According to the unified deployment of national ministries and commissions， and jointly issued policies by multiple departments in Guangxi Zhuang Autonomous Region， including the Medical Insurance Administration and Health Commission， healthcare institutions are permitted to prescribe external dispensing for medications that are temporarily unavailable but clinically necessary. However， most healthcare institutions face challenges in managing external dispensing prescriptions for intravenous （IV） preparations due to the unique characteristics. To further standardize the external dispensing management of IV preparations in healthcare institutions in Guangxi， a multidisciplinary panel of experts—including pharmacy and medical administration specialists from multiple healthcare institutions and pharmaceutical enterprises—conducted in-depth discussions on key aspects such as prescription issuance， review， circulation， payment， drug distribution， and receipt. This program was guided by the Guangxi Pharmacist Association and led by the First Affiliated Hospital of Guangxi Medical University. The panel established qualification criteria for retail pharmacies authorized to dispense IV preparations externally and developed risk control mechanisms， including quality supervision protocols for IV preparations. This consensus provided standardized operational procedures for closed-loop management of external IV dispensing prescriptions in healthcare institutions， clarified the responsibilities and obligations of healthcare institutions and retail pharmacies， and enhanced the regulatory compliance and safety of IV preparation management. It is expected to safeguard patients’ medication rights and support the high-quality development of healthcare institutions in Guangxi by ensuring convenient and secure access to essential IV therapies.
OBJECTIVE To identify the blood-entry components of compound Zhizhuxiang gel plaster （CZGP） by ultra-high-performance liquid chromatography high-resolution mass spectrometry （UHPLC-HRMS）， and to explore the pharmacological substance basis and mechanism of action of CZGP in the treatment of functional dyspepsia （FD） via network pharmacology and molecular docking. METHODS UHPLC-HRMS was used to identify the components of CZGP and the components of transdermal drug delivery. Targets of blood components were obtained from traditional Chinese medicine systems pharmacology （TCMSP）， PharmMapper and SwissTargetPrediction databases. FD-related targets were screened from DrugBank， GeneCards and Online Mendelian Inheritance in Man （OMIM） databases. An intersection was taken to obtain the common targets and imported into Cytoscape 3.9.1 software to construct a “CZGP-blood-entry component-common target” network to screen the core components. Common targets were imported into STRING 12.0 database to construct a protein-protein interaction （PPI） network， which was further imported into Cytoscape software for the screening of core components. Common targets were enriched in the Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathways using the Database for Annotation， Visualization， and Integrated Discovery （DAVID）， and the binding ability of the core components to the key targets was predicted by molecular docking. RESULTS Thirty-nine chemical components in CZGP were identified， of which 27 components were introduced into the blood， yielding 141 targets for the treatment of FD. Among them， 10 components， such as hesperidin， chlorogenic acid， butein， isochlorogenic acid B， isochlorogenic acid A and dehydrocostus lactone， were the core components of CZGP for the treatment of FD， and 10 targets， such as epidermal growth factor receptor （EGFR）， serine and threonine kinase 1 （AKT1）， interleukin 6 （IL6）， interleukin 1B （IL1B）， B lymphocytoma-2 gene （BCL2）， and tumour necrosis factor （TNF） were the core targets of CZGP for the treatment of FD. Combined with the KEGG enrichment results， the mechanism of CZGP in treating FD was related to the phosphatidylinositol 3-kinase （PI3K）-protein kinase B （Akt） signaling pathway， the Janus kinase （JAK） signal transducer and activator of transcription （JAK-STAT） signaling pathway and forkhead box O （FoxO） signaling pathway. The molecular docking results showed that the 10 core blood entry components of CZGP had good binding ability with the 10 key targets， mainly by hydrogen bonding. CONCLUSION CZGP treats FD by acting on multiple components， targets and pathways. This provides a foundation for subsequent in-depth study of its pharmacodynamic substances and mechanisms of action.
