Neurodevelopmental disorders (NDDs) are a group of diseases caused by abnormal development of the brain and nervous system, mainly including global developmental disabilities/intellectual disabilities, autism spectrum disorders, attention deficit hyperactivity disorder, and others; at present, certain progress has been made in the research on common NDDs, and some effective therapeutic approaches have been developed, but for rare NDDs such as fragile X syndrome, Rett syndrome, and Dravet syndrome, the elucidation of their pathogenesis and the development of therapeutic strategies still face major challenges due to insufficient clinical samples, the complexity of the brain structure, and the limitations of existing research models. In recent years, induced pluripotent stem cells (iPSCs) technology has achieved breakthrough progress, where the directed differentiation of patient-derived iPSCs into neurons, glial cells, and cerebral organoids, combined with clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR associated protein 9 (Cas9) gene-editing technology, provides a novel research model for exploring the pathogenic mechanisms and therapeutic strategies of rare NDDs, and this paper reviews the research advances and challenges of iPSCs technology in the study of rare NDDs.

Objective: To investigate the knowledge, attitude, and practice on disposable plastic tableware and self reported gastrointestinal symptoms in college students. Methods: Stratified sampling method was applied in 338 students of a medical university during the 2020-2021 academic year. The study investigated knowledge, attitude and practice on disposable plastic tableware and self reported gastrointestinal symptoms among students. Results: There were 24.0% students were unaware of the specific material of plastic tableware, 82.0% students had no idea about the meaning of "plastic products logo". About 94.1% of the students thought that plastic tableware might contaminate food, and female students (97.1%) were more worried than male (86.3%) ( χ 2=14.32, P <0.05). The attitude towards the use of disposable tableware was not consistent with the cumulative use score of disposable plastic tableware ( F=1.31, P =0.25),students with high consumption had higher score of accumulative use of disposable plastic tableware ( F=8.32, P <0.01). About 18.3% of the students were prone to report gastrointestinal symptoms. The cumulative scores of disposable plastic tableware weekly using frequency in students who reported gastrointestinal symptoms(14.85±4.01) was still higher than that of no gastrointestinal symptoms group(13.78±3.50), regardless of the effect of takeout ordering frequency( F=4.53，P = 0.03 ). Conclusion College students have limited knowledge of disposable plastic products. However, the use of disposable plastic products may be associated with gastrointestinal diseases. It is suggested to active the propaganda and education, to reduce the use of disposable tableware, and enhance the awareness of health and environment.

Objective:To systematically evaluate correlation between the risk of malignancy and dapagliflozin in type 2 diabetes mellitus.Methods:The databases such as PubMed, the Cochrane Library, American Clinical Trial Registry, Embase, JAMA, Wiley-Blackwell, Springer Link, Elsevier, Ovid, Taylor & Francis Online, CNKI, Wanfang, and VIP (up to March 2021) were searched. The randomized controlled trials (RCTs) on dapagliflozin with outcome indicators including malignancy occurrence were collected. Data extraction and quality analysis were performed for the enrolled literature, and meta-analysis was conducted using RevMan 5.3 software.Results:A total of 22 studies were enrolled in the analysis, all of which were multicenter RCTs, and the quality evaluation results were all grade A. Thirty-one thousand four hundred and fifty-one patients were involved in the 22 studies, of which 16 267 were in the experimental group (dapagliflozin 5 or 10 mg daily) and 15 184 in the control group (placebo or other hypoglycemic drugs). The course of treatment in the 22 studies ranged from 24 weeks to 5.2 years and it was 24 weeks in 15 studies (68.2%). A total of 1 302 patients developed malignancy during the trials, including 661 in the experimental group and 641 in the control group. The results of the meta-analysis showed that, regardless in the overall study of different dapagliflozin doses or in studies of dapagliflozin 5 or 10 mg/d, the differences in the risk of malignancy between the experimental group and the control group were not statistically significant [overall study: 4.2% (661/15 911) vs. 4.1% (648/15 884), RR=1.02, 95 %CI: 0.92-1.13, P=0.72; dapagliflozin 5 mg/d: 0.8% (10/1 181) vs. 0.6% (7/1 172), RR=1.35, 95 %CI: 0.57-3.17, P=0.49; dapagliflozin 10 mg/d: 4.4% (651/14 730) vs. 4.4% (641/14 712), RR=1.01, 95 %CI: 0.91-1.13, P=0.78]; the differences in the risk of breast cancer were not statistically significant [overall study: 0.2% (25/12 216) vs. 0.2% (25/12 215), RR=1.00, 95 %CI: 0.59-1.69, P=1.00; dapagliflozin 5 mg/d: 0.6% (2/348) vs. 0 (0/347), RR=3.00, 95 %CI: 0.31-28.65, P=0.34; dapagliflozin 10 mg/d: 0.2% (23/11 868) vs. 0.2% (25/11 868), RR=0.93, 95 %CI: 0.54-1.59, P=0.78]; the differences in the risk of bladder cancer were not significantly significant [overall study: 0.1% (16/12 021) vs. 0.2% (28/12 019), RR=0.59, 95 %CI: 0.33-1.07), P=0.08; dapagliflozin 5 mg/d: 0.7% (1/137) vs. 0 (0/137), RR=3.00, 95 %CI: 0.12-73.00, P=0.50; dapagliflozin 10 mg/d: 0.1% (15/11 884) vs. 0.2% (28/11 882), RR=0.55, 95 %CI: 0.30-1.02, P=0.06]. Conclusion:Dapagliflozin may not increase the risk of malignancy in patients with type 2 diabetes mellitus, but its long-term safety needs further study.

