Continuously promoting the rational use of medicines based on the principles of safety， efficacy， economics， and appropriateness is an important approach to improve clinical management of medicines and optimize the allocation of health resources. Pharmacoeconomics aims to integrate the concept of quantifying the value of medicines into healthcare decisions， thus systematically and scientifically comparing and analyzing the economic costs and health returns of pharmaceutical technologies. It facilitates the formulation of the optimal strategy for decision-making and improvement of the overall efficiency of healthcare resource allocation. Focusing on the issue of rational use of drugs， this review explained how pharmacoeconomic evaluation， real-world treatment status research， medication use patterns and disease burden causal analysis based on the guiding principles of basic theories and research methods of pharmacoeconomics assist drug selection， promote standardized use of drugs， and improve the clinical use model of drugs after they are launched on the market. Targeting on current pharmacoeconomics research issues like insufficient data quality and imperfect study design， this review put forward targeted suggestions and solid scientific basis to help the pharmacoeconomics evidence develop in a higher quality direction and provide guidance for the practice of rational drug use.

OBJECTIVE To evaluate the medication treatment status of severe asthma patients in China and to provide evidence-based support for optimizing medication treatment mode and improving rational medication use in severe asthma patients. METHODS Using regional medical big data from Tianjin （2018—2020）， severe asthma patients were followed for one year. Severe asthma was determined by at least 2 prescriptions for medium-to-high doses of inhaled corticosteroids with an asthma diagnosis， combined with other control medications during the one-year baseline period. The study described proportion of medication use throughout the follow-up period， patients’ adherence to long-term control regimens estimated by proportion of days covered （PDC）， specific use of oral corticosteroids （OCS）， and the frequency of medication use during different types of exacerbations. RESULTS The study included 2 418 severe asthma patients with a mean age of 56.15 years and a Charlson comorbidity index of 2.55. During the one-year follow-up， 93.51% of patients with severe asthma were medicated by inhaled corticosteroids combined with long-acting β₂ agonist， and OCS was given to 10.75% of them. The average adherence to asthma control treatment was 0.439， and only 17.78% of patients showing good adherence （PDC≥0.8）. OCS was used with an average of 82.73 days， with an average daily dose of 15.68 mg. During the acute attacks that require hospitalization， patients had higher usage frequencies of most medications compared to other types of exacerbations. CONCLUSION Current selection of asthma treatment medications largely aligns with domestic guidelines， with the use of OCS being relatively limited. However， there may be deficiencies in the control and treatment of emergency patients， as well as in managing patient compliance. Further improvements in asthma treatment and management are needed to enhance the health outcomes for severe asthma patients.

OBJECTIVE To evaluate the cost-effectiveness of brand and generic oral alendronate from the healthcare perspectives in China. METHODS A pharmacokinetics-pharmacodynamics model was developed to estimate the clinical effect of 3-year treatment period of alendronate and calculate the predictive value of fractures. Then a Markov model was established to calculate lifetime disease transition， health benefits and cost based on the prediction of incidence of fractures calculated from the parameters of alendronate efficacy. The cost-effectiveness was assessed by calculating the incremental cost-effectiveness ratio （ICER）. RESULTS The clinical effect of alendronate simulated from the pharmacometrics model was close to published clinical trials to indicate the well-fitting. The additional quality-adjusted life-years （QALYs） of the brand alendronate was 0.000 4 and increased cost was 846.89 CNY compared with the generic alendronate （80% of bioavailability， F=0.8； ICER of 1 875 214 CNY/QALY）， which was higher than 3 times gross domestic product per capita. It suggested that the brand alendronate did not have a cost-effectiveness， and the generic alendronate with F=1.25 showed dominant cost-effectiveness. CONCLUSION This study demonstrated that generic alendronate is cost-effective by pharmacometrics-pharmacoeconomics model.

