OBJECTIVE To explore the mechanism of Qili Qiangxin （QLQX） Capsule in improving cardiac function after myocardial infarction based on trimethylamine N-oxide （TMAO）/nuclear factor kappa-B（NF-κB） axis. METHODS A rat model of acute myocardial infarction （AMI） was created by ligating the left coronary artery’s anterior descending branch. Echocardiography was used to assess left ventricular ejection fraction （LVEF）， left ventricular fractional shortening （LVFS）， left ventricular internal dimension in diastole （LVIDD）， and systole （LVIDS）. Morphological changes and fibrosis levels in cardiac tissue were examined， and serum levels of trimethylamine oxide （TMAO） and soluble ST2 （sST2） were measured. Meanwhile， protein expression levels of NF-κb， phosphorylated NF-κb （p-NF-κb）， tumor necrosis factor α （TNF-α）， interleukin-6 （IL-6）， interleukin-1 β （IL-1β） were detected. RESULTS Compared to the AMI group， the QLQX group showed significant reductions in serum TMAO and sST2 levels， and protein expressions of p-NF-κB/NF-κB， TNF-α， IL-6， and IL-1β in myocardial tissues， along with notable improvements in LVEF， LVFS， LVIDD， LVIDS， cardiac morphology and fibrosis （P<0.05）. Similarly， rats in the QLQX group demonstrated significantly lower TMAO， sST2， p-NF-κB/NF-κB， TNF-α， IL-6， and IL-1β levels and improved echocardiographic and histopathologic parameters compared to the Choline group （P<0.05）. CONCLUSION QLQX Capsule may improve cardiac function after myocardial infarction by reducing inflammatory markers TNF-α， IL-6， and IL-1β through inhibition of the TMAO/NF-κB axis.

OBJECTIVE To investigate the potential of brain-penetrating components of Jiaotai Pills in inhibiting the inflammation in mouse microglial cells BV2 via ultra-high-performance liquid chromatography combined with an Orbitrap mass spectrometer （UHPLC-Orbitrap MS）， molecular docking， and molecular biology. METHODS UHPLC-Orbitrap-MS was used to analyze the brain-penetrating components of Jiaotai Pills， and key components were identified using molecular docking. An in vitro inflammatory model was established in lipopolysaccharides （LPS）-induced BV2 cells， followed by treatment with berberine （BBR） and magnoflorine （MAG）. The quantitative reverse-transcription polymerase chain reaction （qRT-PCR） was utilized to measure the mRNA levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and IL-6 in cells. Enzyme-linked immunosorbent assay （ELISA） was utilized to measure the contents of TNF-α，IL-1β，and IL-6 in cell supernatants. Cell morphology was observed under an inverted microscope. Western blot analysis was performed to assess the protein expressions of key proteins in the phosphatase and tensin homolog deleted on chromosome 10 （PTEN）/ protein kinase B （AKT）/ nuclear factor kappaB （NF-κB） signaling pathway. RESULTS A total of 13 brain-penetrating components of Jiaotai Pills were identified， all of them were alkaloid compounds. RT-PCR and ELISA results showed that BBR and MAG significantly decreased the levels of TNF-α， IL-1β， and IL-6 in LPS-induced BV2 cells. Meanwhile， BBR and MAG improved inflammatory morphology in LPS-induced BV2 cells. Furthermore， compared with the normal group， LPS-induced BV2 cells presented significantly elevated protein levels of p-PTEN/PTEN， p-AKT/AKT， and p-p65/p65， which were markedly suppressed by BBR and MAG treatment. CONCLUSION The brain-penetrating components BBR and MAG from Jiaotai Pills may exert anti-inflammatory effects on LPS-induced BV2 cells by reducing the expressions of inflammatory cytokines and improving cell morphology via inhibiting the PTEN/AKT/NF-κB signaling pathway.

