OBJECTIVE To investigate the effects of different extracts of Senecio scandens Buch-Ham. on the anti-inflammatory， analgesic， and skin wound healing properties， and to screen the active parts of Senecio scandens Buch-Ham. and to reveal its active components. METHODS Xylene-induced ear swelling in mice and carrageenan-induced paw swelling were modeled to study the anti-inflammatory effect of transdermal administration of different extracts of Senecio scandens Buch-Ham. Mouse writhing response and hot plate test were used to observe the analgesic effects of the alcohol and water extracts of Senecio scandens Buch-Ham. In addition， a full-thickness skin injury model was constructed in Sprague-Dawley （SD） rats， and hematoxylin and eosin （H&E） staining and Masson staining were used to evaluate the wound healing of each extract group. The entropy weight method was used to score the activity of each extract， and Kendall analysis was used to reveal the correlation of chemical components in each extract with their anti-inflammatory， analgesic， and wound healing effects. RESULTS In the anti-inflammatory experiments， low-dose and medium-dose water extract， and medium-dose alcohol extract of Senecio scandens Buch-Ham. significantly inhibited xylene-induced ear swelling. Low-dose and medium-dose alcohol extract， and medium-dose water extract of Senecio scandens Buch-Ham. significantly reduced carrageenan-induced paw swelling. In the analgesic experiments， different doses of Senecio scandens Buch-Ham. extracts showed significant analgesic effects on the pain caused by acetic acid， but they were ineffective in inhibiting thermal pain induced by the hot plate. Low-dose alcohol extract， and medium-dose and high-dose water extract of Senecio scandens Buch-Ham. showed significant wound healing effects. The entropy method and comprehensive scoring indicated that the medium-dose water extract of Senecio scandens Buch-Ham. exhibited the best anti-inflammatory， analgesic， and wound healing effects， followed by the low-dose alcohol extract. The Kendall correlation analysis revealed that the total flavonoids， total phenols， and total alkaloids were significantly correlated with anti-inflammatory effects. Additionally， the total flavonoids and total phenols were significantly correlated with wound healing. CONCLUSION Senecio scandens Buch-Ham. has anti-inflammatory and analgesic and skin wound repairing effects， and middle-dose water extract present the strongest properties. The results of this study provide a theoretical basis for its clinical application.

OBJECTIVE To predict the area under the curve over 24 hours （AUC_{24 h}） of vancomycin from two samples and a few covariates using XGBoost algorithms based on a large-scale simulated dataset and to compare its performance with that of Bayesian estimation. METHODS Serum vancomycin concentrations of 454 samples and clinical information of 246 patients who were treated with vancomycin in the First Affiliated Hospital with Nanjing Medical University from August 2021 to December 2023 were retrospectively collected. The population pharmacokinetics （popPK） model of vancomycin was conducted. A total of 4 000 serum concentrations-time profiles were simulated from the population parameters. The “reference” AUC_{24 h} was calculated from each simulated profile using the trapezoidal rule. Data were split into the training， testing and validation sets. XGBoost algorithms were trained to predict AUC_{24 h} based on the concentrations at 0.5 h before treatment （C_min） and 1 h after treatment （C_max）. Finally， the model was evaluated in the validation set and compared with the Bayesian estimation. RESULTS In total， 454 serum concentrations from 246 adult Chinese patients were fitted using one-compartment model. In the final popPK model， body weight， creatinine clearance and blood urea were the significant covariates on popPK parameters. Residuals variability was modeled by the Power error model. The XGBoost model based on C_min， C_max and their differences， and five covariates （blood urea， body weight， creatinine clearance， daily dose and dose intervals） yielded an accurate AUC_{24 h} estimation in the test set （R²=0.999 3， RMSE=4.80， MAE=3.37）， showing a better performance than the Bayesian estimation in the validation set. CONCLUSION In summary， the XGBoost algorithm trained from the popPK simulation data can accurately and precisely estimate the AUC_{24 h} of vancomycin. This study provides a new idea for precision dosing based on machine learning technology.

