Cyclin-dependent kinase 4/6 （CDK4/6） inhibitors in combination with conventional endocrine therapy significantly enhance progression-free survival and overall survival in hormone receptor （HR）-positive，human epidermal growth factor receptor 2 （HER-2）-negative breast cancer patients，showing a wide range of applications. CDK4/6 inhibitors are metabolized by cytochrome P450 enzymes and transported by some drug transporters. They are susceptible to drug-drug interactions （DDIs） mediated by drug-metabolizing enzymes and drug transporters with other drugs. To ensure the efficacy and safety of CDK4/6 inhibitors in clinical use，this consensus systematically summarized the data on drug-drug interaction of CDK4/6 inhibitors that have been marketed in China for the treatment of breast cancer，and formed relevant consensus opinions to provide references for clinical medical professionals in managing the drug-drug interactions of CDK4/6 inhibitors.
OBJECTIVE To analyze the volatile components of Huaihua Powder，an ancient classical prescription，and to establish a determination method of the main index components，thus preliminarily exploring the mechanism of its action in the treatment of ulcerative colitis. METHODS By gas chromatography-mass spectrometry （GC-MS），the volatile components of Huaihua Powder were identified qualitatively and a content determination method was established for detecting 9 batches of Huaihua Powder. The affinity energies between the main active components and targets of ulcerative colitis （Claudin 2，ZO-1 and Occludin） were calculated by molecular docking technology. RESULTS GC-MS results showed 34 volatile components identified in Huaihua Powder. In 9 batches of Huaihua Powder，the contents of seven components were determined as 0.40%-4.92% for α-pinene，0.36%-2.20% for 3-carene，4.76%-16.48% for limonene，0.12%-1.84% for γ-terpene，4.04%-15.00% for menthone，42.56%-75.52% for pulegone，and 1.80%-8.44% for cedrol. The results of molecular docking showed that Claudin 2 had good binding ability to the seven analytes （–8.16-–6.29 kcal·mol–1，1 kcal=4.186 kJ）. CONCLUSION The established method for the determination of volatile components in Huaihua Powder is simple and reliable. The analysis of volatile components of Huaihua Powder provides a new idea for underlying the mechanisms of its treatment of ulcerative colitis.
OBJECTIVE To explore the protective mechanism of Radix Sophorae Tonkinensis against carbon tetrachloride （CCl4）-induced acute liver injury in rats via metabolomics techniques. METHODS Male Sprague-Dawley （SD） rats were randomly assigned to normal group，model group，silybin group （50 mg·kg–1） and low-dose，medium-dose and high-dose Radix Sophorae Tonkinensis groups （265，529，1 058 mg·kg–1），with six rats per group. The rats in each group were given the corresponding drugs by gavage for 7 consecutive days. Two hours after the last dosage，rats，except for those in the normal group，were intraperitoneally injected with peanut oil containing 10% CCl4 to create an acute liver injury model. After 16 hours，the rats were sacrificed to measure serum alanine transaminase （ALT） and aspartate transaminase （AST），as well as superoxide dismutase （SOD），glutathione peroxidase （GSH-Px），and malondialdehyde （MDA） levels in liver tissues. The liver index of rats was calculated. Liver tissue morphology was assessed via hematoxylin and eosin （H&E） staining. Mitochondrial metabolites in serum，liver，and liver samples were detected by ultra-performance liquid chromatography-mass spectrometry （UPLC/MS）. Principal component analysis （PCA） established the metabolic profile of rats，and differential metabolites were screened by orthogonal partial least squares-discriminant analysis （OPLS-DA），one-way ANOVA and variable weight values. Human Metabolome Database （HMDB） and MassBank of North America mzCloud （mzCloud） databases were used for metabolite identification. MetaboAnalyst 6.0 and the Kyoto Encyclopedia of Genes and Genomes （KEGG） database were used for metabolic pathway enrichment and construction of metabolic networks. RESULTS After treatment of Radix Sophorae Tonkinensis at varying doses，the liver index significantly decreased and the liver histopathological abnormalities improved. Serum activities of ALT and AST，as well as MDA level in liver tissues significantly decreased （P<0.01），while the level of SOD and GSH-Px in liver tissues significantly increased （P<0.01）. Metabolomics studies showed that Radix Sophorae Tonkinensis significantly altered 11 metabolites in serum，15 in liver and 47 in liver mitochondria by metabolomics，mainly involving 9 pathways of amino acid metabolism （phenylalanine，tyrosine and tryptophan biosynthesis，phenylalanine metabolism，glycine，serine and threonine metabolism，alanine，aspartate and glutamate metabolism，cysteine and methionine metabolism，tyrosine metabolism） and unsaturated fatty acid metabolism （linoleic acid metabolism，arachidonic acid metabolism）. CONCLUSION Radix Sophorae Tonkinensis has a certain hepatoprotective effect on rats with CCl4-induced acute liver injury，and exerts a medicinal effect by regulating 59 metabolites and 9 related metabolic pathways.