OBJECTIVE To develop quality markers （Q-Markers） for the treatment of atherosclerosis with Shenqi Tongmai oral liquid （SQTM） guided by the “five principles” of Q-Markers and combined with the technologies of characteristic spectrum， chemometrics， molecular docking， activity evaluation and content determination. METHODS The characteristic spectrum of SQTM was established， and chemical pattern recognition was used to analyse different batches of SQTM. The potential Q-Markers of SQTM were selected by molecular docking and antioxidant activity evaluation was used for preliminary verification. The contents of Q-Markers in SQTM were determined simultaneously. RESULTS In the SQTM characteristic spectrum， nine characteristic components were identified. Among them， five differential components， namely， ononin， baicalin， calycosin-7-O-beta-D-glucoside， luteolin and rosmarinic acid， had the most significant effects on the quality of SQTM. Among the five different components and the two core components with the highest binding energy， luteolin， protocatechualdehyde and rosmarinic acid had relatively strong antioxidant activity， which could be used as the Q-Markers of SQTM. The concentrations of protocatechualdehyde and luteolin in the 17 batches of samples were 11.72–27.13 μg·mL^–1 and 9.19–24.80 μg·mL^–1， respectively. CONCLUSION Guided by the “five principles” of Q-Markers， with the integration of characteristic spectrum of SQTM， chemometrics， molecular docking and activity evaluation techniques， and combined with literature analysis， luteolin and protocatechualdehyde were finally determined as Q-Markers. The content determination methods of protocatechualdehyde and luteolin were established， providing reference for the quality control of SQTM.

OBJECTIVE To visualize and analyze the spatial tissue distribution of hordeine compound after oral administration in rats using desorption electrospray ionization mass spectrometry imaging （DESI-MSI） technique， and to specifically investigate the characteristic distribution of hordeine in kidneys tissues over time. METHODS Hordeine was selected as the target small molecule compound. Female Sprague-Dawley （SD） rats were orally administered with 50 mg·kg^-1 hordeine aqueous solution. After a certain time， rat organs， including the heart， kidney， brain， pituitary， and spleen were harvested， frozen， and sectioned. DESI-MSI technique was employed to analyze the tissue distribution of the target compound at various time points post-administration. Furthermore， the distribution characteristics of hordeine in kidneys tissue sections at 0.5 h， 1 h， 1.5 h， 4.6 h， 6.6 h， and 12 h post-administration were analyzed. RESULTS The mass spectrometry imaging visualization showed varying abundances of hordeine in different tissue structures. Although its distribution in the brain was relatively weak， hordeine was able to cross the blood-brain barrier and reached its target， the pituitary gland. The kidneys exhibited the strongest signal and the most significant distribution changes among all tissues. The mechanism of action of hordeine could be inferred from the mass spectrometry imaging of the kidneys at various time points. CONCLUSION DESI-MSI technique facilitates the exploration of the distribution characteristics of hordeine compound at the tissue level. This study achieved in situ visualization analysis of drugs in rats， providing detailed insights into the potential application prospects of hordeine as a drug candidate compound. It offers a deeper understanding and outlook for its application in drug development and therapy.

OBJECTIVE To study the mechanism of the development and progression of diabetes in mice and the intervention of metformin combined with mulberry leaf using fecal metabolomics based on gas chromatography coupled with mass spectrometry （GC-MS）. METHODS The db/db mice were randomly divided into diabetes model group （DM）， mulberry leaf ethanol extract group （MLE）， metformin group （MET）， and MET-MLE combination group （CMT）. The db/m mice were used as the normal control group （NC）. Interventions were given for 8 weeks. Fecal samples were collected at 5-8 weeks for GC-MS. RESULTS Continuous changes were detected in 12 fecal metabolites in the DM group at 5-8 weeks. Six of them could be reversed by metformin combined with mulberry leaf， including glyoxylate and dicarboxylate metabolism， glycine， serine and threonine metabolism， phenylalanine， tyrosine and tryptophan biosynthesis， phenylalanine metabolism and bile acid metabolism. CONCLUSION Metformin combined with mulberry leaf delays the development of diabetes by regulating abnormal metabolic pathways in mice， showing a synergistic effect.

