Amid ongoing healthcare reform in China， the multi‑campus hospital model operating under a group‑based strategy has emerged as an important pathway for the high‑quality development of public hospitals. Integrated， standardized pharmaceutical management is essential to the efficient operation of such systems； however， challenges persist in extending the pharmaceutical supply chain， scaling pharmacy service coverage， and strengthening quality assurance across multiple campuses. To address these issues， the Department of Pharmacy at the First Affiliated Hospital of the University of Science and Technology of China （Anhui Provincial Hospital） convened a drafting committee comprising experts from more than 60 medical institutions nationwide to develop the Expert Consensus on Pharmaceutical Management in Multi‑Campus Public Hospitals under a Group‑Based Strategy. Using a Delphi process， the consensus proposes a comprehensive framework for pharmaceutical management in multi‑campus hospital systems. The framework spans eleven domains： Pharmacy and Therapeutics （P&T） Committee governance； pharmacy department organization； medicines supply management； dispensing operations and logistics； clinical pharmacy services； pharmacy human resources； pharmacy education and training； pharmaceutical research； pharmacy informatics； pharmaceutical quality control； and professional culture and disciplinary development in pharmacy. The document presents 35 evidence‑based recommendations to provide practical guidance for optimizing pharmaceutical governance， operations， and outcomes in multi‑campus public hospitals across China.
OBJECTIVE To elucidate the gut microbiota-mediated biotransformation of four characteristic flavonoid aglycones from Scutellaria baicalensis-baicalein， scutellarein， wogonin， and oroxylin A-in humans and rats.In order to enrich the metabolic pathway of flavonoids in gut microbiota. METHODS Ultra-high-performance liquid chromatography coupled with quadrupole Orbitrap high-resolution mass spectrometry （UHPLC-Q-Orbitrap HRMS） was employed to profile metabolites produced from in vitro incubations of the four flavonoids with intestinal bacterial preparations derived from healthy male volunteers and male Sprague-Dawley （SD） rats. Metabolites were identified and structurally annotated based on high-resolution MS data. RESULT Sixty metabolites were identified and characterized. Observed biotransformations included amination， amino acid conjugation， acetylation， methylation， hydroxylation， thiolation， demethylation， and dehydroxylation. Notably， amination and amino acid conjugation of baicalein and scutellarein were observed in intestinal bacteria for the first time. Interconversion among baicalein， oroxylin A， and scutellarein was also observed. CONCLUSION This study delineates the human-and rat-derived gut microbiota pathways responsible for the biotransformation of four flavonoid aglycones. The findings provide a foundation for further research into microbe–flavonoid interactions and their implications for the intestinal environment and host exposure.
OBJECTIVE To investigate the effects and underlying mechanism of alisol B （ALB） on metabolic dysfunction-associated fatty liver disease （MAFLD）， focusing on the protein kinase RNA-like ER kinase and activating transcription factor 4 （PERK-ATF4） signaling pathway. METHODS MAFLD models were established in vivo by feeding C57BL/6J mice a Western diet （WD） and in vitro by treating HepG2 cells with oleic acid （OA）. ALB was administered as the intervention. Liver pathology was evaluated by histological staining of tissue sections. Lipid accumulation in HepG2 cells was assessed by Oil Red O staining， and alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in culture supernatants were quantified using commercial kits. Intracellular Ca2+ levels were measured with the Fluo-4 fluorescent probe. Transcriptional activity of the unfolded protein response element （UPRE） was determined by a luciferase reporter assay. Endoplasmic reticulum stress （ERS）- related gene expression was analyzed by reverse transcription-quantitative polymerase chain reaction （RT-qPCR）， and PERK-ATF4 pathway proteins were examined by Western blotting. RESULTS ALB ameliorated WD-induced MAFLD in mice and attenuated OA-induced hepatocyte injury and lipid accumulation （P<0.01）. ALB restored OA-induced Ca2+ dysregulation （P<0.01） and inhibited UPRE transcriptional activity （P<0.05 or P<0.01）. In both models， ALB reduced the expression of ERS-related genes， including ATF6， GRP78， TNFRSF10B， CHOP， ERN1， and XBP1 （P<0.05 or P<0.01）， and decreased PERK-ATF4 pathway-related proteins such as p-PERK， GRP78， and ATF4 （P<0.01）. CONCLUSION ALB may ameliorate MAFLD by suppressing ERS， at least in part through modulation of the PERK-ATF4 signaling pathway.