OBJECTIVE To evaluate the efficacy of total alkaloid extract of Corydalis Rhizoma （CRTAE） in treating vascular dementia，and to detect compositions and multicomponent contents based on ultra-high performance liquid chromatography （UPLC） for separating complex mixtures with a Quadrupole （Q） mass filter and an Orbitrap mass analyzer to achieve high-resolution mass spectrometry （HRMS） （UPLC-Q-Orbitrap-HRMS）. METHODS CRTAE was prepared by acid water extraction and percolation method. Sprague-Dawley （SD） rats were randomly divided into the sham group，model group，CRTAE group，and Nimodipine positive group. The in vivo vascular dementia model was prepared by ligating bilateral common carotid arteries in rats. The pharmacological evaluation of CRTAE against vascular dementia was conducted by motor coordination experiment，hematoxylin and eosin （H&E） staining and immunohistochemistry. Using UPLC-Q-Orbitrap-HRMS technology to analyze the components of CRTAE in the positive ion mode，and contends of four index components with high response values and strong specificity were determined simultaneously. RESULTS CRTAE significantly improved the structure of neural cells and increased the microvessel density （P<0.01），thereby alleviating the symptoms of vascular dementia. A total of 67 components were detected in CRTAE，including phellodendrine，dehydrocheilanthifoline，palmatine and so on. Four index components，including tetrahydropalmatine，palmatine hydrochloride，berberine hydrochloride and dehydrocorydaline were selected for methodological investigation and content determination. The contents were 40.534，21.561，40.521，and 35.514 mg·g–1，respectively. CONCLUSION CRTAE has a good therapeutic effect on vascular dementia. We established a high-resolution and high-precision CRTAE component analysis method by UPLC-Q-Orbitrap-HRMS to determine the content of four index components in CRTAE. This study provides scientific basis for the subsequent research and clinical application.
OBJECTIVE To analyze the song formula of “Eighteen Incompatible Medicaments” in Zhang Zihe’s Ru Men Shi Qin，and to identify core drug pairs using Apriori and MIE algorithms and explore their potential toxicity based on network toxicology，thus guiding rational drug use in clinical practice. METHODS Using the ancient Chinese medical books as a main reference and in combination with literature review，a database of prescriptions containing the contents of “Eighteen Incompatible Medicaments” was created. Apriori algorithm and MIE algorithm in IBM SPSS ModelerV18.0 software were applied to analyze the frequency，medicinal properties，association rules，and correlation of pairs. The anti-drug pair with higher confidence，support and MIE value in the association rule analysis was selected. The TCMSP （Traditional Chinese Medicine Systematic Pharmacology Database and Analysis Platform） was used to obtain the components of Pinellia Rhizoma and Aconitum carmichaelii. Their toxicity was predicted by introducing their components into the ADMETlabV2.0 database. The disease targets of respiratory toxicity were obtained using the GeneCard and OMIM databases. The intersecting targets were screened using the online mapping of VennyV 2.1.0，and subjected to the plotting of a protein-protein interaction （PPI） network using the STRING database. A TCM-component-pathway-target network was created using Cytoscape V3.9.0 to screen the core targets. Gene Ontology Function Enrichment （GO） and Kyoto Encyclopedia of Genes and Genes Pathway Enrichment （KEGG） analyses were performed. RESULTS A total of 82 formulas were included，containing 121 groups of anti-drug pairs. Drug pairs with the highest support in the aconite，licorice，and veratrum groups were Pinellia Rhizoma-Aconitum carmichaelii，Flos Genkwa-Radix et Rhizoma Glycyrrhizic，and Ginseng Radix et Rhizoma-Veratri Nigri Radix et Rhizoma. Anti-drug pairs with the largest MIE values were Ampelopsis Radix-Aconitum carmichaelii，Kansui Radix-Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle，and Asari Radix et Rhizoma-Veratri Nigri Radix et Rhizoma. The high-frequency drug pairs of Pinellia Rhizoma-Aconitum carmichaelii had a total of 28 active ingredients and 127 intersecting targets. KEGG pathway enrichment analysis yielded 128 related pathways，which were mainly enriched in the pathways of cancer，PI3K-Akt，tuberculosis，IL-17，etc. CONCLUSION “Eighteen Incompatible Medicaments” in TCM are widely used in ancient clinics，among which the frequency of use of Pinellia Rhizoma-Aconitum carmichaelii drug pairs is the highest. For the clinical application，the use of anti-drug pairs should be treated dialectically and rational under the safety. Network toxicology research on the core anti-drug pairs of Pinellia Rhizoma-Aconitum carmichaelii indicates that the core targets of its potential respiratory toxicity are AKT1 and IL-6，with key signaling pathways including the cancer pathway and the AGE-RAGE pathway. The research results provide new insights into the toxicity mechanism of Pinellia Rhizoma-Aconitum carmichaelii and offer a feasible approach for exploring the modern scientific implications of TCM contraindications through a combination of classical text analysis and modern informatics methods.
OBJECTIVE To establish a method of measuring contents of 13 components in Oral Qiangshen Liquid via high-performance liquid chromatography in conjunction with an evaporative light scattering detector （HPLC-ELSD），and to perform chemometrics analysis of determined contents. METHODS Using a Phenomenex C18 （250 mm×4.6 mm，4 µm） chromatographic column with acetonitrile-0.1% formic acid solution as the mobile phase with gradient elution （flow rate： 1.0 mL·min–1，column temperature： 30 ℃，sample volume： 10 µL），contents of Calycosin 7-O-β-D-Glucopyranoside，ginsenoside Rg1，ginsenoside Re，ginsenoside Rf，ginsenoside Rb1，astragaloside Ⅳ，ginsenoside Rd，ginsenoside Rb2，astragaloside Ⅱ，astragaloside Ⅰ，schisandrin，ginsenoside Rg3，and panaxatriol in Oral Qiangsheng Liquid were determined by HPLC-ELSD. The content determination results were comprehensively analyzed using hierarchical cluster analysis （HCA），principal component analysis （PCA），and orthogonal partial least squares-discriminant analysis （OPLS-DA）. RESULTS The detected 13 components showed good linear relationships within their respective ranges （r≥0.999 0），with an average recovery rate of 96.3%-102.8% and a relative standard deviation （RSD） of 0.8%-2.9%.The chemometrics analysis results showed that 19 batches of Oral Qiangshen Liquid could be clustered into three categories，and there were some differences in sample quality among different manufacturers. Ginsenoside Rf，ginsenoside Rb2，ginsenoside Rg3，astragaloside Ⅱ，panaxatriol and astragaloside Ⅳ were the main potential markers affecting the quality of Oral Qiangshen Liquid. CONCLUSION The established content determination method by HPLC-ELSD is simple and has good repeatability. Combined with chemometric analysis，it can provide reference for the quality evaluation of Oral Qiangsheng Liquid.