OBJECTIVE To explore the potential mechanism of valproic acid （VPA） induced obesity in children with epilepsy based on network pharmacology， cell experiments and clinical sample detection. METHODS Network pharmacology was used to analyze the key targets and pathways of VPA-induced obesity. Molecular docking was conducted between core targets and VPA. HepG2 cells were stimulated with different concentrations of VPA. Cell viability was detected by cell counting kit-8 （CCK-8） assay， lipid droplet content was detected by fluorescence probe， and fat deposition was observed by Oil Red O staining. Blood samples were collected from patients with low， medium and high concentrations of VPA and the concentration of lysophosphatidic acid （LPA） in the samples was detected by LPA enzyme-linked immunosorbent assay kit. RESULTS Network pharmacology analysis suggested that core target of VPA induced obesity in children was lysophosphatidic acid receptor 6 （LPAR6）， and the main involved signaling pathways were phosphoinositide 3-kinase-protein kinase B （PI3K-Akt） and cyclic adenosine monophosphate （cAMP） pathways. Molecular docking results indicated that LPAR6 could bind well with VPA. Fluorescence probe detection suggested that with the increase of VPA concentration， lipid droplets in cells increased as well. Oil Red O staining results showed that VPA could promote fat deposition in cells， with the promotional effect gradually increasing with higher concentration. The results of clinical sample detection indicated that the concentration of LPA in children’s serum significantly increased with the increase of VPA blood concentration. CONCLUSION LPA and its receptor LPAR6 play a key role in obesity-induced by VPA in children with epilepsy， and the mechanism may be related to the PI3K-Akt and cAMP signaling pathways.

OBJECTIVE To evaluate the cost-effectiveness of fluticasone propionate / salmeterol （FP/SA） powder inhalation versus FP powder inhalation in asthma from the perspective of the Chinese health service system， thus providing evidence-based reference for clinical application. METHODS A Markov model of asthma was established based on an international multicenter randomized controlled clinical study （AUSTRI）. A Markov state transition model was established for simulating the dynamic changes in three states （event-free， acute exacerbation & death）， with the model cycle of one month. The model had a whole horizon of 10 years. The cost only included direct medical cost. The unit price of the drug was derived from the latest data of the YaoZhi website， and the utility value and hospitalization cost were derived from the literature data. Using 3 times of gross domestic product （GDP） in 2023 as the threshold of willingness-to-pay （WTP）， TreeAge Pro 2011 software was applied to perform regression analysis and queue simulation， and sensitivity analysis was used to evaluate the robustness of the basic research results. RESULTS The total cost of inhaled FP/SA and FP was 3 805.87 yuan and 3 244.64 yuan， respectively， and the effectiveness was 11.705 6 quality-adjusted life years （QALYs） and 11.563 5 QALYs， respectively. The incremental cost-effectiveness ratio （ICER） for the FP/SA was 3 949.54 yuan/QALY， which was less than the WTP threshold （268 200 yuan/QALY）. Single factor sensitivity analyses showed that the drug costs in FP/SA group and FP group were the main influencing parameters， but they had little influence on the results of basic analysis. Probabilistic sensitivity analysis showed that the probability of as-needed FP/SA being cost-effective was 90.5%. CONCLUSION Compared with FP maintenance therapy， regular inhalation of FP/SA in asthma patients is more cost-effective.

OBJECTIVE To analyze the occurrence， development， clinical symptoms， laboratory examination， treatment and outcome of immune checkpoint inhibitors （ICIs） induced autoimmune encephalitis （AIE） in patients with lung cancer， and to provide some reference for the diagnosis and treatment of AIE caused by such drugs in clinical treatment. METHODS From January 1， 2011 to August 12， 2024， case reports of AIE induced by the use of ICIs in patients with lung cancer were searched from PubMed， Embase， China National Knowledge Infrastructure （CNKI）， Wanfang and VIP. RESULTS A total of 35 case reports were retrieved， and the information of 32 patients was finally summarized after excluding cases of metastatic lung cancer. In all cases， 69% of patients were non-small cell lung cancer. 69% of the patients were treated with programmed cell death 1 （PD-1）， of which Nivolumab was the most commonly used. 38% of patients had abnormal brain magnetic resonance imaging （MRI） and 47% of patients had abnormal electroencephalogram （EEG）. Immune-related antibodies were detected in serum or cerebro-spinal fluid of 34% of patients. 94% of patients were treated with hormone therapy， and 88% of patients improved. CONCLUSION In the treatment of lung cancer with ICIs， AIE is more likely to occur in PD-1. Auxiliary examination lacks specificity and has a low positive rate. Therefore， it is necessary to pay close attention to neurological symptoms in the treatment process， timely identification， diagnosis and treatment of AIE to improve poor prognosis.