OBJECTIVE To comprehensively characterize the chemical constituents of Baiying Qingmai Mixture （BQM）—a classic hospital preparation and its absorbed components in rat serum thereby establishing a scientific foundation for elucidating the pharmacodynamic material basis of BQM and its clinical applications. METHODS Ultra-high performance liquid chromatography with Orbitrap tandem mass spectrometry （UPLC-Orbitrap-MS/MS） was performed on BQM and serum samples from rats following oral BQM administration. Chemical composition and blood components of BQM were systematically characterized through comparative analysis of blank serum， drug-containing serum， and herbal extracts， analysis ofmolecular weight data， MS/MS fragmentation patterns， and database matching. RESULTS A total of 206 chemical components were characterized in BQM， comprising 59 flavonoids， 15 isoflavonoids， 15 fatty acids and derivatives， 13 phenolic acids， 13 triterpenoids， and 91 compounds from other structural classes. Thirteen blood components of BQM were detected， predominantly flavonoids， polycyclic polyphenols， and diterpenoids. CONCLUSION This study provides the first systematic characterization of in vitro chemical composition and blood components of BQM using UPLC-Orbitrap-MS/MS， providing reliable experimental references for revealing pharmacodynamic basis of BQM， and advancing mechanistic research on its therapeutic efficacy against thromboangiitis obliterans.
OBJECTIVE To investigate the therapeutic mechanism of Xianglian Pills in Helicobacter pylori（H.pylori）-associated gastritis （HPAG） in rats based on the nuclear factor erythroid 2-related factor 2/heme oxygenase 1/glutathione peroxidase 4 （Nrf2/HO-1/GPX4） signaling pathway and gut microbiota. METHODS An HPAG rat model was established using a multifactorial protocol. Successfully modeled rats were randomly assigned to the following groups： Model， Xianglian Pills low dose （0.54 g·kg–1）， intermediate dose （1.08 g·kg–1）， high dose （2.16 g·kg–1）， 3-amino-4-cyclohexylamino ethyl benzoate （Fer-1）， and blank. After 21 consecutive days of treatment， general conditions were assessed. Giemsa staining was used to evaluate H.pylori infection in gastric mucosa， and hematoxylin and eosin （H&E） staining to assess gastric histopathology. Serum ferrous iron （Fe2+）， malondialdehyde （MDA）， superoxide dismutase （SOD） activity， and lipid reactive oxygen species （ROS） were measured by enzyme-linked immunosorbent assay （ELISA）. Western blotting was performed to detect Nrf2， HO-1， solute carrier family 7 member 11 （SLC7A11）， and GPX4 in gastric tissue. Microbial DNA from intestinal contents underwent 16S rRNA gene sequencing. RESULTS Compared with the blank group， model rats exhibited attenuated body weight gain， soft malodorous stools， marked gastric mucosal injury， elevated serum ROS， MDA， and Fe2+， reduced SOD activity， and downregulated protein expression of Nrf2， HO-1， SLC7A11， and GPX4. the difference were statistically significant（P<0.05）.Compared with the model group， Xianglian Pills at low， intermediate， and high doses， as well as Fer-1， improved overall condition and gastric histopathology， significantly reduced ROS， MDA， and Fe2+， increased SOD activity， and upregulated Nrf2， HO-1， SLC7A11， and GPX4. the difference were statistically significant（P<0.05）. Regarding the gut microbiota， Xianglian Pills shifted community structure toward a healthier profile： at the phylum level， Firmicutes decreased， and Bacteroidetes increased， resulting in a reduced Firmicutes-to-Bacteroidetes ratio； at the genus level， beneficial taxa were enriched. CONCLUSION Xianglian Pills significantly ameliorate gastric mucosal injury in HPAG rats. Its therapeutic effect may involve activation of the Nrf2/HO-1/GPX4 axis and inhibition of ferroptosis， together with favorable remodeling of the gut microbiota.