OBJECTIVE To explore the effect of the Danshen Baibixiao Formula combined with Acitretin on treating psoriasis mice via regulating the nuclear transcription factor Kappa B/mitogen-activated protein kinase （NF-κB/MAPK） signaling pathway. METHODS A psoriasis-like skin lesion model in male BALB/C mice was induced by applying imiquimod cream （80 mg daily，for 7 days） on the back of mice. The mice with successful modeling were randomly divided into the model group，triptolide group （12 mg·kg–1），acitretin group （5 mg·kg–1），low-dose Danshen Baibixiao group （3 g·kg–1），high-dose Danshen Baibixiao group （12 g·kg–1），low-dose Danshen Baibixiao + Acitretin group （3 g·kg–1+5 mg·kg–1），and high-dose Danshen Baibixiao +Acitretin group （12 g·kg–1+5 mg·kg–1），with 6 mice in each group. After 7 days of modeling，drug interventions were given for 7 days，during which the psoriasis area and severity index （PASI） scores for all groups of mice were observed and recorded. On day 15，mice were anesthetized and sacrificed to collect blood serum and skin lesion tissues. The hematoxylin and eosin （H&E） staining was used to observe tissue pathology and epidermal thickness. Enzyme-linked immunosorbent assay （ELISA） was used to detect peripheral levels of tumor necrosis factor-α （TNF-α），interleukin-6 （IL-6），interleukin-17 （IL-17），and interleukin-23 （IL-23）. Western blot was employed to assess the protein levels of phosphorylated NF-κB p65，inhibitory kappaB-alpha （IκBα），p38 mitogen-activated protein kinase （p38 MAPK），extracellular regulated protein kinases （ERK 1/2），and c-Jun N-terminal kinase （JNK） in dorsal skin lesions of mice. RESULTS Psoriasis-like symptoms were found on the back skin of mice in the model group. PASI score，inflammatory cell infiltration，epidermal thickness，spleen index，peripheral levels of TNF-α，IL-6，IL-17 and IL-23，protein levels of phosphorylated NF-κB p65，IκBα，p38 MAPK，ERK 1/2 and JNK in dorsal skin lesions were significantly higher in the model group than the control group （P<0.01），which had significantly changed in drug intervention groups than the model group （P<0.05）. The epidermal thickness，spleen index，peripheral levels of TNF-α and IL-23，and protein levels of phosphorylated p38 MAPK，ERK 1/2 and JNK in the high-dose Danshen Baibixiao + acitretin group were significantly lower than the acitretin group （P<0.01）. CONCLUSION The effect of high-dose Danshen Baibixiao combined with acitretin is significantly better than that of a single drug. Their combination can reduce peripheral levels of TNF-α，IL-17，and IL-23 in psoriasis mice and protein expressions of phosphorylated NF-κB p65，IκBα，p38 MAPK，ERK 1/2 and JNK in skin lesions through regulating the NF-κB/MAPK signaling pathway，thereby alleviating inflammatory cell infiltration and epidermal thickening.
OBJECTIVE To obtain adverse drug event （ADE） information of mavacamten in the US Food and Drug Administration （FDA） Adverse Event Reporting System （FAERS） database，and to conduct a comprehensive and in-depth exploration and assessment of its safety，thus promoting its rational application. METHODS The original data about ADE reports related to mavacamten provided by the FAERS database was searched from January 1，2022 to September 30，2024 and analyzed using Python software. The signal detection indicators used were reporting odds ratio （ROR） and proportional reporting ratio （PRR），and the corresponding threshold value standards were set. The ADEs were statistically analyzed and systematically classified. RESULTS A total of 1 913 ADE reports of mavacamten were collected，and 119 effective signals were identified，involving 20 system organ classifications （SOC），mainly including cardiovascular diseases，systemic diseases，various reactions at the site of administration，and various examinations. ADEs with the leading frequency of reporting were atrial fibrillation （133 cases），dyspnea （132 cases），and fatigue （131 cases）. ADEs with the leading frequency of ROR involved cardiovascular symptoms （164.338），left ventricular ejection fraction reduction （63.244），and contractile function disorder （38.234）. At the same time，new ADEs were also discovered，such as atrial fibrillation，infectious diseases，gastrointestinal diseases，and hypertension. CONCLUSION In addition to the ADEs recorded in the instruction manual of mavacamten，ADEs outside the instruction manual，such as atrial fibrillation events and the risk of infection should also be concerned to promptly make clinical interventions.
OBJECTIVE To evaluate the risk factors associated with adverse drug reactions （ADRs） caused by nicotinic acid injection and to construct a nomogram based on these risk factors for internal and external validation. METHODS Inpatients who received nicotinic acid injections in the Third People’s Hospital of Hefei from January 2023 to December 2024 were selected. They were divided into the observation group （32 cases） and the control group （80 cases） based on whether they experienced adverse reactions. Univariate and multivariate logistic regression analysis was used to identify the independent risk factors for ADRs，and a nomogram was constructed based on these risk factors，and subjected to both internal and external validation. RESULTS The incidence rate of ADRs to nicotinic acid injection was 28.6%. Logistic regression analysis indicated that age，body mass index （BMI）≥28 kg·m–2，drug allergy history，concurrent use of vasodilators，concentration of administration ≥0.5 mg·mL–1，and drip rate ≥30 drops/min were independent risk factors for ADRs. The nomogram constructed based on the above six risk factors had good predictive accuracy. The discrimination of the nomogram was assessed by the receiver operating characteristic （ROC） curve，with an area under the curve （AUC） of 0.854. The overall prediction accuracy of the external validation was 71.0%. CONCLUSION The use of nicotinic acid injection should avoid concurrent use of vasodilator drugs and control the concentration and drip rate of administration. Older adults，or individuals with a BMI≥28 kg·m–2，or a history of drug allergies should be closely monitored. The nomogram constructed based on the above risk factors can provide clinical assistance in therapeutic decision-making and promote the safe use of drugs.