OBJECTIVE To compare the cost-effectiveness of enzyme replacement therapy （ERT） versus standard medical care for Chinese patients with Fabry disease. METHODS From the perspective of the Chinese healthcare system， the clinical efficacy of the two treatment regimens was indirectly compared based on individual patient data of a retrospective cohort study in the Chinese population. The matching adjusted indirect comparison method was used to adjust the baseline characteristics of patients to indirectly compare the clinical efficacy of the two regimens. A Markov model was constructed to simulate the 10-year progression of kidney disease in patients with Fabry disease. Transition probabilities were derived from individual follow-up data in the Chinese population. Meanwhile， utility values were sourced from the literatures， and cost data were based on relevant studies and fee schedules from provincial public healthcare institutions in China. The primary outcome was the end-stage renal injury. Cost-utility analysis was conducted using three times the 2023 gross domestic product （GDP） per capita as the willingness to pay （WTP） threshold. One-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis were performed to validate the robustness of the results. RESULTS Compared to standard medical care， ERT provided an additional 0.7 quality-adjusted life years （QALYs）， with an incremental cost of 2 311 405.40 RMB. This resulted in an incremental cost-effectiveness ratio （ICER） of 3 314 875.70 RMB/QALY that significantly exceeded the WTP threshold of 268 074 RMB/QALY. When the price of agalsidase alfa was reduced to 37 891.266 RMB， the ICER fell below or equaled the WTP threshold， making ERT cost-effective. The robustness of the results was confirmed through one-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis. CONCLUSION This study emphasizes the importance of optimizing ERT strategies and reducing treatment costs， and provides a reference for medical insurance decision-making to formulate more rational health insurance policies.

OBJECTIVE To systematically review economic evaluations of polatuzumab vedotin， and to provide an evidence to help decision makers improve the utilization of medical resources. METHODS Studies published from the establishment of the libraries to April 1， 2024 were searched in China National Knowledge Infrastructure （CNKI）， WanFang Data， VIP databases， PubMed， EMBASE and Cochrane library. Research model， pharmacoeconomic evaluation results and sensitivity analysis were systematically reviewed. A systematic analysis was conducted on the study design， study quality， pharmacoeconomic evaluation results and sensitivity analysis. RESULTS A total of eight studies from four countries and regions were included. The main pharmacoeconomic evaluation method was cost-effectiveness analysis. Three studies used the partition survival model and five studies used the Markov model. Literature review showed that tretatment regimen containing polatuzumab vedotin had a cost-effectiveness advantage in treating relapsed or refractory diffuse large B-cell lymphoma （DLBCL） compared with the traditional first-line treatment， but inferior to tafasitamab and lenalidomide treatment. Except for one study， the initial treatment regimen containing polatuzumab vedotin had cost-effectiveness advantages compared with the first-line treatment of DLBCL. CONCLUSION There are limited studies evaluating the cost-economics of polatuzumab vedotin in the treatment of DLBCL， and the heterogeneity of study settings， control groups， and modeling assumptions may contribute to the inconsistent results.Further studies are needed to verify the economics of polatuzumab vedotin for DLBCL in the Chinese population.

OBJECTIVE To evaluate the economic feasibility of oral liquid formulations of commonly used second-generation antihistamines such as loratadine， desloratadine， cetirizine， and levocetirizine for the treatment of allergic diseases in children， and to provide additional economic evidence for pediatric clinical medication. METHODS Efficacy indexes for the above-mentioned drugs in treating pediatric allergic rhinitis and allergic skin diseases were obtained from published literatures. The price of drugs was collected from the drug bidding database， based on which the total cost of the entire treatment course was calculated by referring to the instructions. RESULTS The value of total symptom severity complex between loratadine oral solution and cetirizine hydrochloride oral solution in the treatment of pediatric allergic rhinitis patients was comparable. Network meta-analysis also demonstrated no significant difference in the efficacy rates among the four medicines in the four-week treatment period for those children with urticaria. Taken a 6-year-old patient as a sample， cetirizine hydrochloride syrup （CNY 0.70） offered the lowest average daily cost， followed by loratadine syrup （CNY 1.15）， cetirizine hydrochloride oral solution （CNY 1.35）， cetirizine hydrochloride drops （CNY 1.95）， desloratadine for suspension （CNY 2.20）， and the highest was levocetirizine hydrochloride oral solution （CNY 4.95）. The drug costs associated with the four-week treatment period accounted for less than 10% of the national per capita disposable income， per capita total health costs and per capita health care consumption expenditure， indicating the good affordability. CONCLUSION The total costs of the oral solutions for commonly used second-generation antihistamines are comparable， with cetirizine hydrochloride syrup being the cheaper option.