OBJECTIVE To investigate the potential hepatorenal toxicity of Baiying Qingmai Mixture （BQM） by network pharmacology， molecular docking and animal experiments. METHODS The main active ingredients and targets of BQM， as well as targets for hepatorenal toxicity were screened in TCMSP and HERB databases. The intersection targets of BQM and hepatorenal toxicity were obtained using Venny 2.1.0， and protein-protein interaction （PPI） analysis was performed on the intersection targets using STRING database. Cytoscape3.8.0 was used to perform topology analysis for screening core targets. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis on core targets were performed. Molecular docking was performed using AutoDock version 1.5.7， and the docking results were visualized with PyMOL software. The results were preliminarily validated in animal experiments. RESULTS Network pharmacology identified 186 active ingredients of BQM， 3 211 hepatorenal toxicity targets， and 243 intersection targets of BQM and hepatorenal toxicity. GO analysis revealed that the intersection targets were mainly involved in the positive regulation of gene expression and the positive regulation of transcription by RNA polymerase Ⅱ. KEGG analysis indicated that the intersection targets may involve in the I3K-Akt and IL-17 signaling pathways. The PPI results indicated that TP53， AKT1 and JUN might be the core targets of BQM-induced hepatorenal toxicity， among which TP53 was the most important core target. The results of “component-target-pathway-hepatorenal toxicity” network showed that quercetin， β-sitosterol， kaempferol and luteolin might be the core components of BQM. Molecular docking results showed favorable docking activities of quercetin， β-sitosterol， kaempferol， and luteolin binding to key target molecules like TP53. No death and hepatorenal toxicity were found in animal experiments. CONCLUSION The components， targets and pathways of hepatorenal toxicity induced by BQM are preliminaries explored by network pharmacology and molecular docking technology， and the results were verified through animal experiments. Our findings provide data support for further clinical application research and safety evaluation of BQM.
OBJECTIVE To investigate the quality differences between formula granules of Cynanchum paniculatum （Xuchangqing， a traditional Chinese medicine） and its traditional decoction as a control， thus providing a reference for establishing quality standards for Cynanchum paniculatum formula granules. METHODS A total of 15 batches of Cynanchum paniculatum traditional decoction were prepared， and both the extraction yield and pH values were determined. Additionally， 18 batches of commercially available Cynanchum paniculatum formula granules were collected， with the content of paeonol used as a quantitative indicator. The content of paeonol and its transfer rate in both the traditional decoction and the formula granules were quantified using HPLC. Fingerprint profiles of both the traditional decoction and the formula granules were constructed， and potential quality markers influencing the observed quality differences were analyzed using principal component analysis and high-resolution mass spectrometry. RESULTS The extraction yield of the traditional decoction ranged from 19.12% to 26.43%， with paeonol content of 0.51%-1.85% and a transfer rate of 42.90%-66.20%. In contrast， the paeonol content in the formula granules varied from 0.05% to 0.58%. The fingerprint profile of the traditional decoction identified eight common peaks， including β-sitosterol， acetovanillone， p-hydroxyacetophenone， palmitic acid， naringenin， boldenone undecylenate， hesperidin， and paeonol based on reference chromatograms and ion fragmentation information. The cumulative variance contribution rate of the two principal components in the principal component analysis was 75.62%， with paeonol significantly impacting the overall quality evaluation. CONCLUSION There is a significant difference in the paeonol content of Cynanchum paniculatum formula granules， which is notably lower than that of the traditional decoction. Further improvements are needed in the quality standards for Cynanchum paniculatum formula granules.