OBJECTIVE To explore the material basis and pharmacodynamic mechanism of Yinxie Ling Tablets in intervening psoriasis based on serum pharmacochemistry and network pharmacology. METHODS An in vivo mouse model of psoriatic skin lesions was constructed to evaluate the efficacy of Yinxie Ling Tablets. Ultra performance liquid chromatography-quadrupole/orbitrap high resolution mass spectrometry （UPLC-Q-Exactive Orbitrap MS） was used to analyze the components of Yinxie Ling Tablets， mouse blank serum， and drug-containing serum samples， and the targets were identified by the Compound Discoverer 3.1 based on secondary spectrum characteristics and existing literatures. Bioactive components in blood were predicted by pkCSM， and active components in the blood were predicted by Super-PRED. Additionally， targets of psoriasis were searched using the keyword “psoriasis” in the GeneCards， DisGeNET， and Online Mendelian Inheritance in Man （OMIM） databases. After the intersection set of targets of drug-targets and psoriasis-targets were collected， a protein-protein interaction （PPI） network was constructed in the Search Tool for the Retrieval of Interacting Genes （STRING） database. Key targets were identified by network topology， and subjected to Gene Ontology （GO） enrichment and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis to assess the regulatory mechanisms of blood-entering components of Yinxie Ling Tablets. Transcriptome sequencing was performed to analyze the effect of Yinxie Ling Tablets on gene expressions of mice with psoriatic skin lesions. RESULTS A total of 84 components were identified in Yinxie Ling Tablets， including 22 detected in mouse blood. Furthermore， 12 of them were predicted to possess pharmacological activity. A total of 77 key drug-disease targets were identified， and 22 core targets were finally obtained by network topology. Enrichment analysis showed that blood-entering components of Yinxie Ling Tablets intervened psoriasis by mediating the antifolate resistance pathway， relaxin signaling pathway， T helper 17 （Th17） cell differentiation， hypoxia-inducible factor 1 signaling pathway， interleukin-17 signaling pathway， and advanced glycation end product （AGE）-receptor of AGE （RAGE） signaling pathway. Transcriptome sequencing found that 16 key targets showed treatment-specified expression pattern. Yinxie Ling Tablets were capable of restoring the expression levels of genes such as nuclear factor， erythroid 2 like 2 （FE2L2）， heat shock protein 90 alpha family class A member 1 （HSP90AA1）， heat shock protein 90 alpha family class B1 （HSP90AB1）， Toll-like receptor 4 （TLR4） and proteasome subunit beta type 9 （PSMB9） to normal references. CONCLUSION Active ingredients of Yinxie Ling Tablets entering the bloodstream may intervene in psoriasis through targeting genes like NFE2L2， HSP90AA1， HSP90AB1， TLR4， PSMB9， involving anti-inflammatory， antioxidant activities， and regulation of cell proliferation.
OBJECTIVE To investigate whether the combined application of ethanol extract of Gastrodia elata （EEGE） and recombinant tissue plasminogen activator （rt-PA） can protect neurons in the ischemic penumbra region during the acute phase and extend the thrombolytic time window. METHODS After ischemia modeling in rats by the embolic middle cerebral artery occlusion， rats with the neurologic function grading of 3-5 points were randomly divided into six groups： Sham group， Model group， 4.5 h rt-PA group， 4.5 h rt-PA+EEGE group， 6.0 h rt-PA group， 6.0 h rt-PA+EEGE group， 9.0 h rt-PA group， 9.0 h rt-PA+EEGE group. After the model was established， rats in the rt-PA thrombolysis + EEGE group were given EEGE by gavage at 10 min before thrombolysis， and 6 h and 12 h after thrombolysis. Rats in other groups were given an equal volume of solvent by gavage. Except for the Sham group and Model group， rats in the remaining groups were treated with rt-PA thrombolysis at 4.5， 6.0 and 9.0 h after ischemia. At 24 h after operation， triphenyltetrazolium chloride （TTC） staining， hematoxylin-eosin （HE） staining， and Nissl staining were performed. Immunofluorescence was conducted to visualize microtubule-associated protein 2 （MAP-2） expression， and terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） staining was used to detect neuronal apoptosis. RESULTS After giving EEGE， compared with the model group， rats in the 4.5 h rt-PA group， the 4.5 h rt-PA + EEGE group， and the 6.0 h rt-PA + EEGE group presented significantly decreased cerebral infarction area （P<0.01）， relieved cell damage and nuclear condensation， increased number of neurons， number of Nissl bodies， and immunofluorescence intensity of MAP-2， reduced area of the ischemic center， and expanded area of the ischemic penumbra. Compared with 6.0 h rt-PA + EEGE group， rats in the 6.0 h rt-PA group had significantly reduced cerebral infarction rate （P<0.05）， reduced neuronal damage， increased number of Nissl bodies， relatively intact neuronal structure， decreased area of ischemic center， and increased area of ischemic penumbra. CONCLUSION The combination of EEGE and rt-PA has the potential to prolong the time window of thrombolytic therapy.