OBJECTIVE To compare the efficacy and safety of the generic versus original patented pramipexole dihydrochloride tablets selected in the centralized procurement in real world. METHODS Prescription data of outpatients treated with original patented or generic pramipexole dihydrochloride tablets for Parkinson’s disease or Parkinson’s syndrome in Xuanwu Hospital， Capital Medical University from July 1， 2018 to June 30， 2023 were extracted. Patients who used the original patented drug or generic drug during the identification period were followed up every three months after enrollment. Adverse drug events were identified by recognizing emerging diagnoses and concomitant medications at relative times in patients throughout the follow-up period， thus comparing their safety profile. The degree of change in levodopa equivalent dose （LED） level over 1-year enrollment with at least four follow-up records was assessed to compare efficacy between the two groups. RESULTS A total of 1 685 patients were included in the study， involving 750 patients in the original patented drug group ［involving 315 patients with at least four follow-up records （follow-up for 1 year or more）］， and 935 patients in the generic drug group （involving 197 patients with at least four follow-up records）. There were no significant differences in the baseline characteristics of the two groups after 1∶1 propensity score matching （P>0.05）. A total of 159 adverse drug events reported in the original patented drug group and 123 in the generic drug group. Kaplan-Meier survival analysis and log-rank test results showed no significant difference in the occurrence of adverse drug events between the two groups （P=0.795）. Scheirer-ray-hare test showed no significant difference in the variation degree of LED level between generic drug and original patented drug group over time （H=1.538， P=0.820）. CONCLUSION Efficacy and safety are comparable between the generic and original patented pramipexole dihydrochloride tablets selected in the centralized procurement， and multi-center prospective studies are needed to verify the conclusion.

OBJECTIVE To explore the regulatory effect of 10-hydroxydec-2-enoic acid （10-HDA） in combination with oxaliplatin （Oxa） on the proliferation， migration and apoptosis of colon cancer cells CT26， and the underlying mechanism. METHODS CT26 cells were induced with 10-HDA and Oxa. Cell viability was assessed using the CCK-8 assay， and optimal concentrations of 10-HDA combined with Oxa were determined based on the calculated combination indices using the CompuSyn software. Cell morphology changes were observed with crystal violet staining. After inducing 10-HAD combined with Oxa， cell colony was detected colony formation assay. Cell migration and invasion were examined by wound healing assay and Transwell assay， respectively. Cell apoptosis was detected by Hoechst 33258 staining， flow cytometry and JC-1 fluorescence. Western blot was employed to detect the expression levels of phosphatidylinositol 3-kinase （PI3K）， phosphorylated PI3K （p-PI3K）， protein kinase B （Akt）， phosphorylated Akt （p-Akt）， glycogen synthase kinase-3β （GSK-3β）， phosphorylated GSK-3β （p-GSK-3β）， and the epithelial-mesenchymal transition （EMT） markers （E-cadherin， N-cadherin， Vimentin）， and apoptosis proteins ［B-cell lymphoma 2 （Bcl-2） and proapoptotic protein （Bax）］. RESULTS Treatment of 10-HDA， Oxa and their combination significantly inhibited the proliferation of CT26 cells （P<0.05）. Combination index screening showed the optimal concentrations of 8 mmol·L^–1 10-HDA combined with 20 μmol·L^–1 Oxa. Treatment of 10-HDA combined with Oxa significantly inhibited colony number and size， migration， and invasion， upregulated E-cadherin， and downregulated N-cadherin and Vimentin （P<0.01）. Their combination treatment significantly altered mitochondrial membrane potential， and thus promoted early apoptosis. Treatment of 10-HDA combined with Oxa significantly upregulated Bax， but downregulated Bcl-2 （P<0.01）. In addition， p-PI3K， p-Akt and P-GSK-3β were significantly downregulated （P<0.05）， but their total protein levels were not changed. CONCLUSION 10-HDA combined with Oxa significantly inhibits the proliferation and migration of colon cancer cells CT26， and promotes apoptosis by regulating the PI3K/Akt/GSK-3β signaling pathway.

