Objective To explore and analyze the signals of pneumonia-related adverse events(ADEs)caused by endothelin receptor antagonists(ERAs)and provide reference for clinical safe medication.Methods Based on the the U.S.Food and Drug Administration(FDA)adverse event reporting system(FAERS)database,the data from the first quarter of 2015 to the first quarter of 2023 was extracted,and reporting odds ratio,pro-portional reporting ratio,Bayesian confidence propagation neural network and multi-item gamma poisson shrinker were used for mining.Results 7 279 reports of pneumonia-related ADEs with ERAs as the main suspects were extracted,including 3 705 reports of ambrisentan,1 028 reports of bosentan and 2 546 reports of macitentan.There were 68 pneumonia ADEs related to ERAs,including 21 ambrisentan,25 bosentan and 22 macitentan.According to the criteria for judging the signal of ADEs,there were 14 kinds of ADEs that formed signals,and all the systems involved in system organ classification were infections and infectious diseases.Infectious pneumonia accounted for the highest proportion of adverse reactions(93.61％)and caused the most deaths.Conclusion In the real world,ERAs can lead to pneumonia related ADEs.Female,elderly,and high-dose are important factors in the occurrence of pneumonia-related ADEs,which suggests that medical personnel need to individualized use drugs based on the patient's physiological status and drug characteristics when using ERAs to ensure medication safety.

Objective:To explore the effectiveness of intelligent multifunctional rehabilitation instrument for lower limb diseases in preventing deep vein thrombosis in stroke patients with hemiplegia.Methods:From September 2022 to September 2023, convenience sampling was used to select 121 stroke patients with hemiplegia admitted to the Department of Neurology, Neurosurgery, and Rehabilitation of Cangzhou Central Hospital as the study subject. The study subjects were divided into a control group ( n=58) and an observation group ( n=63) using the random number table method. The control group was treated with standard medication and routine rehabilitation nursing, while the observation group was treated with the intelligent multifunctional rehabilitation instrument for lower limb diseases on the basis of the control group. The intervention time was four weeks for both groups. This study compared the incidence of clinical symptoms of lower limbs (swelling, pain, skin temperature, gastrocnemius test results) and deep vein thrombosis in the lower limbs between two groups of patients after intervention. The plasma D-dimer levels, femoral vein blood flow velocity, and blood flow of the two groups of patients before and after intervention were also compared. Results:After intervention, the number of cases of lower limb clinical symptoms (swelling, pain, elevated skin temperature, positive results of gastrocnemius muscle test) and deep vein thrombosis in the observation group was lower than that in the control group ( P<0.05). In the observation group, the plasma D-dimer levels of patients were lower than those of the control group ( P<0.05), and the femoral vein blood flow velocity and blood flow were higher than those of the control group ( P<0.05) . Conclusions:The intelligent multifunctional rehabilitation instrument for lower limb diseases can effectively prevent the occurrence of deep vein thrombosis in stroke patients with hemiplegia.

Objective A comparison of two method of establishing pressure ulcer rat models to determine which is the most suitable for experimental use.Methods 18 male SD rats were randomly divided into control(n=6),model A(n=6)and model B(n=6)groups.In the control group,iodophor treatment was given after hair removal at the simulated modeling site.In model group A,longitudinal compression was performed by simple deep-tissue foreign body implantation.In model group B,transverse compression was performed via the magnet compression method.The times required to complete the process and for each stage of pressure ulcer model establishment in each group were recorded.The general condition of the rats was observed,and the modeling rate,mortality rate,and infection rate were compared.Results By naked eye,we observed that the model A and model B groups gradually developed redness and swelling,ulceration,bleeding,exudation,and necrosis.Comparison of the whole time to produce pressure uler between model A and model B groups:the difference between the two groups was statitically significant(P＜0.05).Comparison of the time to produce pressure injury between Model A and Model B:The difference between the two groups at stage Ⅰ was not statistically significant(P＞0.05);the difference between the two groups at stage Ⅱ was statistically significant(P＜0 05);the difference between the two groups at stage Ⅲ was statistically significant(P＜0 05);the difference between the two groups at stage Ⅳ was statistically significant(P＜0 05).The mental and sports scores of the rats in the control group were significantly different from those in the model A and model B groups(P＜0.05).The general state of rats in the model group A was significantly different from that in the model B group,and coat color was dimer and activity decreased in the model group A.The modelling rate of rats in both model A and model B groups was 100％.The mortality and infection rates of the model group A were higher than those of the model group B,which were 33.34％and 16.70％,respectively.Conclusions Successful preparation of a four-stage model of pressure ulers in both modalities.The two method have both commonalities and distinct characteristics.The magnet compression method required less time,the rats were generally in good condition,and the mortality and infection rates were low;thus it is suitable for short-term intervention research.The simple deep-tissue foreign body implantation method took longer,required rats to have a certain level of tolerance,had high infection and mortality rates,and is more suitable for use for long-term observations of pressure ulcers.

