OBJECTIVE To mine adverse drug event （ADE） signals of lacosamide， and to provide references for clinically safe drug use. METHODS ADE data for lacosamide reported to the United States FDA adverse event reporting system from January 1， 2009， to December 31， 2022， were collected. Data mining was conducted using the reporting odds ratio method and Bayesian confidence propagation neural network method. Classification statistics were performed using the system organ class （SOC） and preferred terms （PT） from ADE terminology set of Medical Dictionary for Regulatory Activities （Version 25.0）. RESULTS A total of 21 360 lacosamide ADE reports were received， identifying 203 ADE signals across 24 SOCs， with 19 signals not included in the drug’s instruction. The top five PTs ranked by occurrence frequency were medication overdose， technical errors during device use， product use issues， intentional product misuse， and therapy discontinuation. The top five PTs ranked by signal strength were changes in seizure presentation type， congenital hypoplasia of depressor anguli oris muscle， multidrug resistance， brain surgery， and vagus nerve stimulator implantation. ADEs not recorded in the drug instruction included congenital hypoplasia of depressor anguli oris muscle， multidrug resistance， mitochondrial DNA mutation， dissociative identity disorder， and congenital auricular anomaly. CONCLUSIONS For lacosamide-induced ADEs that occur frequently and are already listed in the drug’s instructions， such as bradycardia and atrioventricular block， the clinical application should be careful and attentive， adjusting the dosage timely according to the patient’s condition to avoid severe ADEs. Newly discovered suspect ADEs， such as congenital hypoplasia of depressor anguli oris muscle， mitochondrial DNA mutation， overmature infant， dissociative identity disorder， pigmenturia， behavioral disorders， and dissociative disorders， should be vigilantly recognized to ensure the safety of drug use.

ObjectiveTo investigate the expression level of Golgi transport 1A （GOLT1A） in thyroid carcinoma and its effects on the proliferation， migration， invasion， and epithelial-mesenchymal transition （EMT） of thyroid carcinoma cells. MethodsThe expression of GOLT1A in thyroid carcinoma was analyzed online by tumor immune estimation resource （TIMER）， the University of Alabama at Birmingham cancer data analysis portal （UALCAN）， gene expression profiling interactive analysis 2 （GEPIA2）. The expression level of GOLT1A in thyroid carcinoma cells was detected by real-time fluorescence quantitative polymerase chain reaction （RTFQ-PCR） and western blot. Cell counting kit-8 （CCK-8） assay， colony formation assay， and transwell assay were used to detect the effects of GOLT1A expression on the proliferation， migration， and invasion of thyroid carcinoma cells. Western blot assay was used to detect the effect of GOLT1A on the expression of EMT-related genes including E-cadherin， vimentin， and N-cadherin. ResultsThe online analysis of GEPIA2， TIMER， and UALCAN showed that the expression of GOLT1A was higher in thyroid carcinoma than in normal tissues， and the expression of GOLT1A in thyroid carcinoma cells was significantly higher than in normal control cells. Knockdown of GOLT1A inhibited TPC1 cell proliferation， migration， and invasion. The expression of E-cadherin increased and the expressions of N-cadherin and vimentin decreased in GOLT1A knockdown TPC1 cells. Overexpression of GOLT1A promoted BCPAP cell proliferation， migration， and invasion. The expression of E-cadherin decreased and the expressions of N-cadherin and vimentin increased in GOLT1A overexpression BCPAP cells. ConclusionGOLT1A is highly expressed in thyroid carcinoma and can promote the proliferation， migration， and invasion of thyroid carcinoma cells.

Objective:To explore the access mechanism of medical consumables in public medical institutions and to improve the top-level designs of medical consumables access based on the perspective of healthcare security management.Methods:From five dimensions of healthcare security supervision,implementation of coding standards(referred to as standard implementation),centralized procurement,medical service items and prices,and evaluation technologies,the access process of medical consumables was designed and targeted exploration strategies were proposed.Results:The access process for medical consumables is designed from five dimensions:strengthening the supervision of medical consumables and medical insurance,implementing the healthcare security standards for medical consumables,promoting the implementation of medical consumables healthcare security centralized procurement,promoting the development of healthcare security medical service projects and medical service price projects,and actively carrying out health technology assessment.The targeted strategies for the access of medical consumables were proposed of strengthening the learning and training of healthcare security business,building a multidisciplinary collaborative management system for medical consumables access in hospitals,exploring the establishment of health technology evaluation methods suitable for medical institutions in China and promoting the integration of medical consumables access information.Conclusion:Based on the perspective of healthcare security management,the core position of medical insurance in the access of medical consumables in public medical institutions was theoretically emphasized,which provides new ideas for the research of medical consumables access,and enriches the dimension of medical consumables access management.