OBJECTIVE To establish the high-performance liquid chromatography （HPLC） fingerprint and determination method of six components of Yinhua Gout Granules （YHG）， thus providing reference for its quality control. METHODS A fingerprint of 10 batches of YHG samples was established using an Agilent 5 TC - C₁₈ （150 mm × 4.6 mm， 5 µm） chromatographic column， with a gradient elution of 0.1% formic acid water-acetonitrile as the mobile phase， a detection wavelength of 300 nm， a flow rate of 1.0 mL·min^–1， and a column temperature of 30 ℃. Peak assignment and identification were carried out on the fingerprint chromatograms. Chemical pattern recognition analysis was conducted using SPSS （Statistical Package for the Social Sciences software） and SIMCA （multivariate data analysis software） to further evaluate the quality differences among the 10 batches of YHG. The content determination of the identified chemical components was also performed. RESULTS The HPLC fingerprint of YHG was calibrated with a total of 12 common peaks， and 6 components were identified. The similarity of the fingerprint of 10 batches of YHG samples was all greater than 0.900. Through chemical pattern recognition， the 10 batches of YHG samples were divided into two categories， among which the mass fractions of neochlorogenic acid， chlorogenic acid， ferulic acid， isochlorogenic acid B， senkyunolide A and ligustilide were in the range of 0.321 9—2.214 2 mg·g^–1. CONCLUSION The established HPLC fingerprint method and the content determination method of six components are accurate and reliable for quality evaluation of YHG.

OBJECTIVE To explore the medication law and mechanism of action of Gardeniae Fructus （GF） to prevent and control benign prostatic hyperplasia（BPH） and to conduct an experimental validation. METHODS Based on data mining screening ancient records containing GF prescription， the medication law of compatibility of frequently used traditional Chinese herbals to GF prescription was analyzed. Active ingredient targets of GF and the disease targets of BPH were searched in online databases， and an active ingredient-disease-target network was created. A BHP model in male Kunming mice was created by subcutaneous injections of testosterone propionate oil solution （12.5 mg·kg^–1） into the back of the neck for 28 consecutive days. From the 8th day of modeling， oral gavage of low-dose， medium-dose and high-dose GF was given for consecutive 21 days. Serum estradiol （E₂）， testosterone （T）， interleukin-1beta （IL-1β）， IL-6， tumor necrosis factor-alpha （TNF-α）， and IL-10 were detected by Enzyme-linked immunosorbent assay （ELISA）， and the histopathological changes of the prostate gland were observed by hematoxylin and eosin （H&E） staining in the mice in each group. RESULTS Among the eligible Chinese herbal medicine formulas， there were 893 prescriptions containing raw GF. A total of 9 056 frequencies of compatibility to raw GF were detected， involving 21 high-frequency Chinese herbal medicines （frequency ≥ 90）， and they were mainly cold and slightly cold in drug properties， bitter， pungent and sweet in the flavour， and mostly attributed to the lung， spleen and liver meridians. Functionally， they were used for clearing up heat， tonifying emptiness， and relieving epidemiology. The main active ingredients of GF consisted of quercetin， isoimperatorin， kaempferol， β-sitosterol， etc. The core targets were proto-oncogene c-Src （SRC）， heat shock protein 90α （HSP90AA1）， protein kinase B （AKT1）， and epidermal growth factor receptor （EGFR）， that were mainly enriched in the metabolism of arachidonic acid， and the NF-κB signaling pathway. Animal experiments showed that GF significantly reduced serum E₂， IL-1β， IL-6 and TNF-α in mice with prostatic hyperplasia （P<0.01）， increased IL-10 and T， and alleviated the histological lesions of the prostate gland. CONCLUSION This study confirms that GF has the theoretical basis， material basis and pharmacological activity to improve BPH， and provides modern research support for the core efficacy of GF to improve the "astringent passage of gonorrhoea".