Objective:To understand the clinical characteristics of serotonin syndrome (SS) induced by combined use of linezolid and serotonergic drugs.Methods:Relevant databases at home and abroad as of February 2021 were searched and case reports of SS induced by linezolid combined with serotonergic drugs were collected. Clinical information including patients′ basic characteristics (gender, age, underlying disease, etc.), linezolid and serotonergic drugs application (medication reasons, usage and dosage, drug elution period, etc.), and the occurrence time, clinical manifestations, intervention measures, and outcomes of SS were extracted and analyzed by descriptive statistical method.Results:A total of 50 patients derived from 46 literature were enrolled in the study, including 23 males and 27 females. Of them, 49 patients were aged from 23 to 98 years, and one patient was 4 years old. The reasons for using serotonergic drugs were mental illness (36 patients), pain (8 patients), and Parkinson′s disease (2 patients), etc.; the reasons for using linezolid were staphylococcal infection (24 patients), enterococcal infection (13 patients), and empirical anti-infection treatments (11 patients), etc. Among the 50 patients, 48 were treated with serotonergic drugs and then with linezolid, and 2 were treated with linezolid and then with serotonergic drugs; the drug washout period was not recorded in 44 patients and not long enough in the other 6 patients; the serotonergic drugs were given orally in 40 patients and by intravenous infusion in 10 patients; 35 patients had usage and dosage records, which were all in line with the requirements of drug labels; 27, 16, 5, and 2 patients were treated with 1, 2, 3, and 4 kinds of serotonergic drugs respectively, and the drugs used mainly were selective serotonin reuptake inhibitors, serotonergic drugs and norepinephrine reuptake inhibitors, tricyclic antidepressants, and opioids, etc. Except the administration route of linezolid was not mentioned in 12 patients, it was given by intravenous infusion in 27 patients and orally in 11 patients. The frequency of medication met the requirements of drug labels in 49 patients, and the medication frequency of one child was lower than that specified in the drug labels. SS occurred 3 hours to 20 days after combined use of drugs, mostly 1 to 5 days. The clinical manifestations were mental state change, autonomic nerve dysfunction, and neuromuscular dysfunction in 45, 47, and 45 patients, respectively. After discontinuation of linezolid and/or serotonergic drugs and receiving symptomatic treatments for 2 hours to 9 days, 43 patients were improved, 1 patient died of cardiac arrest after SS occurrence, and 6 patients died of the primary diseases after the symptoms of SS were controlled.Conclusions:SS due to linezolid combined with serotonergic drugs mostly occurred 1 to 5 days after combined use of above 2 drugs, and the clinical manifestations were similar to SS induced by other reasons. After discontinuation of linezolid and serotonergic drugs and symptomatic and supportive treatments, the overall prognosis is acceptable, but serious SS can lead to death.