OBJECTIVE This study aims to analyze the characteristics of clinical co-medication with Ginkgo Biloba Ketone Ester Tablets based on real-world data within community healthcare institutions， providing a reference for rational clinical use. METHODS Data were collected from the electronic medical record system of five community hospitals in Shanghai from June 2016 to April 2023， involving 4 760 patients who had used Ginkgo Biloba Ketone Ester Tablets at least once. Data mining was conducted using R language software to perform cluster analysis on the disease characteristics of the medication population， and association rule analysis was carried out using SPSS Modeler 18.0. RESULTS Among the 4 760 users of Ginkgo Biloba Ketone Ester Tablets， the male-to-female ratio was 1∶1.82， with the elderly （88.7%） being the primary user group and an average age of 72.3 years. The main clinical diagnoses were coronary heart disease， vertigo， and cerebral arteriosclerosis， with accompanying diseases including hypertension， sleep disorders， and hyperlipidemia. Co-medication involved 1 022 different drugs， with the most commonly combined chemical drugs being enteric-coated aspirin tablets， atorvastatin calcium tablets， and amlodipine besylate tablets， and traditional Chinese medicines including Musk Cardiotonic Pills， Xin Keshu Tablets， and Dan Ning Tablets. CONCLUSION The use of Ginkgo Biloba Ketone Ester Tablets is predominantly among the elderly， with a higher frequency of use in females. Co-medication is common and matches the main diagnoses of the patients. The results of this study provide a reference for the rational use of Ginkgo Biloba Ketone Ester Tablets in clinical settings.
OBJECTIVE To explore the application effect of the failure mode and effect analysis （FMEA） combined with root cause analysis （RCA） on the management of drugs used in pediatric clinical trials. METHODS An analysis team was established. FMEA was used to analyze the failure modes in the drug management process of pediatric clinical trials. The key failure modes were determined using a Pareto chart. RCA was then applied to identify the root causes. Corresponding improvement measures were formulated and the effects after intervention were evaluated. RESULTS After the application of the improvement measures， the risk priority number （RPN） values of the 29 key failure modes decreased，the difference statistically significant （P < 0.01）， and the risk levels were reduced to low or very low. CONCLUSION The application of FMEA combined with RCA in the management of drugs used in pediatric clinical trials can effectively standardize the drug management in each link of clinical trials， reduce the management risks of trial drugs， and provide a reference for improving the quality of drug management in clinical trials.
OBJECTIVE To evaluate the real-world effectiveness and safety of high-dose dual therapy （HDDT） combined with Banxia Tiaozhong Granules for the treatment of Helicobacter pylori （Hp） infection. METHODS This single-center， retrospective， two-arm real-world study analyzed medical records of 182 patients newly diagnosed with Hp infection （outpatients and inpatients） treated at the Department of Gastroenterology， Wuhan Hospital of Traditional Chinese and Western Medicine， from January 1， 2023 to November 20， 2024. Patients received either HDDT （high-dose esomeprazole plus amoxicillin； control group， n = 91） or HDDT plus Banxia Tiaozhong Granules （observation group， n=91）. Outcomes included Hp eradication rate， symptom scores， patient-reported outcome （PRO） scale scores， and adverse events （AEs）. RESULTS The observation group achieved significantly higher Hp eradication rate than the control group （94.5% vs. 85.7%， P<0.05）. Post-treatment， all symptom scores （epigastric fullness， dry/bitter mouth， epigastric pain， halitosis， belching， nausea， acid reflux， diarrhea） and PRO scores significantly decreased in the observation group （all P<0.01）. Compared with the control group， the observation group showed greater reductions in epigastric fullness， dry/bitter mouth， halitosis， belching， nausea， acid reflux， diarrhea， and PRO scores （P<0.05， P<0.01）. The incidence of AEs was significantly lower in the observation group than in the control group （5.5% vs.16.5%， P<0.05）. CONCLUSION HDDT combined with Banxia Tiaozhong Granules was associated with a higher Hp eradication rate， greater improvement in clinical symptoms compared with HDDT alone. It has good tolerance and safety， and worthy of promotion.