OBJECTIVE To systematically review the pharmacoeconomic evaluations of relapsed or refractory （R/R） mantle cell lymphoma （MCL）， providing a reference for future decision-making on treatment plans and pharmacoeconomic evaluations of the disease. METHODS A systematic search was conducted in PubMed， EMbase， The Cochrane Library， China National Knowledge Infrastructure （CNKI）， Wanfang Database， and VIP Network to collect and organize relevant studies on the pharmacoeconomic evaluation of R/R MCL from the establishment of the database to February 6， 2024. The quality of the included literature was assessed using the 2022 version of the Consolidated Health Economic Evaluation Reporting Standards （CHEERS） scale， and a systematic review of extracted data was performed. RESULTS A total of 6 studies were included， with an overall compliance rate of over 80%. The partitioned survival model （PSM） was the most commonly used analytical model. The efficacy data for the intervention group came from clinical trials， while control group efficacy data were derived from clinical trials， real-world studies， or literature reviews. Efficacy data were either patient-level data or simulated from KM curves. Utilities were mostly obtained from published literature， and costs were all direct costs， mainly from published literature and medical insurance databases. The main outcome measures were quality-adjusted life years （QALYs） and life years （LYs）. Sensitivity analysis used deterministic sensitivity analysis and probabilistic sensitivity analysis， with the main influencing factors being drug costs. CONCLUTION There are few existing economic evaluations of R/R MCL both domestically and internationally. Pharmacoeconomic evaluation reports do not strictly adhere to the requirements of the CHEERS scale， with issues of incomplete content. There are still some deficiencies in research time limits in model settings， acquisition of utility data， cost composition， which needs to be urgently addressed in the future.

OBJECTIVE To evaluate the cost-effectiveness of sintilimab combined with first-line chemotherapy in the treatment of locally advanced or metastatic non-squamous non-small cell lung cancer （NSCLC） compared with first-line chemotherapy alone from the perspective of China’s health system， providing a reference for clinical rational drug use. METHODS Based on the survival data reported by ORIENT-11， a three-state partitioned survival model （PSM） was constructed. The model period was set to 21 days and simulated to 120 months. The incremental cost-effectiveness ratio （ICER） was calculated using quality-adjusted life years （QALY） as an indicator of health outcomes. The economics of sintilimab combined first-line chemotherapy （intervention group） compared with first-line chemotherapy alone （control group） in the treatment of locally advanced or metastatic NSCLC was evaluated. Single factor sensitivity analysis and probability sensitivity analysis were performed to verify the robustness of the basic analysis results. RESULTS The results of cost-effectiveness analysis showed that compared with control group， the incremental effectiveness of intervention group was 0.484 629 6 QALYs， the incremental cost was 100 170.6 yuan， and ICER was 206 695.2 yuan/QALY. The results of single factor sensitivity analysis showed that the parameters that had a greater impact on ICER were the utility value of the unadvanced state， the price of sintilimab， the price of docetaxel， the price of pemetrexed and the utility value of the advanced state. Probabilistic sensitivity analysis indicated that when the willing to pay threshold was set 3 times China’s 2023 percapita gross domestic product （GDP）， the probability of economic performance in the intervention group was 94.7% compared with the control group. CONCLUSION Compared with chemotherapy alone， sintilimab combined with first-line chemotherapy is cost-effective in the treatment of locally advanced or metastatic non-squamous NSCLC.