OBJECTIVE To investigate the effect and mechanism of Lonicera fulvotomentosa-Lonicera Japonica in alleviating gouty arthritis （GA） in rats by regulating the Ras/MEK/ERK signaling pathway. METHODS A total of 72 sprague-dawley （SD） rats were randomly divided into the control group， model group， colchicine group， low-dose and high-dose Lonicera fulvotomentosa groups， low-dose and high-dose Lonicera Japonica groups， and low-dose and high-dose Lonicera fulvotomentosa-Lonicera Japonica groups. Oral gavage of corresponding drugs was performed for consecutive 7 days. The GA model was established by injecting sodium urate solution into the ankle of rats on the 4^th day of oral gavage. Pathological changes were observed with the hematoxylin and eosin （H&E） staining. Serum levels of inflammatory factors interleukin 17A （IL-17A）， interleukin 17F （IL-17F）， cyclooxygenase-2 （COX-2）， C-X-C motif chemokine-2 （CXCL-2）， interleukin 1β （IL-1β）， and tumor necrosis factor α （TNF-α） in rats were detected by enzyme-linked immunosorbent assay （ELISA）. The mRNA levels of HRas， RRas， MAPK3， and MAP2K1 in rat ankle tissues were quantified using quantitative reverse-transcription polymerase chain reaction （qRT-PCR）. Additionally， the protein expressions associated with the Ras/MEK/ERK signaling pathway were assessed through Western blot. RESULTS Compared with those of the model group， Lonicera fulvotomentosa-Lonicera Japonica could improve the pathological state of synovial tissue and inhibit the release of inflammatory factors.The mRNA expressions of HRas， RRas， MAPK3 and MAP2K1 in ankle tissues were significantly down-regulated， and the protein expressions and phosphorylation levels of Ras， MEK1/2 and ERK1/2 were significantly down-regulated as well （P<0.05， P<0.01）. CONCLUSION Lonicera fulvotomentosa-Lonicera Japonica can effectively treat GA by inhibiting the activation of the Ras/MEK/ERK signaling pathway and reducing inflammatory response.

OBJECTIVE To establish an ultra-performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） assay for measuring serum concentration of isavuconazole. METHODS In a multiple reaction monitoring mode， UPLC-MS/MS was performed using an ACQUITY UPLC BEH C₁₈ （2.1 mm×100 mm， 1.7 μm） column， with a gradient elution of 0.1% formic acid-acetonitrile at 0.4 mL·min^–1 for 1.8 min， and an electrospray ionization source with a positive ionization scan. Serum samples were subjected to protein precipitation by acetonitrile solution containing ［D4］-isavuconazole as an internal standard， and then the serum concentration of isavuconazole was determined by UPLC-MS/MS. The established method was validated and used to determine the steady-state serum trough concentration of isavuconazole in patients treated with standard doses of isavuconazole （>3 d） in the departments of haematology， pulmonary and critical care medicine and infectious diseases. RESULTS The established method for measuring serum concentration of isavuconazole showed good linearity within the range of 0.2-20 μg·mL^–1. The intra-day and inter-day accuracies ranged from 103.00% to 107.46%， with a precision of less than 10%. The extraction recoveries were between 94.50% and 100.28%， and the internal standard normalized matrix factors ranged from 1.03 to 1.05. Serum isavuconazole was stable at room temperature for 24 h， at 4 ℃ for 7 d， at –20 ℃ for 3 cycles of freezing and thawing， at –80 ℃ for 30 d， and at room temperature for 24 h in processed vials. The mean serum trough concentration of the enrolled 16 patients was （5.29±2.21） μg·mL^–1， ranging from 1.58 to 9.92 μg·mL^–1. CONCLUSION The established UPLC-MS/MS has good specificity and accuracy， and suitable for the rapid detection of serum concentration of isavuconazole. The mean serum trough concentration of isavuconazole in the enrolled patients is high， which can be further explored for the safety and influencing factors in the real-world studies.