Objective:To systematically evaluate correlation between the risk of malignancy and dapagliflozin in type 2 diabetes mellitus.Methods:The databases such as PubMed, the Cochrane Library, American Clinical Trial Registry, Embase, JAMA, Wiley-Blackwell, Springer Link, Elsevier, Ovid, Taylor & Francis Online, CNKI, Wanfang, and VIP (up to March 2021) were searched. The randomized controlled trials (RCTs) on dapagliflozin with outcome indicators including malignancy occurrence were collected. Data extraction and quality analysis were performed for the enrolled literature, and meta-analysis was conducted using RevMan 5.3 software.Results:A total of 22 studies were enrolled in the analysis, all of which were multicenter RCTs, and the quality evaluation results were all grade A. Thirty-one thousand four hundred and fifty-one patients were involved in the 22 studies, of which 16 267 were in the experimental group (dapagliflozin 5 or 10 mg daily) and 15 184 in the control group (placebo or other hypoglycemic drugs). The course of treatment in the 22 studies ranged from 24 weeks to 5.2 years and it was 24 weeks in 15 studies (68.2%). A total of 1 302 patients developed malignancy during the trials, including 661 in the experimental group and 641 in the control group. The results of the meta-analysis showed that, regardless in the overall study of different dapagliflozin doses or in studies of dapagliflozin 5 or 10 mg/d, the differences in the risk of malignancy between the experimental group and the control group were not statistically significant [overall study: 4.2% (661/15 911) vs. 4.1% (648/15 884), RR=1.02, 95 %CI: 0.92-1.13, P=0.72; dapagliflozin 5 mg/d: 0.8% (10/1 181) vs. 0.6% (7/1 172), RR=1.35, 95 %CI: 0.57-3.17, P=0.49; dapagliflozin 10 mg/d: 4.4% (651/14 730) vs. 4.4% (641/14 712), RR=1.01, 95 %CI: 0.91-1.13, P=0.78]; the differences in the risk of breast cancer were not statistically significant [overall study: 0.2% (25/12 216) vs. 0.2% (25/12 215), RR=1.00, 95 %CI: 0.59-1.69, P=1.00; dapagliflozin 5 mg/d: 0.6% (2/348) vs. 0 (0/347), RR=3.00, 95 %CI: 0.31-28.65, P=0.34; dapagliflozin 10 mg/d: 0.2% (23/11 868) vs. 0.2% (25/11 868), RR=0.93, 95 %CI: 0.54-1.59, P=0.78]; the differences in the risk of bladder cancer were not significantly significant [overall study: 0.1% (16/12 021) vs. 0.2% (28/12 019), RR=0.59, 95 %CI: 0.33-1.07), P=0.08; dapagliflozin 5 mg/d: 0.7% (1/137) vs. 0 (0/137), RR=3.00, 95 %CI: 0.12-73.00, P=0.50; dapagliflozin 10 mg/d: 0.1% (15/11 884) vs. 0.2% (28/11 882), RR=0.55, 95 %CI: 0.30-1.02, P=0.06]. Conclusion:Dapagliflozin may not increase the risk of malignancy in patients with type 2 diabetes mellitus, but its long-term safety needs further study.