OBJECTIVE To mine and analyze the safety warning signals of four anti-calcitonin gene-related peptide monoclonal antibodies （anti-CGRP/CGRPR mAbs）， including the Erenumab （EM）， Galcanezumab （GM）， Fremanezumab （FM） and Eptinezumab （EP）， and compare their safety profile by analyzing the adverse drug events （ADEs）， thus providing references for rational drug use in clinical practice. METHODS All ADE reports of the four anti-CGRP mAbs were retrieved from the United States Food and Drug Administration （FDA） Adverse Event Reporting System （FAERS） database from the first quarter （Q1） of 2020 to Q3 of 2023， and the reporting odds ratio and proportional reporting ratio were analyzed. Assessment and comparisons were made between the four drugs in terms of ADRs from the nervous， skin， gastrointestinal and cardiovascular systems. RESULTS After screening， the number of ADE reports with anti-CGRP/CGRPR mAbs as the primary suspect （PS） drug was 15 875 in EM， 8 854 in GM， 2 268 in FM， and 1 983 in EP. After calculations， 46， 68， 43 and 40 effective ADE signals were reported in EM， GM， FM and EP， respectively. ADE signals in the gastrointestinal system and muscular system were stronger for EM than other agents， and much more in the heart and cardiovascular system. ADE signals in the skin and nervous system were stronger for FM than other agents. High-risk ADE signals in the muscular system were not seen for FM. ADE signals in the heart and cardiovascular system were stronger for EP than other agents. Except for pregnancy， high-risk ADE signal was not detected. The remaining three drugs all reported the risk of ADE signals in the reproductive system. CONCLUSION In the clinical use of anti-CGRP/CGRPR mAbs， it is essential to monitor the risk of cardiovascular， and menstruation abnormalities in females. Attention should be paid to assess the new ADE signals， such as Raynaud’s phenomenon and muscle discomfort when using EM and GM. The latest evaluation and comparison of safety about anti-CGRP/CGRPR mAbs ADE can reduce the risk of drugs and increase the selectivity of drugs．

OBJECTIVE To evaluate the clinical efficacy and safety of nebulized inhalation of ambroxol hydrochloride solution in the treatment of mucous phlegm syndrome in elderly patients. METHODS This multi-center， open-label， single-arm study enrolled a total of 1 192 patients from May 2021 to April 2022. The patients were divided into an elderly group （>60 years） and a non-elderly group （≤60 years）. All patients received nebulized ambroxol hydrochloride solution twice daily for up to 7 days. The primary observation indicators were the changes in sputum characteristics score before and after treatment， and secondary observation indicators included changes in sputum expectoration difficulty， sputum volume， cough symptoms， sputum viscosity， and quality of life （assessed by EQ-5D score）， along with the incidence of adverse reactions during treatment. RESULTS With prolonged treatment， both groups showed significant reductions in sputum characteristics， sputum expectoration difficulty， sputum volume， cough symptoms， and sputum viscosity scores （P<0.05）. At the end of treatment， the sputum characteristics score decreased by 75.8% from baseline in the elderly group and by 79.3% in the non-elderly group， with no statistically significant difference （P=0.06）. However， the non-elderly group showed greater improvements in sputum expectoration difficulty， sputum volume， cough symptoms， and sputum viscosity compared with the elderly group （P<0.05）， whereas the elderly group exhibited a significant improvement in quality of life （P<0.05）. The incidence of adverse reactions was similar in both groups （4.7% in the elderly group vs. 5.0% in the non-elderly group， P=0.792）， primarily consisting of mild to moderate gastrointestinal and respiratory symptoms， with no reports of severe adverse reactions. CONCLUSION Nebulized inhalation of ambroxol hydrochloride solution effectively improves mucous phlegm symptoms in elderly patients， with good safety.

OBJECTIVE To systematically evaluate the risk factors for polymyxin B-associated acute kidney injury （AKI） in adult patients. METHODS The clinical studies on polymyxin B-associated AKI in adult patients published in domestic and foreign academic journals from January 2000 to February 2024 were retrieved. Data were extracted and statistical evaluation was performed by RevMan 5.3 software. RESULTS A total of 15 articles representing 2 215 patients were included. Statistical analysis showed that risk factors for polymyxin B-associated AKI included age （OR=1.02，95%CI：1.01-1.03）， ICU stay （OR=2.17，95%CI：1.49-3.15）， malignancy （OR=4.97，95%CI：1.69-14.67）， hypoalbuminemia （OR=4.69，95%CI：1.95-11.29）， vancomycin （OR=1.93，95%CI：1.52-2.44）， vasoactive drugs （OR=2.06，95%CI：1.59-2.67）， loop diuretics （OR=1.30，95%CI：1.01-1.67） and daily dose of polymyxin B （OR=1.59，95%CI：1.27-2.00）. CONCLUSION Elderly patients， ICU stay， malignancy， hypoalbuminemia， vancomycin， vasoactive drugs， loop diuretics， and daily dose of polymyxin B （> 150 mg） are susceptible to AKI.