OBJECTIVE To investigate the medicinal combination pattern and efficacy principle of seventy-flavored pearl pills （the Tibetan medicine Ranasampel， RNSP） in treating cardio-cerebrovascular diseases and neurological disorders. METHODS Based on the Four Medical Tantras and Jingzhu Materia Medica， the formulae， dosages and apparent flavours of RNSP were collected， and a vector structure model was constructed. The medicinal properties of the formula in the six flavours， three transformed flavours and seventeen effects were analyzed. RESULTS The taste of the formula was mainly sweet and bitter； the chemotaxis was mainly bitter and sweet； the effects were mainly heavy， blunt and cool， which were useful for treating the disease characteristics of lightness， sharpness and heat. In the network of “formula-pharmacological-property-disease”， “SHingMngr-heavy-light-long”， and “guggul-cool-heat-chiba” weighted heavier. CONCLUSION There are more mineral medicines in the formula of Ranasampel， playing an important role in the balance of trace elements and normal functioning of the human body. Meanwhile， the metal nanoparticles in Zotaxa can penetrate the blood-brain barrier and reach the brain region to play a role in repairing and enhancing the activity of nerve cells. The sweet and bitter flavours help to produce the light and dynamic properties of “Long”； the moist and soft properties of “Bacon” help the movement and non-obstruction in treating the symptoms of slow blood flow， blood viscosity， etc. Tibetan medicine “three stomach fire” digestive theory and the modern medicine of nutrient digestion by gut microbiota have a high degree of compatibility. The heavy effect of seventeen effects treats the lightness of Lung， alleviating dizziness， blurred vision and other symptoms； and the cool and blunt effect treats the hotness and sharpness of Chiba， alleviating the symptoms of fever， restlessness， headache， and palpitation. The Ro Nus ZhurJes of RNSP corresponds to the pathology and etiology of cardio-cerebrovascular diseases and neurological diseases， providing important references for the rational use in clinical setting.

OBJECTIVE To establish a rapid and accurate high-performance liquid chromatography （HPLC） method for measuring serum concentration of voriconazole， and to provide a scientific basis for the clinical optimization of drug administration. METHODS Using the Waters symmetry C₁₈ column （4.6 mm×250 mm， 5 μm） at the mobile phase of acetonitrile/water （V/V=41：59）， flow rate of 1.0 mL·min^–1， detecting wave length of 256 nm， column temperature of 30 ℃， and sample size of 80 μL， HPLC was used to measure serum concentration of voriconazole. It was also used to measure serum concentration of voriconazole in clinical patients. RESULTS The chromatographic peaks of voriconazole were well separated. A good linear range of voriconazole concentration was between 0.25 mg·L^–1 and 15.12 mg·L^–1， and the regression equation was S=1 472.17+27 807.69C（r=1.000）. The relative recovery of low， medium and high concentration ranged 97.25%-104.31%， and the average extraction recovery rate was 102.54%±5.46%. The intra-day relative standard deviation （RSD） and inter-day RSD were both less than 5%. Serum concentration of voriconazole was measured in 34 patients treated with voriconazole， including 28 patients in the effective range of voriconazole （0.5-5.0 mg·L^–1）， and 6 patients out of the effective range. CONCLUSION HPLC is a specific， simple， accurate and low-cost method to measure serum concentration of voriconazole， which is suitable for a routine determination of voriconazole concentration in clinical patients. It contributes to improving clinical efficacy and reducing the occurrence of adverse reactions.

OBJECTIVE To systematically evaluate the effects of two antiviral therapies， including the nucleot（s）ide analog （NA） monotherapy versus NAs combined with interferon-α （IFN-α） on the risk of hepatocellular carcinoma （HCC） in patients with chronic hepatitis B （CHB）. METHODS Relevant articles from PubMed， Embase， Cochrane Central Register of Controlled Trials， CNKI， VIP， and Wanfang database were retrieved from the databases until August 2024. The risk of HCC and other hepatitis B virus （HBV） complications were assessed using relative risk （RR） and its 95%confidence intervals （CI）. The RevMan 5.4 software was used for meta-analysis and presentation of results. RESULTS A total of 10 studies representing 9 544 patients were included. The risk of HCC in CHB patients treated with IFN-α was significantly lower than those treated with NA monotherapy （RR=0.26， 95%CI：0.18-0.38， P<0.01）. IFN-α combined with NAs also provided a better performance than the NA monotherapy in reducing the risk of other HBV complications （RR=0.13， 95%CI：0.07-0.28， P<0.01）. A lower risk of HCC was found in the cirrhotic population treated with IFN-α combined with NAs than the NA monotherapy （RR=0.21， 95%CI：0.05-0.87； P<0.05）. Among treatment options that reduced the risk of HCC， the IFN-α combination/sequential NAs regimen （RR=0.34， 95%CI：0.20-0.61， P<0.01） was superior to NA monotherapy. CONCLUSION IFN-α-based antiviral therapy， especially the IFN-α combination/sequential NAs， is superior to NA monotherapy in reducing the risk of HCC in CHB patients.