OBJECTIVE To investigate the key miRNAs of polyphyllin Ⅰ （PPⅠ） involved in lipopolysaccharide （LPS）-induced inflammation in human myeloid leukemia monocytic （THP-1） macrophages based on high-throughput sequencing of microRNAs （miRNAs）. METHODS An in vitro LPS-induced macrophage inflammation model in THP-1 cells was constructed. The influence of PPⅠ on the activity of THP-1 macrophages was examined by cell counting kit-8 （CCK-8） assay. Enzyme-linked immunosorbent assay （ELISA） was performed to detect the release of tumor necrosis factor-alpha （TNF-α）， and interleukin-6 （IL-6）. MiRNA sequencing was performed in LPS-induced THP-1 cells either treated with PPⅠ or not， and the identified six differentially expressed miRNAs were validated by quantitative real-time polymerase chain reaction （qRT-PCR）. The weighted gene co-expression network analysis （WGCNA） identified the most relevant co-expressed modules. LASSO regression analysis further identified key miRNAs. The biological function and anti-inflammatory property of differentially expressed miRNAs were predicted by Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses. RESULTS PPⅠ treatment at the concentrations of 1–8 μmol·L^–1 was non-toxic to THP-1 macrophages. Secretion of TNF-α and IL-6 significantly decreased after the treatment of 2， 4 and 6 μmol·L^–1 PPⅠ treatment in LPS-induced THP-1 cells.A total of 836 differentially expressed miRNAs were identified， of which 398 miRNAs were up-regulated and 438 were down-regulated. The qRT-PCR further validated the differential expressions of miR-11401， miR-372-3p， miR-4494， miR-8084， miR-445-3p and miR-6744-3p screened by miRNA sequencing. WGCNA yielded a total of 16 co-expressed modules， of which the dark orange module showed a significant negative correlation with the anti-inflammatory property of PPⅠ against LPS-induced macrophage inflammation （r=–0.99， P＜0.01）. Four miRNAs， including miR-6881-3p， miR-5583-3p， miR-570-3p， and miR-4757-3p were screened by Lasso regression analysis. Target genes of differentially expressed miRNAs were mainly associated with inflammatory metabolic pathways. CONCLUSION PPⅠ plays a role in the treatment of LPS-induced THP-1 macrophage inflammation by regulating multiple miRNAs.

OBJECTIVE To discuss the pathological mechanism of diabetic kidney disease （DKD） and the therapeutic potential of Jinlida Granules. METHODS The GSE30122 dataset was analyzed by R4.4.2 software to obtain the differentially expressed genes （DEGs）. Targets of DKD were screened by GeneCards and other online databases and the intersecting genes were extracted. CytoScape 3.10.2 software was used to construct a protein-protein interaction （PPI） network. Key hub genes were identified， and the gene set enrichment analysis was conducted. The biomarker prediction model was constructed by machine learning methods （e.g.， Lasso regression） integrated with an external validation using the GSE104954 dataset. The active ingredients and intervention targets of Jinlida granules were obtained from the Traditional Chinese Medicine Systems Pharmacology （TCMSP） database and other databases， and molecular docking was performed by AutodockTools 1.5.7 software to evaluate the core complex interactions. RESULTS A total of 535 DEGs of DKD and 1 534 target genes related to DKD were obtained， finally yielding 121 intersecting genes， and 39 hub genes. Machine learning analysis showed that CX3C chemokine receptor 1 （CX3CR1）， C-C motif ligand 2 （CCL2）， secreted protein acidic and rich in cysteine （SPARC） were the key biomarkers for DKD and CX3CR1， CCL2 and Diabetic Kidney Disease Gene Set （DKDGS） had higher predictive abilities for DKD. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses showed that inflammatory immune response and fibrosis were mainly enriched in hub genes. A total of 21 targets of Jinlida granules were identified， which were mainly enriched in the interleukin （IL）-17 and tumor necrosis factor （TNF） signaling pathways， NOD-like receptor signaling pathways， and advanced glycation end products-receptor of advanced glycation end products （AGE-RAGE） signaling pathways， showing a strong bind to the key active ingredients of Jinlida granules. CONCLUSION Inflammatory immunity and fibrosis are the dominant pathological mechanisms of DKD， and CX3CR1， CCL2， and SPARC are the key biomarkers for its pathogenesis. Jinlida granules play a therapeutic role by modulating multiple inflammatory immunity and fibrosis-related pathways.

OBJECTIVE To explore the antidepressant effect of icariin （ICA） in a depression mouse model based on the NOD-like receptor protein 3 （NLRP3） inflammasome and the mechanism. METHODS The depression mouse model was established by chronic unpredictable mild stress （CUMS）， and divided into positive drug group （FLU）， low-dose ICA group （ICA-L）， middle-dose ICA group （ICA-M） and high-dose ICA group （ICA-H）. CUMS-induced mice without interventions were included in the CUMS group， and mice in blank control were set as Control group. The depression-like behaviors were assessed by sucrose preference test， forced swimming test， tail suspension test and field test. Enzyme-linked immunosorbent assay （ELISA） was used to detect the changes of serum inflammatory factors. The morphology and number of hippocampal neurons were observed by Nissl staining. Immunohistochemistry and Western blot were used to analyze the expressions of inflammatory corpuscles and inflammation-related proteins in mouse hippocampus. RESULTS Compared with the CUMS group， ICA at various doses significantly improve the sucrose preference rate， alleviated CUMS-induced depression-like behaviors， inhibited the secretion of pro-inflammatory cytokines IL-1β， IL-6 and TNF-α in serum， relieved inflammatory damage in hippocampal neurons， down-regulated protein levels of NLRP3， Caspase-1， adapter protein apoptosis associated speck-like protein containing a CARD （ASC）， interleukin-1beta （IL-1beta） and interleukin-18 （IL-18）， and reduced the positive signal intensity of NLRP3. CONCLUSION ICA has an antidepressant effect by inactivating the NLRP3 inflammasome.