OBJECTIVE To understand the current situation of pharmacy clinics in China's second-level and above general hospitals， and to provide theoretical and practical basis for improving the management system. METHODS Through the annual survey of pharmacy professional quality control conducted by the National Center for Medical Quality Control in Pharmaceutical Management， we collected information on the development of pharmacy clinics in second-level and above general hospitals in 31 provinces （autonomous regions and municipalities directly under the central government） and the Xinjiang Production and Construction Corps from 2020 to 2022. Statistical software was used for summary and calculation. RESULTS The number of hospitals included in the analysis from 2020 to 2022 were 5 225， 5 064 and 6 040， respectively. Compared with 2020， the rate of pharmacy clinic development increased from 9.32% to 48.54% in 2022， showing a significant growth trend. Among all types of hospitals， tertiary public hospitals continued to lead in the rate of pharmacy clinic development， followed by tertiary private hospitals， secondary public hospitals and secondary private hospitals. The annual average number of pharmacy outpatient visits dropped slightly， from 475 to 463， but second-level private hospitals still maintained a high number of visits， highlighting their unique advantages in the field of pharmacy services. The rate of pharmacy outpatient charges decreased from 24.44% to 18.97%， a change that contrasted sharply with the trend of growth in the number of hospitals. The categories of pharmacy clinics offered by the hospitals participating in the survey from 2021 to 2022 were diverse， with independent pharmacy clinics dominating， and pharmacists’ comprehensive outpatient clinics being the main type. CONCLUSION China’s hospital pharmacy clinic is developing rapidly， and in the future， it is still necessary to further strengthen the construction of pharmacy disciplines， deepen the cultivation of clinical pharmacy talents， and clarify the value of pharmacist services in order to promote the healthy and sustainable development of pharmacy clinics.

OBJECTIVE To investigate the dose rounding method of anti-neoplastic drugs， and to evaluate the cost savings in cancer treatment， so as to provide a basis for reducing the cost of anti-cancer. METHODS The dose of anti-neoplastic drugs used by patients in Cancer Hospital， Chinese Academy of Medical Sciences， Shenzhen Center in 2023 was counted， and the cost savings of anti-neoplastic drugs were evaluated by waste-cost analysis and theoretical dose saving. The waste-cost analysis was used to describe the number of drugs discarded due to the use of partial bottle. Theoretical dose savings were applied to describe the cost that might be avoided by rounding the prescription dose to the nearest vial size. The theoretical rounding dose was compared with the prescription dose. RESULTS A total of 67 535 orders of anti-neoplastic drugs were collected in 2023， of which 7 311 orders were rounded. Rounding the dose could avoid the waste of 185 435.15 mg anti-neoplastic drugs and save a cost of 548 277.53 yuan. The rounding range was 0.14% to 10.00%. CONCLUSION On the premise that the deviation of dose rounding is in line with the guidelines， dose rounding of anti-neoplastic drugs prescriptions can effectively save costs and avoid drug waste.

OBJECTIVE To establish a cloud-based recording system for pharmacy intravenous admixture service （PIVAS）， thereby optimizing work processes and improving efficiency. METHODS By utilizing the software-as-a-service （SaaS） model and employing Kingsoft Docs AirScript as the development platform， along with smartphones as input tools， the work records of PIVAS were digitized and networked， and a cloud-based recording system was established. A questionnaire survey was conducted to assess user experience， and the changes in the number of work records before and after the implementation of the cloud-based recording system for PIVAS were compared. RESULTS The cloud-based recording system for PIVAS was established， which included six worksheets （work logs， incentive mechanisms， air handling unit monitoring plans， temperature-humidity-static pressure difference records， cleaning and disinfection records， and duty rosters）. The system covered 70% of the PIVAS’s work records and enabled online real-time， multi-point， multi-user collaborative editing， viewing， and sharing of work records. The system basically met the daily operational needs of the PIVAS. The survey results indicated that 95.8% of users preferred using the cloud-based recording system in their work， as it facilitated information entry， collaboration， searching， and sharing， thereby improving work efficiency and management quality and basically meeting the work requirements of PIVAS. Despite the advantages， 4.2% of users reported difficulties in operating on smartphones and found it inconvenient to input medication information. Furthermore， 91.7% of users acknowledged that paper records posed challenges in collaboration， management， sharing， and searching. All respondents （100%） believed that the cloud-based recording system increased the standardization of records， thereby avoiding errors caused by non-standardized writing. Nonetheless， 37.5% expressed concerns about potential risks of information leakage and data loss associated with the cloud system. After four months of using the cloud-based recording system， the number of work records in the PIVAS increased by 41% compared to paper records， indicating enhanced documentation efficiency. CONCLUSION By digitizing and networking the work records of the PIVAS， the cloud-based recording system has transformed work methods and improved work efficiency and management quality. Compared with paper records， it offers more advantages and may potentially replace paper records， but further improvements are still needed.