OBJECTIVE To investigate the efficacy and safety of vonoprazan in combination with antimicrobial agents with varying medication frequencies in treating Helicobacter pylori （H.pylori） infection. METHODS Based on real-world retrospective data，clinical data were collected from patients who were diagnosed with H.pylori infection and received vonoprazan-based combination therapy with antimicrobial agents in the First Affiliated Hospital，Zhejiang University School of Medicine from November 1，2021 to December 31，2022. Patients were stratified into two groups according to the administration frequency of vonoprazan： the QD group （368 patients，20 mg once daily） and the BID group （238 patients，20 mg twice daily）. All patients underwent either a 13C/14C-urea breath test or gastroscopic biopsy for pathological examination at least 4 weeks after treatment discontinuation. Intention-to-treat （ITT） and per-protocol （PP） analyses were performed to compare the H.pylori eradication rates between the two groups，and adverse reactions during treatment were documented. RESULTS In the QD group，322 patients completed the study，15 were lost to follow-up，28 failed to undergo reexamination，and 3 discontinued the treatment due to adverse reactions. In the BID group，199 patients completed the study，11 were lost to follow-up，24 failed to undergo reexamination，and 4 discontinued the treatment due to adverse reactions. ITT analysis showed that the H.pylori eradication rate was 73.9% in the QD group versus 69.7% in the BID group （P>0.05）. PP analysis revealed an eradication rate of 84.5% in the QD group and 83.4% in the BID group （P>0.05），with no significant differences observed in both analyses. Eight patients （2.5%） in the QD group and 9 patients （4.5%） in the BID group experienced adverse reactions，with no significant difference observed between the groups （P>0.05）. All adverse reactions were mild and resolved spontaneously after treatment discontinuation. CONCLUSION For the treatment of H.pylori infection，vonoprazan administered at 20 mg QD demonstrates comparable efficacy and safety to that at 20 mg BID，while the 20 mg QD regimen offers a lower total cost.
OBJECTIVE To establish an innovative service benchmark for orthopedic resident pharmacists relying on the National Center for Orthopaedics. METHODS By strengthening the team building of resident pharmacists in the Orthopaedic Department，and taking the orthopedic characteristic disease phantom limb pain as the entry point，a postoperative phantom limb pain service model based on medical humanism at the National Center for Orthopaedics was established. In addition，combined with medical insurance，centralized procurement and other drug administration information，four-step interventions of “analysis-intervention-discussion-tracking” were formed to formulate a reasonable drug use intervention system for orthopedics in Shanghai Sixth People's Hospital. Training and teaching of clinical pharmacists，as well as orthopedic pain-related basic and clinical research were conducted. RESULTS The postoperative phantom limb pain service model based on medical humanism at the National Center for Orthopaedics was established，with the average pain score significantly decreasing from 6.4±1.2 to 2.4±0.8 （P<0.05） and the satisfaction rate significantly increasing from 70% to 88% after interventions （P<0.05）. A box of medical consensus and specifications for the management of pain for orthopedics in and out of hospitals has been formulated. In addition，under the intervention of orthopedic pharmacists in resident departments，the quality control indicators of reasonable use of antimicrobial drugs，such as orthopedic antimicrobial drugs and average drug cost have been smoothly controlled. CONCLUSION The construction of the integrated innovative service model of “medical-education-research-management” of the orthopedic pharmacists in Shanghai Sixth People's Hospital provides references for accelerating the high-quality development of pharmacists in Shanghai and improving the working model of resident pharmacists.
