regional myocardium were measured using 2D-STI. The differences in time to peak strain between the LV free wall and RV free wall (two-chamber dyssynchrony, 2C-DYS) and between the septum and LV free wall (one-chamber dyssynchrony, 1C-DYS) were also calculated.Results:There were no significant differences between the two groups in conventional systolic and diastolic functional parameters for the LV and RV(all P>0.05). The myocardial deformation parameters and 2C-DYS obtained by 2D-STI showed no statistical differences between two groups(all P>0.05). However, 1C-DYS was significantly more prolonged in the AD group than control group[28.50(13.50, 39.25)ms vs 19.50(8.00, 29.25)ms, P=0.042]. Conclusions:LV systolic mechanical dyssynchrony in fetuses of mothers with autoimmune antibodies suggests in-utero subclinical damage of the cardiac conduction system.