Objective:To investigate the effect of acupoint stimulation assisted anesthesia on the agitation during recovery and the levels of serum opioids (Opiorphin) and amyloid A (SAA) in elderly patients after hip fracture surgery.Methods:Eighty-six older patients who underwent hip fracture surgery in Shaoxing Second Hospital from February 2020 to September 2021 were randomly divided into the routine group and the research group, each with 43 patients. They were given acupoint sham stimulation and acupoint stimulation respectively, and the general indexes of the two groups, recovery quality, cognitive function and changes in serum Opiorphin and SAA levels were compared.Results:There were no differences in operation time, anesthesia time, recovery time and intraoperative blood transfusion between the two groups ( P>0.05). The dosage of remifentanil in the research group was significantly lower than that in the routine group: (270.64 ± 17.62) μg vs. (291.82 ± 23.34) μg, P<0.05. The incidence of agitation during the recovery period in the research group was significantly lower than that in the routine group: 13.95% (6/43) vs. 48.84% (21/43), P<0.05. The mini-mental state examination (MMSE) scores in the research group at 12, 24 and 48 h after operation were significantly higher than those in the routine group: (22.80 ± 2.04) scores vs. (19.31 ± 3.61) scores, (24.92 ± 2.44) scores vs. (21.49 ± 3.58) scores, (26.73 ± 2.57) scores vs. (24.23 ± 3.95) scores, there were statistical differences ( P<0.05). The serum Opiorphin level at 24 h after operation in the research group was higher than that in the routine group: (32.74 ± 8.57) mg/L vs. (25.40 ± 6.36) mg/L; and the SAA level was lower than that in the routine group: (157.36 ± 10.24) mg/L vs. (204.37 ± 15.56) mg/L, there were statistical differences ( P<0.05). Conclusions:Acupoint stimulation adjuvant anesthesia can reduce the occurrence of agitation during the recovery period of elderly patients with hip fracture, reduce the dosage of anesthetics, reduce postoperative cognitive impairment, regulate serum Opiorphin and SAA levels, and help early postoperative recovery.

For the past several decades, the infectious disease profile in China has been shifting with rapid developments in social and economic aspects, environment, quality of food, water, housing, and public health infrastructure. Notably, 5 notifiable infectious diseases have been almost eradicated, and the incidence of 18 additional notifiable infectious diseases has been significantly reduced. Unexpectedly, the incidence of over 10 notifiable infectious diseases, including HIV, brucellosis, syphilis, and dengue fever, has been increasing. Nevertheless, frequent infectious disease outbreaks/events have been reported almost every year, and imported infectious diseases have increased since 2015. New pathogens and over 100 new genotypes or serotypes of known pathogens have been identified. Some infectious diseases seem to be exacerbated by various factors, including rapid urbanization, large numbers of migrant workers, changes in climate, ecology, and policies, such as returning farmland to forests. This review summarizes the current experiences and lessons from China in managing emerging and re-emerging infectious diseases, especially the effects of ecology, climate, and behavior, which should have merits in helping other countries to control and prevent infectious diseases.
Behavior ; China ; epidemiology ; Climate ; Communicable Diseases ; classification ; epidemiology ; Communicable Diseases, Emerging ; epidemiology ; Disease Outbreaks ; Ecology ; Forecasting ; Humans ; Incidence

Objective: To evaluate the safety and feasibility of treating de novo coronary lesions with paclitaxel-eluting balloon. Methods: This is a retrospective study, which enrolled 76 patients with 80 de novo coronary lesions treated with paclitaxel-eluting balloons(<30% residual stenosis and there was no blood flow limited dissection after pretreatment) from April 2015 to November 2016 in Guangdong general hospital. The data of basic characteristics,procedures,devices and follow-up information were retrieved and analyzed. The primary endpoint was the composite of cardiac death, recurrent myocardial infarction and target lesion revascularization. Results: (1)The age was (63.3±10.3) years. There were 68.4%(52/76) acute coronary syndrome patients, prevalence of type 2 diabetes was 36.8%(28/76), and 64.5%(49/76)patients with at least one high bleeding risk. (2)The lesion length was (17.4±7.6)mm, and the stenosis was (88.1±8.2)%.The reference vessel diameter≥2.75 mm accounted for 51.2% (41/80), and bifurcation stenosis accounted for 67.5%(54/80). (3)53.7%(43/80) lesions were pretreated with scoring balloon to optimize plaque modification. The paclitaxel-eluting balloon length and diameter were (22.3±5.5)mm and (2.74±0.52)mm.The residual stenosis was (12.3±10.3)%. Procedural success was 88.8%(71/80).Bail-out stenting rate was 5.0%(4/80). (4)The median follow-up duration was 12(6, 25) months. Primary endpoint occurred in 3 cases (3.9%), including 2 cardiac deaths(1 patient died of recurrent myocardial infarction, and 1 patient died of acute heart failure induced by severe mitral insufficiency), and one patient receivedtarget lesion revascularization. Conclusion In case of no more than 30% residual stenosis and no blood flow limited dissection after lesion pretreatment,it is safe and feasible to treat de novo coronary lesionsusing paclitaxel-eluting balloon.