OBJECTIVE To construct an intelligent data platform for clinical trials of anti-cancer drugs，thus providing support to enhance the management and operational efficiency of clinical trials. METHODS A general standard dataset based on the characteristics of clinical trials of anti-cancer drugs was built by integrating multiple hospital service system data from the HIS （Hospital Information System），LIS （Laboratory Information System），EMR （Electronic Medical Record），and PACS （Picture Archiving and Communication System）. Natural language processing （NLP） was employed to structure medical semantic-information. Machine learning models were used to deeply explore the value of data，and create an intelligent data platform. RESULTS The functions of trials management，subject recruitment，intelligent monitoring，online image transmission，and site selection visit were realized by the intelligent data platform for clinical trials of anti-cancer drugs. From May 2021 to April 2025，884 clinical trials were managed on the platform，enrolling 4 158 patients. Intelligent quality control was utilized in 242 trials. The subject recruitment module screened 2 381 patients from 68 trials，with 292 enrolled participants，yielding a conversion rate of 12.3%. The time required for monitoring a single subject decreased from 6.5 hours to 2.1 hours. A total of 137 trials adopted remote monitoring module，conducting 763 remote monitoring visits. A total of 28 142 imaging datasets were exported online，with an average transmission time of 2 minutes per dataset. Additionally，the site feasibility module was used in 554 clinical trials for preliminary reviews，reducing the average review time from 2 hours to 0.4 hours per item. CONCLUSION The intelligent data platform for clinical trials of anti-cancer drugs significantly improves subject recruitment efficiency，monitoring productivity，imaging data transmission speed，and feasibility review processes，demonstrating its value in intelligent trial management.
OBJECTIVE To systematically analyze the role of medication reconciliation （MR） in promoting continuity of medication information and clarify its current implementation status and potential challenges，and to propose optimization recommendations to facilitate its wider adoption in the continuity of care. METHODS A systematic review was conducted. Literatures relevant to MR-facilitated continuity of medication information during healthcare transitions were retrieved and analyzed from Chinese and English databases. RESULTS The systematic search identified 675 English articles and 406 Chinese articles. After screening，30 eligible studies were included. Regarding implementation status，MR is often a mandatory practice in foreign countries，covering multiple care transition stages for patients，with information platforms and technologies enhancing its accuracy and efficiency. Domestically，MR implementation varies significantly across institutions and regions. Poor communication of medication information between institutions increases implementation difficulty，compromising information completeness and timeliness. Regarding effectiveness，most studies demonstrated that MR significantly reduces medication discrepancies and the risk of adverse drug events，while improving patient medication adherence and therapeutic outcomes，highlighting its clinical value. CONCLUSION MR effectively addresses current deficiencies in information continuity by collecting and integrating patient medication information. Future efforts should focus on improving the quality and efficiency of MR through policy standardization and incentives，application of standardized and intelligent information technologies，enhancement of pharmacists' service capabilities，and increased patient engagement. This will ultimately improve patient medication safety and advance the development of continuity of pharmaceutical care.
OBJECTIVE To construct a whole-dimensional working mode of intensive care unit （ICU） resident pharmacists based on medical teaching and management，evaluate its effectiveness in improving the quality of pharmaceutical services and promoting rational drug use，thus providing references for clinical practice of ICU resident pharmacists. METHODS Selecting the Hepatic ICU of Beijing Tsinghua Changgung Hospital as the pilot ward，a whole-dimensional working mode was created by a deep incorporation of pharmacists into the clinical practice，teaching，research and management，as well as delivering specialized pharmaceutical services. An evaluation system was preliminarily developed to assess the pharmacist’s performance across clinical practice，pharmaceutical indicators，and educational/research activities. RESULTS After once year of exploration，a working mode of ICU resident pharmacists meeting the disease characteristics in our hospital was initially established，and a quantitative index evaluation system for resident pharmacists was formulated. Evaluations showed that all pharmaceutical quality control metrics in the Hepatic ICU significantly improved and met targets，including antimicrobial use intensity，antimicrobial utilization rate，rational prescription review rate，drug cost proportion of total medical expenses，and average drug cost per hospitalization. The standardization of the medication in the department was improved. Resident pharmacists assisted the clinical department in establishing two standards for pediatric medications in ICU and the perioperative anti-infection treatment path of liver transplantation. Dynamic scores of the work of resident pharmacists were all full marks. CONCLUSION This study established a whole-dimensional working mode of ICU resident pharmacists characterized by comprehensive participation and specialized service，demonstrating its effectiveness in improving pharmaceutical care quality and advancing rational drug use. An evaluation system for resident pharmacists has been initially established to promote the work of resident pharmacists in a standardize and quantitative way.