OBJECTIVE To explain the potential mechanism of Ginger-Chinese plums drug pair on regulating intestinal motility by integrating network pharmacology and in vitro experiments. METHODS The drug components and corresponding targets of ginger-Chinese plums drug pair were searched from different databases， and the disease genes of acute diarrhea were collected using GeneCards and Online Mendelian Inheritance in Man （OMIM） databases. The “drug-active component-target-disease” network was constructed by Cytoscape 3.10.2 software. The obtained intersection targets of “drug-disease” were imported into the Search Tool for the Retrieval of Interacting Genes （STRING） database to construct a protein-protein interaction （PPI） network. Gene Ontology （GO） functional enrichment analysis of the complex target sites were performed using the Database for Annotation， Visualization and Integrated Discovery （DAVID）. Based on the results of enrichment analysis， the mechanism of regulating intestinal motility was validated using in vitro experiments. RESULTS A total of 36 active ingredients and 176 targets of active ingredients were selected. The enrichment analysis results showed that the regulatory effect of the Ginger-Chinese plums drug pair on intestinal motility was closely related to protein phosphorylation， apoptosis， mitochondria， and adenosine triphosphate （ATP）. In vitro experiments further validated the enrichment analysis results. CONCLUSION Network pharmacology reveals that ginger-Chinese plums drug pair drug pair exerts its therapeutic effect on regulating intestinal motility through multiple pathways， multiple components and multiple targets. In vitro experiments confirm that the mechanism of action is to increase intracellular reactive oxygen species （ROS） content， decrease mitochondrial membrane potential and ATP content， promote autophagy， induce apoptosis， reduce cell number to regulate intestinal motility and improve intestinal hyperperistalsis.
OBJECTIVE To investigate the differences in the types， quantities， contents and antioxidant activity of volatile components from stir-fried Massa Medicata Fermentata （Shenqu）， and to confirm the primary antioxidant components. METHODS Stir-fried Shenqu samples were prepared using two different processing methods， stir-frying and bran-frying. The volatile oils of Shenqu samples were extracted through steam distillation and separated with ethyl acetate. Gas chromatography-mass spectrometry （GC-MS） was performed using an HP-5MS capillary column， employing helium as the carrier gas. An electron impact ionization source （70 eV） was utilized to detect the volatile components of Shenqu. A DPPH free radical scavenging assay was carried to assess the antioxidant activity of Shenqu volatile oils， with vitamin C as control. Canonical correlation analysis （CCA） was then applied to confirm the material basis of the antioxidant effects of the volatile components of Shenqu. RESULTS A total of 51 volatile components belonging to 8 different types were identified in the volatile oils of raw Shenqu， stir-fried Shenqu， and stir-fried Shenqu with bran， yielding 18， 20 and 42 chromatographic peaks， respectively， and 11 common peaks. The antioxidant capacity of Shenqu volatiles decreased following stir-fried. Among the common components， two phenolic compounds， including of 2，4-（1，1-dimethyl ethyl）-phenol and bis（1，1-dimethylethyl）-4-methyl-phenol were closely correlated with the antioxidant activity. CONCLUSION This study provided a reliable combination method of component analysis and assay detection that identified main materials in the volatile components of Shenqu against oxidation. Our findings offer an evidence for the clinical application of Shenqu in medicine selection.