OBJECTIVE To provide reference for improving the dispensing accuracy of similar drugs and reducing dispensing error risk through exploring the dispensing mode of similar drugs. METHODS The effectiveness and feasibility of the similar drug dispensing management mode was explored through adjusting the traditional horizontal or vertical sorting method to a “Z” shaped cargo location sorting， implementing similar drug in different zones dispensed by different people， and combining measures such as adjusting the format of drug dispensing documents and improving inventory methods. The role of similar drug dispensing mode in drug dispensing management was evaluated comprehensively from two aspects： work quality and work efficiency. RESULTS After the implementation of similar drug dispensing mode， total number of monthly dispensing errors （18.42±8.79 vs. 28.50±6.87，P= 0.005） and the proportion of monthly dispensing errors of similar drugs （[ 4.17±5.71）% vs. （10.96±7.05）%，P＝0.017] were significantly lower than before the implementation； the monthly consistency rate between accounts and materials （[ 98.46±0.73）% vs. （97.61±0.57）%， P＝0.004] was significantly higher than before implementation； completion time of dispensing in each batch was not significantly affected， and daily work was carried out smoothly and orderly. CONCLUSIONS The similar drug dispensing mode has a significant effect in improving the accuracy of dispensing similar drugs， reducing the risk of dispensing errors， and does not affect the efficiency of dispensing work.

Objective:To explore the effect of intelligent rehabilitation device on lower limb function rehabilitation in stroke patients with hemiplegia.Methods:Using convenience sampling, 186 stroke hemiplegic patients admitted to the Department of Neurology and Surgery of Brain Hospital, Cangzhou Central Hospital from July 2021 to July 2022 were selected as the study subject. The patients were divided into a control group, a strengthening group, and an intelligent rehabilitation group, with 62 patients in each group using the random number table. The control group received routine rehabilitation for 40 minutes per day, 5 days per week, for a total of 4 weeks. On the basis of the control group, the strengthening group received an additional 30 minutes of routine rehabilitation training every day. The intelligent rehabilitation group received an additional 30 minutes of intelligent rehabilitation device exercise per day on top of the control group. The Fugl-Meyer Assessment Lower Extremity (FMA-L), Berg Balance Scale (BBS) scores, and Functional Ambulation Category (FAC) grading of three groups of patients before and after intervention were compared.Results:Sixty patients in each group completed the study. The FMA-L and BBS scores of the three groups of patients after intervention were higher than those before intervention, and the FAC grading was better than that that before intervention, with statistical differences ( P<0.05). After intervention, the FAM-L and BBS scores of the intelligent rehabilitation group were higher than those of the control group and the strengthening group, and the FAC grading was better than that of the control group and the strengthening group, and the differences were statistically significant ( P<0.05) . Conclusions:The intelligent rehabilitation device can improve the lower limb function of stroke patients with hemiplegia, and is worthy of clinical promotion and practice.

OBJECTIVE To evaluate the efficacy ，safety，and economy of selexipag in the treatment of pulmonary arterial hypertension（PAH）. METHODS After literature screening ，data extraction and quality evaluation ，the results of included studies were analyzed descriptively by retrieving PubMed ，Embase，Web of Science ，Cochrane Library ，Epistemonikos，SinoMed， CNKI，VIP，Wanfang data ，CBM，official websites of domestic and foreign health technology assessment institutions and relevant database. RESULTS&CONCLUSIONS A total of 7 literature were included ，involving 6 meta-analysis and 1 pharmacoeconomic study. In terms of efficacy ，selexipag could improve patients ’exercise tolerance and hemodynamic indexes ，and reduced the incidence of clinical worsening events and hospitalization . However，intravenous/subcutaneous administration of prostacyclin analog had better effects in improving WHO functional class and reducing all -cause mortality （P＜0.05）. There were no statistically significant differences in the impact on outcome indexes between selexipag and other targeted agents （P＞0.05）. In terms of safety ， the incidence of adverse drug events and drug withdrawal due to adverse reactions was increased by selexipag （P＜0.05），but there were no significant differences between the effects of selexipag and other targeted drugs on adverse events ，serious adverse events and drug withdrawal due to adverse reactions （P＞0.05）. In terms of economy ，based on the background of Canada ’s health system，it was not economical for selexipag to treat PAH ，and there was a lack of economic research based on China ’s national conditions. Further comparative studies on the efficacy and economics of selexipag and prostacyclins in the real world are needed .