Clozapine，as a second-generation antipsychotic，is widely regarded as the “gold standard” for the treatment of treatment-resistant schizophrenia. Although achieving significant efficacy in alleviating clinical symptoms，its broader clinical use is often limited by a range of adverse drug reactions. To date，therapeutic drug monitoring （TDM） has emerged as an effective strategy for optimizing clozapine therapy and enhancing patient outcomes. In clinical practice，blood samples are the primary biological samples used for TDM analysis of clozapine and its metabolites. However，in recent years，alternative biological matrices，such as dried blood spots，saliva，and urine，have gained increasing attention and progressively been utilized to facilitate individualized treatment strategies. This paper presented a systematic review of research conducted over the past decade on the various biological sample types and analytical methods used for clozapine and its metabolites，with the aim of supporting the implementation of TDM in clozapine-treated patients with schizophreniaand guiding future clinical and scientific research.
The theory of traditional Chinese medicine （TCM） properties is a guiding theory for the clinical use of TCM herbs. Correct labeling of drug properties safeguards the rational use of TCM in clinical setting. According to the theory of TCM that sweet can tonify，relieve and reconcile，and pungent can release and promote，the labeling of sweet and pungent of Gypsum Fibrosum，a commonly used Chinese medicine，is inconsistent with its functional indications for clearing away heat and purging fire，removing annoyance，and quenching thirst. As a result，a lot of confusion challenges clinical practice. In fact，according to the theory and practice system of Tangye Jingfa Map，Gypsum Fibrosum is a sour Chinese herb，which can tonify the lung to treat lung deficiency syndrome （thirst，fever and cough），astringe the heart to treat heart deficiency or heart syndrome （upset and insomnia），and purge the liver to treat liver syndrome （headache and cramp with fever）. These characteristics are exactly consistent with the functional indications of Gypsum Fibrosum. Therefore，the dominant medicinal taste of Gypsum Fibrosum should be sour，rather than sweet or pungent. Under the framework of Tangye Jingfa Map，this paper deeply demonstrated the possibility of sour taste of Gypsum Fibrosum from the perspectives of efficacy pharmacology，phenomenological pharmacology，cold and heat properties，and the experience of famous clinical experts，thus providing medical guidance for the clinical application of Gypsum Fibrosum that truly meets the functional indications and a paradigm for the breakthrough research of the theory of Chinese medicine.
To describe a case of methotrexate （MTX） poisoning due to misadministration，and to analyze the drug regimens and pharmaceutical care，thus providing a reference for the prevention and treatment of MTX poisoning. Clinical pharmacists collaborated with physicians to devise personalized drug regimens and pharmaceutical care，leveraging established protocols for antidotes to high-dose MTX chemotherapy and literature review of previous antidote strategies of small-dose MTX poisoning. After admission，calcium folinate was administered as a rescue treatment. Additionally，hydration alkalinization was performed to promote the excretion of methotrexate （MTX）. Parenteral nutrition support was performed by giving fat emulsion，amino acid （17） and glucose （11%） injections （1 440 mL）. Subcutaneous injections of granulocyte stimulating factor and recombinant human interleukin-11 were given to promote the recovery of the blood count. For the initial condition of agranulocytosis accompanied by fever，a step-down anti-infective program and targeted antimicrobial therapy after blood culture were given. The patient was discharged with improvement after treatment.
This paper reported a case of cross drug-induced hypersensitivity syndrome （DIHS） occurring in a coronary heart disease patient during antiplatelet therapy with aspirin and indobufen. The aim is to enhance the clinical team's understanding and identification of DIHS. Through a retrospective analysis of the clinical data of a DIHS patient admitted to the cardiology department in December 2024，including history of adverse reactions，clinical manifestations，disease progression，treatment，and outcome，the occurrence of cross-DIHS was identified to be associated with the cyclooxygenase-1 （COX-1） pathway. Supplemented by literature review on DIHS induced by similar drugs，this case highlighted the need for vigilance against cross-allergy when administering indobufen to individuals with a history of aspirin-related DIHS.