OBJECTIVE To establish qualitative and quantitative analysis methods for the chemical composition of Aiweixin Oral Liquid. METHODS The chemical components of Aiweixin Oral Liquid were identified by pre-experiments. The contents of total polysaccharides， total polyphenols and total amino acids in Aiweixin Oral Liquid were quantitatively analyzed by UV-spectrophotometry. The basic chemical compositions of Aiweixin Oral Liquid were determined by ultra-performance liquid chromatography in tandem with quadrupole and electrostatic field orbital trap high resolution mass spectrometry （UPLC-Q-Orbitrap-MS）. RESULTS According to the preliminary experiment findings， Aiweixin Oral Liquid may contain glycosides， phenols， amino acids and other components. The average content of total polysaccharides， total polyphenols and total amino acids was 222.54 mg·mL–1， 13.79 mg·mL–1 and 1.63 mg·mL–1， respectively. A total of 90 components were identified by UPLC-Q-Orbitrap-MS， including flavonoids， amino acids and terpenoids. CONCLUSION This study quantitatively analyzed the total polysaccharides， total polyphenols and total amino acids in Aiweixin Oral Liquid， and qualitatively analyzed the chemical components in Aiweixin Oral Liquid by UPLC-Q-Orbitrap-MS， providing a scientific basis for improving the quality control level of Aiweixin Oral Liquid.
OBJECTIVE To systematically analyze the chemical constituents and blood-absorbed components of Hedyotis diffusa aqueous extract， aiming to provide theoretical references for elucidating the pharmacodynamic material basis of its efficacy against lung cancer. METHODS The ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF-MSE） technology integrated with the UNIFI platform was employed to characterize and identify components in the Hedyotis diffusa aqueous extract， blank plasma， and drug-containing plasma by leveraging literature data， databases， and secondary fragment ion analysis. Targets of blood-absorbed components against lung cancer were screened using SwissTargetPrediction and GeneCards databases， while core targets were identified via Cytoscape software. Molecular docking and molecular dynamics simulations were conducted by AutoDockTools and Gromacs， respectively to validate interactions between blood-absorbed components and core targets， thereby clarifying the material basis of Hedyotis diffusa’ against lung cancer. RESULTS By comparing differences in the spectrum of Hedyotis diffusa aqueous extract， blank plasma， and drug-containing plasma under the same conditions， a total of 184 compounds were identified in the Hedyotis diffusa aqueous extract， including flavonoids， iridoids， and phenolics. Twenty blood-absorbed components were characterized in drug-containing plasma. Network pharmacology revealed 91 key anti-lung cancer targets， with 10 representative blood-absorbed components （e.g.， asperulosidic acid， β-sitosterol， shikonin） demonstrating stable binding （binding energy <–6 kJ·mol–1） to 10 core lung cancer targets （e.g.， BCL2， CASP3， HSP90AA1）. They were active anti-lung cancer constituents and therapeutic targets. CONCLUSION This study systematically analyzed and identified the chemical constituents of Hedayotis diffusa aqueous extract and its blood-absorbed components， revealing that the blood-absorbed components may represent the pharmacodynamic components responsible for its efficacy against lung cancer. These findings further clarify the material basis of the anti-lung cancer pharmacodynamic properties of Hedyotis diffusa.
OBJECTIVE To estimate the cost-effectiveness of mirvetuximab soravtansine （MIRV） versus single-agent chemotherapy in treating recurrent， platinum-resistant， folate receptor α （FRα）-positive ovarian cancer. METHODS From the Chinese healthcare perspective， a three-state partitioned survival model was constructed using the data of MIRASOL trial. The following parameters were set： 1 month of cycle length， 5 years of time horizon， and 5% of annual discount. Primary outcome indicators included total costs， quality-adjusted life month （QALM）， and incremental cost-effectiveness ratio （ICER）. The willingness-to-pay （WTP） was set at 3 times GDP per capital of China in 2024. Univariate， probabilistic sensitivity analyses and scenario analyses were performed. RESULTS MIRV group gained incremental QALM of 4.47 and incremental cost of ￥1 098 700 compared with single-agent chemotherapy， resulting in an ICER of ￥246 069/QALM that was higher than WTP. Univariate sensitivity analysis indicated that the monthly average cost of MIRV had the greatest impact on the ICER. Probabilistic sensitivity analysis revealed that the probability of MIRV being cost-effective at WTP was 0. The scenario analysis proved the robust conclusions. Furthermore， MIRV should be reduced to ￥5 160 /100 mg to become a preferred option. CONCLUSION MIRV is not cost-effective versus single-agent chemotherapy for treating recurrent， platinum-resistant， FRα-positive ovarian cancer in China.