Objective:To explore the relationship between disease uncertainty, coping style, and self-perceived burden (SPB) in patients with lower extremity deep vein thrombosis (DVT) .Methods:Totally 280 patients with lower extremity DVT who were hospitalized in the Department of Vascular Surgery of three ClassⅢ Grade A hospitals in Cangzhou from September 2020 to April 2021 were selected by convenience sampling and investigated with the general information questionnaire, Medical Coping Style Questionnaire, Self-Perceived Burden Scale (SPBS) , Medical Coping Modes Questionnaire (MCMQ) , and Mishel's Uncertainty in Illness Scale (MUIS-A) . Pearson correlation was used to analyze the correlation between variables. A total of 280 questionnaires were distributed in this study, and 262 valid questionnaires were recovered, with an effective recovery rate of 93.6%.Results:The SPB score of the 262 patients with lower extremity DVT was (28.83±7.43) ; disease uncertainty, avoidance, and yielding were positively correlated with the patients' SPB ( r=0.651, 0.477, 0.469; P<0.01) , while facing was negatively correlated with SPB ( r=-0.485, P<0.01) . The path analysis revealed that avoidance and yielding played a partial mediating effect between disease uncertainty and SPB, accounting for 14.6% of the total path effect. Conclusions:Disease uncertainty can indirectly affect SPB in patients with lower extremity DVT through avoidance and yielding. Clinical medical staff should formulate targeted intervention and health guidance strategies to improve patients' disease cognition and coping ability, and reduce their SPB.

Objective? To explore the effects of new orthopedic high-waist shoes on preventing foot drop deformity among spinal cord injury patients with lower limb paralysis. Methods? From April 2016 to January 2018, we selected a total of 44 spinal cord injury patients with paralysis. All of the patients were divided into experimental group and control group according to the order of admission and random number sampling approaches. Patients of experimental group wore new orthopedic high-waist shoes from the first day after admission, while patients of control group used the square soft pillow in foot. We compared the incidence of foot drop deformity among patients two weeks after admission. Results? The incidences of foot drop deformity, pressure injury on foot as well as strephenopodia of patients in experimental group and control group were 18.2% vs. 40.9%, 4.5% vs. 18.2% as well as 27.3% vs. 59.1% respectively with statistical differences (P＜0.05). Conclusions? Early use of new orthopedic high-waist shoes can effectively prevent foot drop, protect function of ankle joint and promote the rehabilitation of neuromuscular function in limb among spinal cord injury patients with paralysis.

Objective To explore the clinicopathological characteristics of pancreatic neuroendocrine neoplasms ( P-NENs) and the prognosis .Methods The clinicopathological data of 72 patients with P-NENs in Sun Yat-Sen Memorial Hospital from December 2011 to September 2017 were analyzed retrospectively , and the gender, age, tumor size, local infiltration, neural invasion and distant metastasis were collected .According to the diagnostic criteria of P-NENs ( Chinese edition 2013 ) , tumor classification was determined by histological mitotic figure count and cell proliferation index ( Ki67 ) proliferation activity .Expressions of Syn , CgA, NSE and CD56 were determined by immunohistochemical staining .Results Seventy-two patients with P-NENs were enrolled, including 33.3％male(n=24) and 66.6％ female (n=48), and the median age was 56 years old (range:12-76).24 patients (33.3％) were NET G1,44 patients (61.1％) were NET G2 and 4 patients (5.6％) were NET G3.The mean size of tumor was 38.2 ±19.2 cm3 ( range:0.1-371 cm3 ). Immunohistochemistry staining positive rates for Syn , CgA, NSE and CD56 were 98.6％, 95.8％, 88.9％and 90.3％ respectively.Tumor classification was correlated with tumor size , local infiltration, perineural infiltration and distant (liver) metastasis (all P<0.05).There was no statistically significant differences on positive rate of Syn, CgA, NSE and CD56 among G1, G2 and G3.Conclusions Tumor classification, size, local invasion , perineural infiltration and distant ( liver ) metastasis were all important clinicopathological features and prognostic factors of P-NENs.Syn, CgA and Ki67 were essential immunohistochemical markers to diagnose P-NENs.

We compared the ways of deproteinization for crude polysaccharides of Coprinus comatus, and finally selected Sevage method as the optimal method. Two main fractions of Ccp-I-A and Ccp-I-B were obtained after DEAE-52 cellulose and Sephadex G-200 chromatography, both were white-floc, soluble in water, insoluble in absolute ethyl alcohol, acetone and other organic solvents. Additionally, Fehling reagent, CTAB, Sulphuric acid-carbazole, I-KI and FeCl₃ reaction were all negative. GC analysis showed Ccp-I-A was composed of mannitose, glucose and galactose in molar ratios of 2.03:9.52:1, whereas Ccp-I-B was composed of fucose and galactose with molar ratios of 1:5.21. Antioxidant activity test showed that Ccp-I-A and Ccp-I-B had good scavenging abilities on DPPH and ·OH. Compared to Ccp-I-B,the scavenging activity of Ccp-I-A was much stronger, and the scavenging rate could reach 72.1% and 55.3% respectively when the concentration was 300 μg/mL.