OBJECTIVE To investigate the reasons for the different efficacy of pregabalin in treating postherpetic neuralgia （PHN）. METHODS PHN inpatients hospitalized in the Department of Dermatology of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from April 2022 to April 2024 were included， and pregabalin was given by titration. The efficacy was evaluated. The steady-state effective blood drug concentration and the maximum ineffective dose of pregabalin in PHN patients were determined by liquid-quantity coupling method. The effects of the administered dose of pregabalin and the blood concentration of pregabalin on the clinical efficacy were investigated. RESULTS A total of 117 PHN patients were included in the study， 86 of whom were treated effectively and 31 of whom were not， resulting in an effective rate of 73.50%. No significant difference was observed in the blood drug concentrations between the effective and ineffective groups （P>0.05）. At doses of less than 300 mg·d^–1， blood concentration of pregabalin exhibited a significant increase in a dose-dependent manner （P<0.01）. However， at doses exceeding 300 mg·d^–1， there was no significant difference in the increase of plasma concentration （P>0.05）. The clinical efficacy of pregabalin improved significantly with the increasing administration dose within 450 mg·d^–1 （P<0.05）. However， above this dose， the efficacy was no longer enhanced considerably. Additionally， individual differences in patients， including gender and herpes site， were found to have a significant effect on the efficacy of pregabalin （P<0.05）. CONCLUSION The clinical efficacy of pregabalin is not significantly correlated with its blood concentration， but influenced by the administration dose and individual differences. The clinical efficacy （blood concentration） of pregabalin may show a ceiling effect when the administered dose above 450 mg·d^–1 （300 mg·d^–1）.

OBJECTIVE To construct a model for predicting delayed excretion of high-dose methotrexate （HD-MTX） in osteosarcoma patients and to explore the associated risk factors by the machine learning method. METHODS Clinical data of 255 treatment cycles of HD-MTX in 80 eligible osteosarcoma patients were retrospectively collected from June 2018 to August 2023 at the General Hospital of Eastern Theater Command. The Least Absolute Shrinkage and Selection Operator （LASSO） method was used to screen patient characteristics related to delayed elimination. Predictive models were created by six machine learning algorithms， and their performance was assessed by calculating the area under the curve （AUC）， accuracy， and precision. RESULTS LASSO regression analysis identified 10 predictive features， including the creatinine clearance （CrCL）， MTX dose， alanine transaminase （ALT）， body mass index （BMI）， infusion rate， hydration value， MTHFR C677T gene polymorphisms， gender， age， and co-administration of bisphosphonate. Performance metrics of the models built by the six machine learning algorithms were compared. Among them， the Random Forest model had the best predictive ability， with an AUC of 0.95， average precision （AP） of 0.79， accuracy of 89.61%， precision of 83.33%， recall of 41.67%， and F1 value of 55.56%. CONCLUSION A prediction model of delayed excretion of HD-MTX using the random forest method can improve the drug safety of osteosarcoma patients using HD-MTX in the clinic and prevent the occurrence of related adverse drug events.

OBJECTIVE To explore the effects of ABCB1 （rs1128503， A>G） and ADRB2 （rs1042718， A>C） gene polymorphisms on the dosages of remifentanil and sevoflurane， and the occurrence of adverse events in patients undergoing artificial joint replacement， in order to provide guidance for the formulation of individualized medication regimen. METHODS A retrospective study was conducted on patients who received artificial joint replacement in the Department of Orthopedics， the First Affiliated Hospital of Zhengzhou University. The clinical baseline data and the use of anesthetics during surgery were extracted from the Jiahe electronic medical record system of our hospital. This study evaluated the effects of ABCB1 and ADRB2 gene polymorphisms on the dosages of remifentanil and sevoflurane during surgery based on the results of genetic testing and clinical drug use. Meanwhile， the incidence and severity of adverse events among different phenotypes were analyzed and compared. RESULTS A total of 278 patients were included in this study. Based on the ABCB1 genotype， patients were divided into the low-risk group （GG，n=29） and high-risk group （AA+AG，n=249）. There were no significant differences in the clinical demographic data between two groups （P>0.05）. No significant differences in the dosages of remifentanil and sevoflurane were found between two groups （P>0.05）. Malignant hyperthermia， severe nausea or vomiting， or other gastrointestinal adverse reactions were not observed. Patients were divided into the low-risk group （CC，n=151） and high-risk group （AA+AC，n=127） based on the ADRB2 genotype. No significant differences in clinical and demographic data were found between these groups （P>0.05）. There were no significant differences in the dosages of remifentanil and sevoflurane between the two groups （P>0.05）. Acute hypotension was not reported. Blood pressure reduction was observed in 34.6% of patients in the high-risk group and 30.5% in the low-risk group. CONCLUSION ABCB1 and ADRB2 gene polymorphisms are not yet sufficient to guide remifentanil and sevoflurane dosages and predict adverse reactions in surgical settings as independent genetic reference factors. It may be necessary to comprehensively consider the basic characteristics， concomitant medication and gene polymorphisms of patients， as well as the experience level of anesthesiologists， thus providing individualized medication strategies.