Objective:To understand the clinical characteristics of serotonin syndrome (SS) induced by combined use of linezolid and serotonergic drugs.Methods:Relevant databases at home and abroad as of February 2021 were searched and case reports of SS induced by linezolid combined with serotonergic drugs were collected. Clinical information including patients′ basic characteristics (gender, age, underlying disease, etc.), linezolid and serotonergic drugs application (medication reasons, usage and dosage, drug elution period, etc.), and the occurrence time, clinical manifestations, intervention measures, and outcomes of SS were extracted and analyzed by descriptive statistical method.Results:A total of 50 patients derived from 46 literature were enrolled in the study, including 23 males and 27 females. Of them, 49 patients were aged from 23 to 98 years, and one patient was 4 years old. The reasons for using serotonergic drugs were mental illness (36 patients), pain (8 patients), and Parkinson′s disease (2 patients), etc.; the reasons for using linezolid were staphylococcal infection (24 patients), enterococcal infection (13 patients), and empirical anti-infection treatments (11 patients), etc. Among the 50 patients, 48 were treated with serotonergic drugs and then with linezolid, and 2 were treated with linezolid and then with serotonergic drugs; the drug washout period was not recorded in 44 patients and not long enough in the other 6 patients; the serotonergic drugs were given orally in 40 patients and by intravenous infusion in 10 patients; 35 patients had usage and dosage records, which were all in line with the requirements of drug labels; 27, 16, 5, and 2 patients were treated with 1, 2, 3, and 4 kinds of serotonergic drugs respectively, and the drugs used mainly were selective serotonin reuptake inhibitors, serotonergic drugs and norepinephrine reuptake inhibitors, tricyclic antidepressants, and opioids, etc. Except the administration route of linezolid was not mentioned in 12 patients, it was given by intravenous infusion in 27 patients and orally in 11 patients. The frequency of medication met the requirements of drug labels in 49 patients, and the medication frequency of one child was lower than that specified in the drug labels. SS occurred 3 hours to 20 days after combined use of drugs, mostly 1 to 5 days. The clinical manifestations were mental state change, autonomic nerve dysfunction, and neuromuscular dysfunction in 45, 47, and 45 patients, respectively. After discontinuation of linezolid and/or serotonergic drugs and receiving symptomatic treatments for 2 hours to 9 days, 43 patients were improved, 1 patient died of cardiac arrest after SS occurrence, and 6 patients died of the primary diseases after the symptoms of SS were controlled.Conclusions:SS due to linezolid combined with serotonergic drugs mostly occurred 1 to 5 days after combined use of above 2 drugs, and the clinical manifestations were similar to SS induced by other reasons. After discontinuation of linezolid and serotonergic drugs and symptomatic and supportive treatments, the overall prognosis is acceptable, but serious SS can lead to death.

Objective: To investigate the diagnosis and treatment of rapidly growing mycobacteria bloodstream infections.Methods: Based on the two pharmaceutical consultation practice for one case of rapidly growing mycobacteria bloodstream infections after fracture operation, the paper summarized and analyzed the problems in different stages of treatment.Results: The first consultation optimized the dosage of vancomycin according to the patient''s serum concentration and creatinine clearance rate.The second consultation suggested doctors actively perform anti-infection treatment for rapidly growing mycobacteria after the patient''s clinical symptoms and examination results were improved significantly.It is recommended to withdraw anti TB drugs, and the use of clarithromycin combined with amikacin was suitable.The patient was discharged with improved health conditions.Conclusion: Positive intervention and correct diagnosis are the keys for the successful treatment of suspected or definite mycobacteria infection in surgical sites.

Objective:To investigate the thoughts and methods of clinical pharmacists involving in the treatment of 2 cases of atyp-ical pathogen infection. Methods:The consultation cases of 2 patients with atypical pathogens infection were analyzed,and the consul-tation experience was summarized. Results: After the consultation, the treatment efficacy of the patients was obvious. Conclusion:Clinical pharmacists can assist doctors in improving the efficacy and safety of drug treatment.

Objective:To summarize the participation of clinical pharmacists in the treatment of patients after craniocerebral opera-tion with pulmonary infection. Methods: Clinical pharmacists assisted physicians in identifying infectious bacteria and colonization bacteria of one patient with pulmonary infection after craniocerebral operation and establishing the anti-infection treatment regimen. Re-sults:Clinical pharmacists analyzed various factors such as infection risk factors, clinical and laboratory manifestation and medication history, and effectively selected antibacterial drugs covering the infectious bacteria to timely control the infection. Conclusion: With pharmaceutical knowledge, clinical pharmacists can assist physicians in the interpretation of bacterial culture and drug susceptibility re-ports to promote safer, more timely and effective medication for patients.

Objective To characterize the secondary osteoporosis in hemiplegic patients. Methods By use of dual energy X ray absorptometry, the bone density and bone mineral quantity of 156 hemiplegic inpatients were tested and analyzed. Results The incidence of osteoporosis was 44.4% during 3～6 months after stroke and 21.1% found during 9～12 months after stroke. The average incidence was 30.8%. The osteoporosis was more common in patients with flaccid hemiplegia than in those with spastic hemiplegia. The bone mineral quantity in the affected upper limbs was significantly lower than that in nonaffected side ( P 0.05). Conclusion The bone mineral quantity of hemiplegic patients varies with the duration of disease. The reduction of bone mineral quantity is regular and reversible.