Taxus L is the generic name of Taxus， which mainly contains taxanes， flavonoids， lignans， phenols and other chemical constituents. Taxus L has many pharmacological effects such as anti-tumor， anti-inflammatory， analgesic， antioxidant and hypoglycemic effects. This study integrated and summarized the chemical composition and pharmacological effects of Taxus chinensis. Based on the theory of quality marker （Q-Marker） of traditional Chinese medicine， the Q-Marker of Taxus chinensis was predicted and analyzed from the aspects of plant phylogeny， the peculiarity of chemical components， testability of chemical components， pharmacodynamics and blood components. Preliminary predictions suggested that paclitaxel， harringtonine， bacatineⅢ， 10-deacetylbacatineⅢ， （+）-taxing， quercetin， kaempferol， sciadopitysin， ginkgo biloba， amentoflavone， and so on may be potential Q-Markers for it. Our findings provide a basis for establishing and improving the quality evaluation of Taxus chinensis.

Atherosclerosis （AS） is characterized by chronic inflammation， which is primarily driven by lipid deposition， the accumulation of oxidized low-density lipoprotein， increased production of reactive oxygen species， and the formation of foam cells. The efficacy of conventional therapeutic drugs is often limited due to adverse reactions. With the development of nanotechnology and its application in the field of pharmacy， functionalized macrophage membrane biomimetic nanoparticles are gradually being applied in the pharmaceutical industry. These nanoparticles can target atherosclerotic plaques and competitively inhibit macrophages， thereby reducing foam cell formation and the expression of inflammatory factors and proteins. Meanwhile， they also enhance the ability of macrophages to process lipids， accelerate cholesterol efflux， regulate the anti-inflammatory macrophage phenotype， promote foam cell apoptosis， and mitigate tissue damage caused by reactive oxygen species， achieving safe and efficient treatment of AS. This article reviews the application of functionalized macrophage membrane biomimetic nanoparticles in the treatment of AS， aiming to provide new insights for targeted therapeutic strategies against the diseases.

Tacrolimus， as a calcineurin immunosuppressant， needs to be given more attention in treatment due to its narrow therapeutic window， obvious individual difference， and numerous adverse reactions. This paper reported a 55-year-old female patient with dermatomyositis associated interstitial lung disease （MDA5 positive） who was treated with tacrolimus and methylprednisolone. The dose of tacrolimus was adjusted to 1.5 mg bid， but after 4 days of medication， tacrolimus toxicity symptoms appeared， including increased blood pressure fluctuating between 150–170/90–100 mmHg， elevated lactate to 4 mmol·L^–1， severe pain in right shoulder with general weakness and diarrhea. Blood concentration of tacrolimus was beyond the detection limit >30.0 ng·mL^–1. Clinical pharmacist suggested that tacrolimus should be suspended and phenobarbital should be used to reduce the excessively high concentration of tacrolimus. Pantoprazole with less drug-drug interaction was used instead of omeprazole. Captopril for lowering blood pressure， sodium bicarbonate for lowering lactic acid， and tramadol for relieving pain， the symptoms of the patient gradually remitted. In addition， we reviewed relevant literature at home and abroad in order to provide warnings for clinicians， pharmacists and nurses on the off-label usage of tacrolimus.