OBJECTIVE To establish a list of commonly used intravenous drugs in the intensive care medicine， thus providing a basis for drug compatibility of intravenous infusion. METHODS From January 2024 to December 2024， cases of drug usage in the intensive care unit （ICU）， neurocritical intensive care unit （NICU）， emergency intensive care unit （EICU） and cardiac care unit （CCU） of Hebei General Hospital were investigated. They were ranked from high to low. After evidence-based search and expert argumentation， 33 commonly used intravenous drugs in the intensive care medicine were determined. A compatibility table was drawn following the review of compatibility data. RESULTS A total of 255 drugs were used in ICU， NICU， EICU and CCU， and an intersection of 89 drugs was identified. A total of 37 drugs were used more than 300 times annually in ICU， NICU， EICU and CCU. After evidence-based search， bromoxine injection， hydroxyethyl starch/sodium chloride injection， salvianolate injection and famotidine injection were excluded， and 33 drugs were recommended as commonly used intravenous drugs in the intensive care medicine. A compatibility table was obtained. CONCLUSION Amiodarone possesses the lowest compatibility， followed by furosemide， esomeprazole， magnesium sulfate， ambroxol， esmolol， and mannitol. The compatibility data for phosphorus supplements， ulinastatin， isosorbide dinitrate， and traditional Chinese medicine injections are relatively scarce. The compatibility data for furosemide， methylprednisolone， propofol， and midazolam are more contradictory. It is necessary to actively carry out stability and compatibility tests for drug combinations with insufficient compatibility data and contradictory data.
OBJECTIVE To establish a closed-loop management of precise medication of meropenem led by clinical pharmacists， and to analyze the differences in serum concentration and clinical efficacy before and after the intervention. METHODS Using an interrupted time-series analysis， this study enrolled patients with traumatic brain injury who were diagnosed with hospital acquired pneumonia and treated with meropenem in the Neurosurgery Department of Affiliated Suzhou Hospital of Nanjing Medical University. According to the time node of closed-loop management mode， patients from October 2019 to December 2021 were retrospectively collected as the control group， while those prospectively recruited from January 2022 to October 2024 comprised the intervention group. The steady-state trough concentration （Cmin） and clinical efficacy of meropenem were compared between the two groups. RESULTS A total of 134 patients was enrolled. They were divided into the control group （63 cases） and intervention group （71 cases）. The initial median Cmin of meropenem in the intervention group was significantly higher than that in the control group ［2.62（1.09，9.90） vs.0.98（0.50，4.92）， P<0.01］. The proportion of patients with Cmin<2 mg·L–1 in the control group was significantly higher than that in the intervention group （63.49% vs. 44.93%， P<0.01）. Although no significant intergroup differences were observed in the clinical efficacy （78.2% vs. 68.9%， P=0.292） and Gram-negative bacterial eradication rate （69.1% vs. 57.8%， P=0.241）， the intervention group achieved superior eradication rate of meropenem-susceptible isolates with minimum inhibitory concentration （MIC）≤8 mg·L–1 （84.3% vs. 66.7%， P=0.041）. Health economic analyses revealed a significant lower antimicrobial cost in the intervention group， with a reduced proportion of total treatment costs （11.5% vs.12.9%， P=0.020）. CONCLUSION The closed-loop management mode of precise medication effectively enhances the Cmin of meropenem and improves clinical anti-infective efficacy against Gram-negative susceptible bacteria， thereby facilitating the advancement of individualized meropenem therapy.