OBJECTIVE To analyze the clinical characteristics and the related risk factors of cardiovascular adverse events in patients with multiple myeloma （MM） treated with bortezomib. METHODS Clinical data of hospitalized MM patients who received bortezomib treatment in the Second Hospital of Shandong University from January 1， 2018 to December 31，2023 were retrospectively collected， including the demographic characteristics， medication information， clinical characteristics， pathological characteristics， and the occurrence of cardiovascular adverse events. The clinical status of cardiovascular adverse events in MM patients was summarized. The software SPSS 27.0 was used for data statistics. Univariate analysis and multivariate analysis were performed to analyze on the risk factors that may be related to cardiovascular adverse events. RESULTS Among the 78 MM patients， cardiovascular adverse events were reported in 25 patients （32.05%）， including heart failure， valve disease， arrhythmia， coronary artery disease， hypertension， and acute myocardial damage usually in the first treatment cycle. The cardiovascular adverse events caused by bortezomib were not dose-related. Univariate analysis showed that different International Staging System （ISS） stages， urinary natriuretic peptide and serum creatinine before medication were significantly correlated with cardiovascular adverse events （P<0.05）. Logistic multivariate analysis showed that the above factors were not independent risk factors for cardiovascular adverse events. CONCLUSION Cardiovascular adverse events in MM patients treated with bortezomib involve various manifestations， such as heart failure， heart valve disease， and arrhythmia. These adverse events mostly occur in the first cycle of medication. MM patients with ISS Ⅲ stage， elevated serum creatinine and brain natriuretic peptide levels have a higher risk of cardiovascular adverse events. It is recommended to focus on monitoring the medication process for these populations.

OBJECTIVE To provide references for clinical medication for men with family planning through the statistical analysis of male fertility information labeled in drug instructions. METHODM Drug instructions were collected from the “National Essential Medicines List （2023）” “National Drug Centralized Procurement Selection Results Table （2022）” and Pharmacy of the Third Affiliated Hospital of Chongqing Medical University， and male fertility labeling information was statistically analyzed by reading them one by one. Studies on the effects of drugs on male fertility were searched in the PubMed， Web of Science， China National Knowledge Infrastructure （CNKI）， Wanfang Database and VIP. Drugs that reported reproductive toxicity in literatures but were not included in the instructions were summarized. RESULTS A total of 2 823 drug instructions were collected， including 1 644 Western medicine instructions （476 indicated information related to male fertility） and 1 179 instructions of traditional Chinese patent medicines （7 were marked with male fertility related content）. The total labeling rate was 17.11%. In Western medicine instructions， anti-tumor drugs （60.45%） showed the highest labeling rate. The labeling rate of imported drugs was 48.01%， of which 48.07% were labeled under the category of "fertility/infertility". The labeling rate of domestic drug instructions was 23.28%， of which 29.83% were labeled under the category of "fertility/infertility". Among all the investigated instructions， 30 drugs had literature reporting on reproductive toxicity but were not explicitly stated in the instructions. CONCLUSION The overall labeling rate of male fertility information is not high， and there is a lack of human data and medication guidance information. The impact of drugs on male fertility requires more evidence-based medicine to improve drug instructions， in order to provide reliable information for healthcare workers and patients.