OBJECTIVE To explore the clinical efficacy of pegylated interferon （PEG-IFN） in the treatment of chronic hepatitis B （CHB） patients with baseline hepatitis B surface antigen （HBsAg）<200 IU·mL^–1 and related influencing factors. METHODS Patients with CHB and baseline HBsAg<200 IU·mL^–1 who received the PEG-IFN antiviral therapy in the Affiliated Hospital of Qingdao University from January 2019 to June 2023 were included in the retrospective analysis. Subcutaneous injection of PEG-IFN 180 UG was performed once a week for 48 weeks. Patients were divided into the negative conversion group and non-negative conversion group according to whether the HBsAg level was lower than the lower limit of detection at the end of the treatment course. The levels of HBsAg， hepatitis B virus DNA （HBV-DNA）， alanine transaminase （ALT）， aspartate transaminase （AST）， total bilirubin （Tbil） and their changes were compared between the two groups before the treatment and at the 12^th， 24^th and 48^th weeks of treatment. Their predictive effects on the virological response to CHB were evaluated. RESULTS After PEG-IFN treatment， the negative conversion rate of HBsAg was 50.00% （12/24） in 24 patients with a baseline of 100-200 IU·mL^–1； 54.54% （12/22） in 22 patients with a baseline of 10 - 100 IU·mL^–1， and 90.90% （20/22） in 22 patients with a baseline<10 IU·mL^–1， showing a significant difference （P<0.05）. The HBsAg negative conversion rate at 48 weeks was significantly higher in patients with HBsAg decline>0.5 lgIU·mL^–1 at 12 weeks than those with HBsAg decline<0.5 lgIU·mL^–1 （67.90% vs. 23.10%， P<0.05）. The HBsAg negative conversion rate at 48 weeks was significantly higher in patients with HBsAg decline>1 lgIU·mL^–1 at 24 weeks than those with HBsAg decline <1 lgIU·mL^–1 （64.00% vs. 33.33%， P<0.05）. Forty-four patients turned negative at the 48^th week of treatment. Multivariate analysis showed significant differences in the decreasing rate of HBsAg at the 24^th week （OR=1.023， 95%CI： 1.041-1.325， P<0.05） and ALT at the 24^th week （OR=1.046， 95%CI： 1.006-1.087， P<0.05）. CONCLUSION Baseline HBsAg level， HBsAg decline at 12 weeks and 24 weeks of interferon therapy， and ALT level at 24 weeks can predict HBsAg clearance after 48 weeks of interferon therapy in patients with CHB.

OBJECTIVE To enhance the methodology of pharmacoeconomic evaluations for treating neovascular age-related macular degeneration （nAMD） and to provide guidance for the nAMD drug selection， selection of medical insurance coverage and drug pricing strategies in China. METHODS A systematic search of literatures on pharmacoeconomic evaluation of anti-vascular endothelial growth factor （VEGF） drugs for nAMD was conducted across Chinese and English databases， including China National Knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform， VIP Database， PubMed， Web of Science， and the Cochrane Library， from database inception to December 25， 2023. Using Excel 2021， data were compiled on the basic characteristics， model structures and parameters， pharmacoeconomic evaluation outcomes， and uncertainty analyses of identified literatures. Consolidated Health Economic Evaluation Reporting Standards （CHEERS） 2022 guidelines were employed for qualitative assessment of the literatures. RESULTS A total of 22 articles were included， comprising 1 health technology assessment report and 21 journal articles or theses. The majority of enrolled articles conducted cost-utility analyses， adopting either a healthcare system or societal perspective. Direct medical costs are the predominant， with patient health status primarily assessed based on best-corrected visual acuity （BCVA）. Health utility values were predominantly derived from reviews， and transition probabilities were sourced from clinical trials. Main economic evaluation models included Markov and patient-level simulation models， with study durations ranging from 1 year to 30 years and cycle periods varying from 1 month to 1 year. All studies conducted uncertainty analyses， though only one employed a half-cycle correction. CONCLUSION Current pharmacoeconomic evaluations of anti-VEGF therapies for treating nAMD can benefit from enhanced study design and reporting completeness. Given recent approvals in China for new anti-VEGF drugs， such as faricimab and brolucizumab， rigorous pharmacoeconomic evaluations tailored to the Chinese population are urgently needed for guiding clinical practices in nAMD treatment and shaping effective pharmaceutical policies.