OBJECTIVE To construct an active monitoring trigger for adverse drug events （ADE） related to glucagon-like peptide-1 receptor agonists （GLP-1RAs）， and to establish an active monitoring method for ADEs in elderly hospitalized patients， thus providing a scientific basis for the safe use of GLP-1RAs in the elderly. METHODS Based on the Global Trigger Tool （GTT） white paper and relevant literatures， ADE trigger items were preliminarily drafted， and an expert consultation questionnaire was designed. Two rounds of expert consultations were conducted using the Delphi method to screen out trigger items with consistent expert opinions. A retrospective study was conducted on elderly hospitalized patients medicated GLP-1RAs in the Chongqing University Three Gorges Hospital from January 2021 to December 2023. Medical records were reviewed according to the GTT method， and cases with positive triggers were double-blind evaluated by clinical pharmacists. The ADE detection rate， positive predictive value， and sensitivity were calculated. RESULTS A total of 113 319 elderly hospitalized patients were included， including 64 076 males and 49 243 females. The authority coefficient of the expert consultation questionnaire， coefficient of variation and consistency coefficient of expert opinions were 0.79±0.08， 0.24±0.06， and 0.341， respectively （P<0.01）. Using 22 trigger items， 3 150 alarm cases were monitored， of which 830 were confirmed as ADE-positive after manual evaluation， showing a positive predictive value of 26.3%， a sensitivity of 100%， and an ADE detection rate of 0.73%. CONCLUSION The ADE trigger for GLP-1RAs constructed by the Delphi method provides a reliable tool for GTT active monitoring， especially for elderly patients using high-risk drugs or multiple medications. The combination of GTT active monitoring and spontaneous passive reporting can significantly improve ADE monitoring efficiency and promote medical quality improvement.
OBJECTIVE To systematically evaluate prediction models for immune-related adverse events （irAEs）， and to understand the establishment of the existing models， thus providing suggestions for the subsequent development of the prediction models. METHODS The literatures on prediction models of irAEs risk were collected by searching CNKI， Wanfang， VIP， Biomedicine， PubMed， Web of Science， EMbase and The Cochrane Library. The quality of the included literatures was evaluated strictly， and key information was extracted， including model construction methods， included predictors， and predictive performance indicators. RESULTS A total of 9 literatures were included， including 14 risk prediction models. PROBAST evaluation results showed that all the 9 literatures had a high risk of bias. The predictive performance of all models was average， with an area under the curve （AUC） ranging from 0.604-0.873. No external verification was carried out. There were 8 predictors of strong consensus， namely： age， interstitial lung disease， emphysema， C-reactive protein， eosinophilic cell count， thyroid stimulating hormone， platelet to lymphocyte ratio （PLR）， and systemic immune-inflammation index （SII）. CONCLUSION The existing prediction models of irAEs risk are not perfect enough， with an overall high bias and lack of external validation. Further optimization and validation are needed to improve the prediction performance and clinical practicability of the models， so as to provide a more reliable basis for clinical decision-making.
OBJECTIVE To illustrate the pediatric medication information in oral drug instructions in children’s hospitals in China， and to provide references for further improvement of pediatric drug information in oral drug instructions， thus promoting the rational use of antibiotics in children. METHODS Based on the division of seven major geographical regions of China， a total of 4 391 oral drug instructions were collected from 20 children’s hospitals. The medication information labeling on children was investigated and analyzed. RESULTS This survey of pediatric drug information in oral drug instructions covered 5 major categories， 32 oral dosage forms， and only 190 medicines specifically for children. A total of 351 instructions labeled for pediatric medications， involving 226 Western medicines and 125 Chinese patent medicines. A total of 827 instructions labeled for the usage and dosage of pediatric medications， involving 672 Western medicines and 155 Chinese patent medicines. The total labeling rate for pediatric medication items was 59.74%. The labeling rate for pediatric pharmacokinetic parameters and contraindications was low. Except for contraindications， there were significant differences in indications， usage and dosage， pediatric medication items and precautions between Western medicines and Chinese patent medicines （P<0.05）. In addition to indications， usage and dosage， and labeling of contraindications， there were significant differences in other items between domestically produced drugs and non-purely domestically produced drugs （joint ventures or imported） （P<0.05）. Among different dosage forms， the labeling rates of indications （39.14%） and usage and dosage in granules/powders （62.00%） were the highest. The highest labeling rate was found in pediatric tablet medications （54.75%）. CONCLUSION There are few special varieties of oral dosage forms for children， and a lack of suitable dosage forms for children. It is recommended that relevant departments pay attention to further standardize and improve the pediatric medication information in oral drug instructions to ensure the rational use of drugs by children.