OBJECTIVE To establish a “1+X” grid-based pharmaceutical service model aimed at shortening the duration of parenteral nutrition （PN） intravenous therapy， reducing the cost of parenteral nutrition drugs， and minimizing the irrational use of PN medications. METHODS A nutrition therapy management team was established to construct and implement the “1+X” grid-based pharmaceutical service model at clinical， pharmaceutical， and hospital levels. Nutritional therapy pharmaceutical consultations， methods of nutritional therapy， PN drug costs， and treatment durations in interventional departments before and after the implementation of the “1+X” grid-based pharmaceutical service model were compared. Additionally， changes in PN intravenous infusion usage rates and single-bottle PN infusion usage rates in interventional departments and among all hospitalized patients were compared. RESULTS After the implementation of the “1+X” grid-based pharmaceutical service model， the number of pharmaceutical consultations in nutritional therapy increased from 11 to 1 211 cases. In terms of nutritional therapy methods， total PN significantly decreased， while combined parenteral and enteral nutrition significantly increased in three interventional departments （P<0.01）. The duration of PN therapy was significantly reduced in thoracic and gastrointestinal surgery departments （P<0.01）， but increased in the gastroenterology department （P<0.05）. The costs of PN drug significantly decreased in thoracic surgery department， but significantly increased in gastrointestinal surgery department （P<0.01）. The intravenous infusion usage rate of PN in interventional departments significantly dropped from 64.47% to 33.10%， and among all hospitalized patients， it significantly decreased from 14.29% to 5.22% compared to pre-implementation levels （P<0.01）. The single-bottle PN infusion usage rate in interventional departments significantly dropped from 91.02% to 7.69%， and among all hospitalized patients， it significantly decreased from 90.38% to 46.6% compared to pre-implementation levels （P<0.01）. CONCLUSION The establishment of the “1+X” grid-based pharmaceutical service model in clinical parenteral nutrition therapy improve the capacity and quality of pharmaceutical services provided by pharmacists， standardize the indications and application forms of PN drugs， and provide theoretical basis and practical reference for medical institutions to carry out nutrition therapy pharmaceutical services.

OBJECTIVE To comprehensively evaluate the clinical application of non-steroidal anti-inflammatory drugs （NSAIDs） in the medication of cancer pain using the attribute hierarchy model. METHODS The drug use evaluation standards of NSAIDs in the People’s Hospital of Bozhou were established on the basis of drug instructions， diagnostic and treatment standards， and expert consensus. A retrospective study was conducted base on the attribute hierarchy model to comprehensively evaluate 887 cases of cancer pain medicated with NSAIDs in our hospital in 2023. RESULTS The main problems with the use of NSAIDs in the treatment of cancer pain in the hospital were failure to follow the basic principles of cancer pain medications （640 cases， 72.15%）， off-label indications （402 cases， 45.32%）， unreasonable combination therapy （288 cases， 32.47%）， inappropriate usage and dosage （199 cases， 22.44%）， and exceeding the treatment course and limited daily dose （120 cases， 13.53%）. The average medical record score was 76.98±9.23， with ≥90 scores achieved in 121 cases （13.64%）， 80-<90 scores in 276 cases （31.12%）， 70-<80 scores in 316 cases （35.63%）， 60-<70 scores in 133 cases （14.99%） and <60 scores in 41 cases （4.62%）. The per capita cost of NSAIDs was 108.67 yuan， accounting for 2.02% of the total per capita drug cost. CONCLUSION The use of NSAIDs in the treatment of cancer pain has a concentrated issue in our hospital. The supervision to promote rational drug use， especially the widespread use of NSAIDs injections， NSAIDs combination medication and the failure to strictly adhere to the basic principles of cancer pain medication should be strengthened.

The combination of immune checkpoint inhibitors and chemotherapy is the first-line treatment for advanced non-small cell lung cancer that prolongs the survival. In this study， we reported a case of acute hepatic failure resulting in death after the first cycle of sintilimab combined with albumin-bound paclitaxel， and analyzed the process， relevance， treatment and cause of death， so as to improve the awareness of the safety of this treatment program.

A patient with small cell lung cancer treated with coronary stent implantation and postoperative long-term atorvastatin therapy developed severe drug-induced liver injury （DILI） after three months of combination treatment of adebrelimab， carboplatin and etoposide. Comprehensive treatment with choleretics， hepatoprotectants， corticosteroids， human intravenous immunoglobulins， mycophenolate mofetil， and artificial liver support did not reverse DILI. We analyzed the present case， explored the pathogenesis of DILI， and emphasized the complexity and importance of managing hepatotoxicity in the context of combined immunotherapy. This study recommended the need for early recognition and prompt intervention to mitigate the risk of irreversible severe liver damage.