Background::Ainuovirine (ANV) is a new generation of non-nucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus (HIV) type 1 infection. This study aimed to evaluate the population pharmacokinetic (PopPK) profile and exposure-response relationship of ANV among people living with HIV.Methods::Plasma concentration-time data from phase 1 and phase 3 clinical trials of ANV were pooled for developing the PopPK model. Exposure estimates obtained from the final model were used in exposure-response analysis for virologic responses and safety responses.Results::ANV exhibited a nonlinear pharmacokinetic profile, which was best described by a two-compartment model with first-order elimination. There were no significant covariates correlated to the pharmacokinetic parameters of ANV. The PopPK parameter estimate (relative standard error [%]) for clearance adjusted for bioavailability (CL/F) was 6.46 (15.00) L/h, and the clearance of ANV increased after multiple doses. The exposure-response model revealed no significant correlation between the virologic response (HIV-RNA <50 copies/mL) at 48 weeks and the exposure, but the incidence of adverse events increased with the increasing exposure ( P value of steady-state trough concentration and area under the steady-state curve were 0.0177 and 0.0141, respectively). Conclusions::Our PopPK model supported ANV 150 mg once daily as the recommended dose for people living with HIV, requiring no dose adjustment for the studied factors. Optimization of ANV dose may be warranted in clinical practice due to an increasing trend in adverse reactions with increasing exposure.Trial registration::Chinese Clinical Trial Registry https://www.chictr.org.cn (Nos. ChiCTR1800018022 and ChiCTR1800019041).

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective To explore the relationship between the typing of MSCT and prognosis in infant with interstitial pneumonia (IP).Methods MSCT features of 44 infants with IP were analyzed retrospectively and classified according to the pathological pro-gress.The relationship between the MSCT typing and clinical prognosis was statistically analyzed.Results The result of the MSCT typing was as follows:the exudation in 22 cases,the proliferation in 18 cases and the ruin in 4 cases.There was significant difference for the clinical prognosis among the different MSCT groups (P＜0.01 ).And there was a significant correlation between the MSCT typing and clinical prognosis (r＝0.784,P＜0.01).The prognosis of the exudation type was better than the proliferation type,and both of them were better than the ruin type.Conclusion Based on the MSCT features,MSCT typing reveals the inflammatory patho-logical process of the infant IP,which plays an important role in treatment options decision and prognosis prediction.

Objective To explore the value of multi-slice computed tomography (MSCT) on the typing and staging of bronchiolitis obliterans (BO) in children.Methods Twenty-eight BO patients were recruited and underwent X-ray and MSCT from August 2012 to August 2015.The classification of MSCT signs and radiological manifestations in different stages of BO were discussed.Results Mosaic sign and bronchial wall thickening appeared in all cases and pulmonary atelectasis in 6 patients.MSCT signs were divided into 18 cascs of simple type and 10 of pneumonic type,respectively.Radiological imaging undergone after treatment for 2 ～ 4 weeks indicated that 20 patients turned normal,but 8 patients to chronic stage,including pulmonary interstitial fibrosis (7 cases),bronchoiectasis (6 cases),calcification in bronchial distal (3 cases) and pleural adhesions (2 cases).Conclusion Mosaic sign is a distinctive MSCT manifestation for BO in early phase,and CT typing and staging contribute to guiding the treatment.

Objective To explore the value of echocardiography in evaluation of pulmonary venous in total anomalous pulmonary venous connection (TAPVC).Methods Fifty-five children with TAPVC were enrolled in the study.The data of echocardiography and CT angiography were retrospectively analyzed and compared with intraoperative findings.Results Totally 55 patients with TAPVC were classified into supra-cardiac type (n=24),cardiac type (n=20),infra-cardiac type (n=7) and mixed type (n=4) according to the sites of drainage of pulmonary venous in echocardiography.In 15 patients with obstruction of pulmonary vertical vein,the sites of obstruction in the supra-cardiac type mostly presented between vertical vein and superior vena cava or innominate vein,and the sites of obstruction in the infra-cardiac presented all between vertical vein and hepatic or portal vein.In 4 patients with pulmonary vein stenosis,3 cases with local pulmonary vein stenosis were all cardiac type,which presented between individual pulmonary vein and common confluence or right atrium;1 patient with diffuse pulmonary vein stenosis was infra-cardiac type.In 9 patients of abnormal individual pulmonary vein,8 cases were not detected by echocardiography,but all were detected by CT angiography.Conclusion Echocardiography is able to make more comprehensive evaluation for the pulmonary venous drainage,obstruction,and proximal stenosis of individual pulmonary vein in TAPVC.CT angiography is superior in evaluation of abnormalities of connection and amount of individual pulmonary vein,and imaging of distal pulmonary vein.