Objective To analyze the causes for the failures after posterior pedicle screw instrumentation for thoracolumbar fractures.Methods From June 2003 to December 2014,182 patients with thoracolumbar fracture were treated by fixation through the posterior approach using pedicle screws and fully followed up in our institute.We analyzed the cases of postoperative infection,recovery of neural symptoms,breakage and loosening of pedicle screws and connecting rod,non-union of the fractured vertebra,and correction loss of kyphosis in associations with the AO classification and Loading Sharing Classification of Spine Fracture (LSCSF) system,osteoporosis,intervertebral disc injury and methods of internal fixation.Results In this series,altogether 27 cases failed(14.8％).The rate of postoperative infection was 1.1％ (2/182).The rate of breakage of pedicle screw or connecting rod was 7.7％ (14/182).The implant breakage rates for fractures of AO types A1,A2 and A3.1 were significantly lower than for other types (P ＜ 0.05).The implant breakage rate for the patients with ≤6 LSCSF points was significantly lower than for those with ≥7 LSCSF points (P ＜ 0.05).The implant breakage occurred in 3 cases of those who underwent fixation of one normal vertebra respectively below and above the two contiguous segments but not in those who underwent additional fixation of the injured vertebrae.The rate of screw loosening was 2.2％ (4/182).The non-union rate of the injured vertebra was 2.7％ (5/182).The rate of kyphosis recurrence was 1.1％ (2/182).Conclusions To prevent the failure of posterior pedicle screw fixation,surgeons should pay more attention to the following key points before operation:the type and evaluation of spinal fractures,a proper approach and method of internal fixation,and the weight bearing capability of the anterior column.

Objective:To compare the effectiveness of proximal femoral nail antirotation (PFNA) with intertrochanteric antegrade nail (InterTAN) in the treatment of intertrochanteric fractures in the elderly. Methods:A retrospective study of 62 elderly patients with intertrochanteric fractures who received two operation methods from Sep 2014 to May 2016 was done. There were 28 patients in PFNA group, and 34 patients in InterTAN group. The operation time, blood loss in operation, hospitalization time, healing time, and Harris hip joint functional score were compared and analyzed. Results:Operation time and the amount of intraoperative blood loss in PFNA group were less than that in InterTAN group. Hospitalization time,fracture healing time and Harris hip joint functional score after ten months had no significant difference between the two groups. And 59 cases in total were followed up with an average of 11.5 months (from 9 to 16 months) . In PFNA group, 27 patients were followed up, and one patient was lost to follow up, who died because of chronic renal insufficiency. The rest 26 patients all achieved bony union (including one case of hip versus) . At follow-up 9 months, hip joint function was excellent in 18 cases, good in 6, fair in 2, bad in 1, and the excellent-good rate was 88.9%. In InterTAN group,32 patients were followed up,and two cases were lost to follow up. In followed-up cases, there was one patient who was no healing of fracture. After hip arthroplasty, this patient got recovery. The hip joint function was excellent in 21 cases, good in 7, fair in 3, and bad in 1. The differences between the two groups were not statisticaly significant. Conclusion:Both PFNA and InterTAN can treat intertrochanteric fractures in the elderly with good result,but PFNA has obvious advantages over InterTAN on less hemorrhage and operation time.

Community-acquired pneumonia (CAP) is a common respiratory infectious disease.The etiologic diagnosis of CAP remains an uneasy task.Early etiologic diagnosis is critical for proper treatment and might improve the prognosis.So,it is important to identify pathogens causing CAP in early time and accurate way with sensitive and effective method.This paper summarizes the recent progress in the research of the detection assay for CAP.

Objective To investigate the effect of coenzyme complex on the cardiac and renal functions of patients with type 2 cardiorenal syndrome. Methods Sixty-two patients with type 2 cardiorenal syndrome were enrolled in from June 2013 to December 2014 in Zhujiang Hospital , Southern Medical University. These patients divided were into routine group (n = 31) and coenzyme complex (n = 31). The therapy scheme of coenzyme complex group was on the basis of routine group with coenzyme complex intravenous drip , 400 U/day for 2 weeks. The cardiac function was determined by New York Heart Function Assessment, and the cardiac ultrasound, the levels of BNP. The renal function was determined by serum creatinine and urine volume. Results Compared with routine group, the rates of NYHA Ⅲ and Ⅳ were reduced, the LVEF levels were increased and the levels of BNP were increased (P < 0.05). The serum creatinine was decreased and urine volume were increased in the coenzyme complex group (P<0.05). Conclusion Coenzyme complex could improve the cardiac and renal functions of the patients with type 2 cardiorenal syndrome.