OBJECTIVE To explore a new drug dispensing model for inpatients， and to provide references for the construction of a smart integrated central pharmacy with full-process drug traceability. METHODS A central pharmacy with unified planning and layout was established by combining the inpatient pharmacy and pharmacy intravenous admixture service （PIVAS）. A variety of intelligent equipment was introduced， and the workflow was restricted by informatization， thus creating a smart integrated central pharmacy with full-process drug traceability. By comparing the dispensing errors， PIVAS dispensing and labeling errors， PIVAS sorting errors， dispensing error tracing efficiency， PIVAS dispensing and labeling efficiency， PIVAS sorting efficiency， and the number of support personnel in the central pharmacy before （from July 2023 to September 2023） and during the operation period （from October 2023 to December 2023）， the construction effect of the smart integrated central pharmacy with full-process drug traceability was evaluated. RESULTS Through practice， the central pharmacy achieved an intelligent integrated operation， and the entire process of dispensing drugs could be traced. The dispensing errors， PIVAS dispensing and labeling errors， and PIVAS sorting errors were significantly reduced， while the dispensing error tracing efficiency， PIVAS dispensing and labeling efficiency， and PIVAS sorting efficiency were significantly elevated （all P<0.05）. Twenty support personnel were reduced， thus optimizing the human resource allocation. CONCLUSION The smart integrated central pharmacy can provide a one-stop solution to the drug dispensing/dispensing needs of hospitalized patients， achieving a full-process drug traceability， greatly improving dispensing efficiency and accuracy， and ensuring the quality of pharmaceutical services. It is of reference significance to the construction of a smart center pharmacy in other hospitals.

OBJECTIVE To test the reliability and validity of the drug literacy scale in patients with tuberculosis.， thus providing a reliable tool to assess the level of drug literacy in Chinese patients with tuberculosis. METHODS Using a general data questionnaire and a drug literacy scale， 370 tuberculosis patients admitted to Infectious Disease Hospital of Heilongjiang Province were investigated by face-to-face surveys to test the reliability and validity of the scale. RESULTS The reliability analysis results showed that the Cronbach’s α coefficient of the scale was 0.956， and that of each dimension was 0.944， 0.983， and 0.983， respectively. The split-half reliability coefficient of the scale was 0.819， and that of each dimension was 0.853， 0.938， and 0.981， respectively. The re-tested reliability was 0.768. The results of confirmatory factor analysis showed that the load coefficients of all factors exceeded 0.5， and the structural equation model of the three-factor model had a good fit （χ²/ν=2.600， approximate error root mean square=0.066， comparative fitting index=0.988， incremental fitting index=0.988， Tucker-Lewis index=0.984）. The correlation coefficients of each dimension were less than the corresponding square root of the average variance extracted （AVE）. The results of multi-group confirmatory factor analysis showed that the drug literacy scale had the measurement equivalence across gender， age and education level. CONCLUSION The drug literacy scale has good reliability and validity among tuberculosis patients， and the measurements show that the scale satisfies measurement invariance across gender， age and education level. Overall， the scale is qualified to assess drug literacy in tuberculosis patients.