OBJECTIVE To construct a nomogram prediction model for renal anemia in patients undergoing maintenance peritoneal dialysis in pharmaceutical clinic. METHODS A standardized service process for peritoneal dialysis in the pharmaceutical clinic was established， including pharmaceutical evaluation， nutritional assessment， personalized education and follow-up guidance for medication therapy management. A retrospective cohort study was conducted， involving outpatients who regularly received peritoneal dialysis in Wuhan No.1 Hospital from June 2023 to June 2024 as the study objects. The patients were divided into the pharmaceutical outpatient group and general outpatient group according to whether they visited pharmaceutical outpatient department or not. Propensity score matching （PSM） was used to match the two groups at a 1∶1 ratio， and baseline data were statistically analyzed. The mean values of each index within six months in the two groups were calculated and compared for evaluation. Logistic regression equations were used to analyze the influencing factors for hemoglobin level attainment in peritoneal dialysis patients. A nomogram was established. The accuracy and consistency of the nomogram were evaluated using the area under the receiver operating characteristic curve （AUC） and Hosmer-Lemeshow （HL） test， respectively. RESULTS Patients in the pharmaceutical outpatient group had significantly higher levels of hemoglobin， ferritin， serum iron saturation， and albumin， and lower Subjective Global Assessment （SGA） score and phosphorus levels compared to the general outpatient group. Univariate and multivariate logistic regressions identified four independent influencing factors for hemoglobin attainment in peritoneal dialysis patients （all P<0.05）， and a nomogram to predict hemoglobin attainment was constructed. The receiver operating characteristic curve （ROC） results showed that the AUC， sensitivity， and specificity of the nomogram were 0.896 （95% CI：0.843–0.950）， 0.702（95% CI：0.695–0.721）and 0.920（95% CI：0.865–0.933）， respectively （all P<0.001）. The HL goodness-of-fit test indicated good consistency of the nomogram. CONCLUSION The standardized service process in peritoneal dialysis of pharmaceutical clinic helps patients to achieve target levels of hemoglobin and ferritin， improving the condition of renal anemia in peritoneal dialysis patients. Pharmacy clinic visits， red blood cell count ≥3.5×1012 L–1， serum total iron-binding capacity ≥50 µmol·L–1， and transferrin saturation ≥50% are independent influencing factors for achieving target levels of renal anemia in outpatients undergoing peritoneal dialysis. The nomogram constructed based on these influencing factors has a high predictive value for renal anemia in outpatients undergoing peritoneal dialysis.
OBJECTIVE To evaluate the efficacy and safety of different time points initiating anticoagulation for the prevention of venous thromboembolism （VTE） following intracerebral hemorrhage （ICH）， and to investigate the optimal timing for the initiation of anticoagulation therapy. METHODS Clinical data of ICH patients admitted between June 2012 and December 2023 were retrospectively analyzed. The primary outcome was a composite outcome of VTE and intracranial rebleeding. Secondary outcomes included VTE and recurrent ICH events as individual outcomes. A restricted cubic spline regression model was employed to examine the nonlinear relationship between anticoagulation initiation timing and outcome events， with the relationship visually represented. Based on the inflection point of the curve， patients were divided into two groups matched in a 1∶1 ratio using propensity score matching （PSM）. Multivariate COX proportional hazards model was used to compare the differences between the two groups， and different models were created to compare the stability of the results. Multivariate Cox proportional risk models were used to explore the hazard ratios （HR） and 95% confidence intervals （CI） of specific subgroups for association with outcome events， and different groups and outcome events in patients with different etiologies of ICH. RESULTS Patients were categorized into <7 days and ≥7 days groups based on the cutoff point of the nonlinear relationship plot， and 425 patients were included in each group after PSM. Compared with the <7 days group， patients in the ≥7 days group had a significantly increased risks of composite outcomes and VTE events （HR=1.28， 95%CI： 1.01–1.61， P=0.043； HR=1.89， 95%CI： 1.45–2.47， P<0.001）， and a significantly decreased risk of intracranial rebleeding events （HR=0.47， 95%CI： 0.30–0.74， P=0.001）. A significant interaction between etiology and location of ICH subgroups and treatment group was observed in the composite outcome （P=0.057； P=0.044）. Compared with the <7 days group， patients with spontaneous ICH in the ≥7 days group had significantly higher risks of composite outcomes and VTE events and a significantly decreased risk of intracranial rebleeding events. For patients with traumatic ICH， there were no statistically significant differences in the risks of composite outcomes and VTE events between the groups. Compared with the <7 days group， those in the ≥7 days group had a significantly decreased risk of intracranial rebleeding events. CONCLUSION Initiating anticoagulation therapy within 7 days after ICH may help balance the risks of hemorrhage and thrombosis. The timing of anticoagulant initiation can be selected based on individualized factors for patients with different etiologies and locations of ICH.