OBJECTIVE To analyze the characteristics of medication-related consultations in a WeChat-based follow-up group for renal transplant recipients and to discuss the design of an intelligent medication Q&A platform. METHODS We retrospectively analyzed medication consultation records posted from March to October 2024 in a WeChat follow-up group for recipients who underwent allogeneic kidney transplantation at Union Hospital， Tongji Medical College， Huazhong University of Science and Technology during 2022–2023. Consultation topics and drug categories were classified and summarized； priority areas were identified using Pareto charts. A standardized database of typical question-answer pairs was curated， and preliminary considerations for developing an intelligent medication Q&A platform were outlined. RESULTS A total of 412 medication consultations were recorded. Pareto analysis revealed that the leading consultation topics were indications and drug selection （31.88%）， dosage and administration （19.60%）， drug availability/supply （12.28%）， therapeutic drug monitoring of blood concentrations （7.72%）， and comparison/selection among similar drugs （7.33%）. The most frequently consulted drug categories were immunomodulatory （immunosuppressive） agents （39.95%）， anti-infective drugs （17.32%）， Chinese proprietary （patent） medicines （9.93%）， gastrointestinal drugs （7.16%）， and cardiovascular drugs （6.00%）. Based on these findings， we established a standardized database of typical medication consultation Q&As and proposed initial design ideas for an intelligent medication Q&A platform. CONCLUSION Pareto analysis of medication consultation data helps pharmacists identify priority information needs of renal transplant recipients. A standardized Q&A database can serve both as a practical reference for clinical medication counseling and as an effective knowledge base for developing an intelligent medication Q&A platform. Such a platform has the potential to deliver timely and precise medication consultation services for renal transplant recipients.
Multidrug-resistant bacterial infections are one of the major threats in global public health， which are associated with multiple adverse outcomes， including higher disease mortality and healthcare burden. Selection of appropriate antimicrobial agents has become increasingly challenging for clinical management in recent years due to the increasing number of multidrug-resistant bacterial infections. The risk of multidrug-resistant bacterial infections is particularly high in the pediatric population. The characteristics of multidrug-resistant bacterial infections in the pediatric population differ from those of the adult population. The immature immune systems in children are susceptible to a variety of risk factors， and multidrug-resistant bacterial infections tend to be more severe than those in adults. Therefore， understanding the current status and risk factors of multidrug-resistant bacterial infections in children in China is essential for the development of effective prevention and treatment strategies. This study systematically reviewed the epidemiological characteristics， resistance mechanisms， and risk factors of multidrug-resistant bacteria in the pediatric population in our country. Based on the research findings， specific prevention and control recommendations were proposed， such as optimizing antimicrobial drug management and strengthening hospital infection control， aiming to provide references for the rational use of antimicrobial drugs and the control of the spread of multidrug-resistant bacteria in children.
Heart failure with reduced ejection fraction （HFrEF） is a clinical syndrome characterized by high morbidity， disability， and mortality， severely impairing patients' quality of life and life expectancy. Although traditional neurohormonal blockade therapies have been widely implemented in clinical practice， the mortality and rehospitalization rates of HFrEF patients remain alarmingly high. Therefore， this review focuseed on the application prospects of non-traditional pharmacological agents and combination therapeutic strategies in the treatment of HFrEF. In addition， it further explored the emerging developments in precision medicine for HFrEF， aiming to provide new insights into optimizing its management.