Objective To assess the value of MRI combined with CT in the diagnosis of ovarian sex cord stromal tumor (OSCST).Methods The CT and MRI features of 29 cases with OSCST confirmed by pathology were analyzed retrospectively.Results Fibrothecoma in 19 cases showed a solitary round mass with a regular border,solid in 12 cases (63.1％) and cystic-solid in 7 cases (36.9％),calcification in 2 cases,isointense on T1WI and hypointense or slight hyperintense on T2WI with slight enhancement.Granule cell tumor in 9 cases showed a solitary cystic solid mass with thick wall,without nodules on cystic wall,and slight enhancement in the solid parts.Sertoli-leydig cell tumor in 1 case showed a solid mass,slightly hyperintense on T1WI,hyperintense on T2 WI,and obvious enhancement.Conclusion CT and MRI manifestations of OSCST demonstrate some characteristics.Combination with MRI and CT can improve the accuracy of the diagnosis.

Objective To explore prophylactic bilateral internal iliac arteries balloon occlusion in treating pernicious placenta previa complicated with placenta implantation before cesarean section.Methods Data of 32 patients with pernicious placenta previa complicated with placenta implantation underwent prophylactic bilateral internal iliac arteries balloon occlusion(Balloon Group)were analyzed retrospectively.40 patients with pernicious placenta previa complicated with placenta implantation without treatment of prophylactic bilateral internal iliac arteries balloon occlusion(Control Group)were selected.The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score were compared between the two groups.Results The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score of balloon group was superior to the control group and the difference was significant.All mothers and infants were healthy detected by clinical checking on 3-6 months after birth.Conclusion Prophylactic bilateral internal iliac arteries balloon occlusion is a safe and effective treatment before cesarean section used in pernicious placenta previa complicated with placenta implantation,and worthy of further promotion.

Objective To evaluate the application of MSCT perfusion imaging (PI)in diagnosing solitary pulmonary nodule (SPN).Methods 60 patients with SPN diagnosed by pathology were divided into two groups.Study group (SG)included 32 patients with lung cancer,and control group (CG)included 28 patients with benign nodules.The patients of two groups underwent 64-slice spiral CT PI and routine contrast-enhanced scan (ES).PI parameters were compared between SG and CG.The diagnosis value of PI was compared with that of ES.Results Compared with CG,SG had markedly higher BV,BF,PS and lower MTT (all P <0.01).Compared with ES, PI was more sensitive in detecting lung cancer and had a higher accuracy in diagnosing SPN (P <0.01).Conclusion MSCT PI plays an important role in diagnosing SPN.

OBJECTIVE:To provide reference for rational drug use and strengthen the management of adjuvant medication man-agement in the hospital. METHODS:1 080 and 860 discharged medical records of 12 Vitamins for injection were selected from our hospital during Jun.-Nov. 2014 (pre-special comment group,i.e. group A) and Jun.-Nov. 2015 (post-special comment group,i.e. group B),respectively. The application of 12 Vitamins for injection,hospitalization stay,drug cost and the incidence of ADR were compared before and after adjuvant medication special comment. RESULTS:After adjuvant medication special comments,the propor-tion of drug use of no indication,unsuitable solvent selection,irrational drug dosage,drug use of drug interaction and contraindica-tion,drug cost and the incidence of ADR in group B were all lower than in group A,with statistical significance(P<0.05). There was no statistical significance in hospitalization stay between 2 groups(P>0.05). CONCLUSIONS:Clinical pharmacists adopt adju-vant medication special comments to effectively standardize clinical application of 12 Vitamins for injection in our hospital.

Objective To investigate the value of MRI in diagnosis of congenital cystic lung disease.Methods The MRI was per-formed in 105 fetuses with congenital cystic lung disease.Subjects were classified into two groups including group A (the gestational age ranged from 12-20 w)and group B (the gestational age>20 w).The MRI and ultrasonography characteristics,as well as path-ologic diagnosis were compared.Results Among 105 cases,there were 80 cases of congenital cystic adenomatoid malformation (CCAM)(including 23 cases of typeⅠ,38 cases of typeⅡ and 1 9 cases of typeⅢ),18 cases of bronchopulmonary sequestration (BPS),5 cases of congenital lobar emphysema,1 case of bronchogenic cyst,and 1 case was BPS with CCAM.In group A,MRI can diagnose the majority of the anomalies (41/45),ultrasonography can diagnose anomalies of 39 cases.There was no significant differ-ence of diagnostic accuracy between the two methods (P >0.05).In group B,compared with ultrasonography,MRI could diagnose more cases accurately (58 vs 52),with statistical significance (P <0.05).Conclusion MRI is a reliable method in diagnosing con-genital cystic lung disease;MRI can provide more useful information for the cases in the gestational age >20 w compared with ultra-sonography.