OBJECTIVE To explore the factors influencing the operating costs of the Pharmacy Intravenous Admixture Service （PIVAS）， thus providing references for standardizing the construction and operation of PIVAS， and establishing charging standards by relevant departments. METHODS Questionnaires were distributed by the WJX platform. Based on the “Guidelines for the Construction and Management of PIVAS” （trial）， the daily per capita allocation， per unit area allocation， per unit area allocation in clean areas， allocation undertaken at workstations， daily average working hours， and cost per bag were analyzed. Data processing and analysis were conducted using Excel and SPSS software. RESULTS A total of 91 eligible sets were divided into group 1 （≤1 000 bags， 10 copies）， group 2 （1 001-2 000 bags， 56 copies）， group 3 （2 001-3 000 bags， 21 copies）， and group 4 （≥3 001 bags， 4 copies）. Except for the average daily working time and the cost per bag， the remaining indicators increased with the increase in the workload. The longest daily working time was detected in group 2， with about 11.28 h. The cost per bag decreased with an increasing workload. Linear regression showed a significant effect of daily dispensing per capita on the cost per bag （P<0.05）. The 414 sets of data were divided into group 1 （lower than the workload and daily per capita allocation）， group 2 （equivalent to the workload and daily per capita allocation） and group 3 （greater than the workload and daily per capita allocation） according to the workload and daily per capita allocation. The results showed that， except for the cost per bag （group 3<group 2<group 1）， each index was the largest in group 3， followed by group 2 and group 1. The linear regression showed a significant difference in the effect of daily per capita allocation on the cost per bag （P<0.05）. CONCLUSION In this study， the operating cost of PIVAS is affected by the daily per capita allocation， and the adaptability of personnel numbers should be fully considered in the medical institutions. Under the standardized construction and operation， the average cost per bag is between 5.89 RMB and 6.49 RMB. The redeployment fee is recommended not to be lower than this range， thus ensuring the sustainable development of PIVAS.

Polycystic ovary syndrome （PCOS） is a common reproductive endocrine disorder in women of childbearing age， which can cause metabolic disorders， cardiovascular diseases， ovarian and uterine cancers， and other complications. It seriously endangers the health. The pathogenesis of PCOS is complex， involving changes in multiple signaling pathways mediated by genes， genetics， environment， and their interactions. The Chemerin/CMKLR1 signaling pathway is involved in the regulation of energy homeostasis and reproductive function， and is a newly discovered signaling pathway involved in the pathogenesis of PCOS from multiple aspects. On this basis， this article reviewed the biological characteristics of the Chemerin/CMKLR1 signaling pathway， its role and mediated signaling transduction in the pathogenesis of PCOS， as well as the research status of traditional Chinese medicine （TCM） in treating PCOS via regulating it. The purpose is to elucidate how the Chemerin/CMKLR1 signaling pathway affects the occurrence and development of PCOS. In the future， the focus should be on exploring whether it can become one of the indicators for clinical prediction and early diagnosis of PCOS， in order to provide new ideas for the clinical prevention and treatment of PCOS. This review offers a direction for the development of targeted new drugs for the treatment of PCOS.

Surufatinib is a novel multi-kinase inhibitor （MKI） that frequently induces a range of adverse reactions during clinical use. This article detailed the pharmacological monitoring and analysis conducted by a clinical pharmacist in a patient with rectal neuroendocrine tumor and surufatinib-induced severe hand-foot skin reaction （HFSR）. The potential mechanisms underlying the severe HFSR was explored， which may be attributed to the blockade of the vascular endothelial growth factor receptor （VEGFR） pathway. Specifically， the inhibitory effect of surufatinib on VEGFR may prevent the self-repair of damaged tissues， impair keratinocyte regeneration and proliferation， and thereby cause HFSR. Through a close collaboration between the clinical pharmacist and the treatment team， an individualized management plan and pharmaceutical care were provided， leading to significant improvement in the clinical symptoms. This case highlighted the critical role of clinical pharmacists in optimizing individualized anti-cancer therapy and served as a reference for managing surufatinib-induced adverse reactions.

Two patients with type 2 diabetes mellitus （T2DM） and treated with dapagliflozin to lower blood sugar presented skin rash， redness， swelling， and itching throughout the body， and hypersensitivity with elevated temperature， and they were finally diagnosed with dermatitis medicamentosa. After discontinuing dapagliflozin and symptomatic anti-allergic， diuretic， anti-swelling and anti-inflammatory treatments， the patient’s allergic symptoms disappeared. This study analyzed and summarized the causes， processes， correlations， and treatment measures of the above-mentioned two cases of allergic reactions， aiming to provide references and warnings for rational clinical medication.

Tislelizumab is currently used in the treatment of a variety of cancers. With its widespread clinical application， there are growing reports of immune-related adverse events （irAEs）. Pituitary irAEs， including hypophysitis and hypopituitarism， are commonly induced by cytotoxic T lymphocyte antigen 4 inhibitors， rarely induced by programmed cell death protein 1/programmed death ligand 1 （PD-1/PD-L1） inhibitors， and even rarely caused by tislelizumab. This study reported two cancer patients with tislelizumab-induced pituitary irAEs， in order to enhance clinicians' understanding of its adverse effects.