OBJECTIVE To systematically evaluate the therapeutic efficacy and safety of aripiprazole combined with risperidone in treating schizophrenia. METHODS Randomized controlled trials （RCTs） reporting the combination therapy of aripiprazole and risperidone in treating schizophrenia published up to June 30， 2024 were systematically searched in PubMed， Embase， The Cochrane Library， Web of Science， CBM， VIPC， Wanfang Data， and CNKI. Two reviewers independently screened the literatures， extracted data， and assessed the risk of bias. Meta-analysis was conducted using RevMan5.2 software. RESULTS Fourteen RCTs involving 1，102 patients were included， with 551 in the treatment group and 551 in the control group. The Meta-analysis indicated that compared to the control group， serum prolactin （PRL） levels were significantly reduced （SMD=–4.25， 95%CI–5.31，–3.19， P<0.01）， and the negative symptom scores on the Positive and Negative Syndrome Scale （PANSS） were significantly elevated （MD=–2.43， 95%CI–3.41，–1.45， P<0.01）. Additionally， serum low-density lipoprotein （LDL） levels significantly decreased in the treatment group （MD=–0.32， 95%CI–0.56，–0.08， P=0.03）. CONCLUSION Aripiprazole combined with risperidone significantly alleviates clinical symptoms and reduces serum prolactin， showing an improvement of blood lipids.
OBJECTIVE To explore the refined management of pre-prescription review in the medical community， so as to provide references for improving the rational drug use level in the medical community. METHODS With the help of the pre-prescription review system of the county medical community of Xindu Hospital of Traditional Chinese Medicine， refined management of the prescription review rules for proton pump inhibitors （PPIs） was conducted to target main problems in the outpatient and emergency department prescriptions of PPIs within the medical community. The rationality effects of prescriptions before and after the setting of the prescription review rules were compared， evaluated and analyzed. RESULTS Through the comparison of the prescription data of the medical community before and after the setting of the prescription review rules， the rational rate of prescriptions for PPIs in outpatient and emergency departments has increased from 63.55% to 86.68%. The proportion of prescriptions with inappropriate indications has dropped from 15.03% to 3.81%； the proportion of prescriptions with drug interactions has decreased from 6.70% to 2.53%； the proportion of prescriptions with duplicate medications has fallen from 5.20% to 1.47%； the proportion of prescriptions with inappropriate usage and dosage has declined from 4.47% to 1.12%； and the proportion of prescriptions with inappropriate medications for special populations has decreased from 3.17% to 0.97%. CONCLUSION The refined management of the pre-prescription review rules for outpatient and emergency prescriptions of PPIs in the county-level medical community has realized the homogeneous management of pharmaceutical services in prescription review within the medical community， and promoted rational drug use， which is worthy of promotion and application.
OBJECTIVE To explore the compatibility characteristics and formula composition rules of traditional Chinese patent medicines for the treatment and prevention of acute attacks of angina pectoris under the guidance of the “Tangye Jingfa Map” theoretical system. METHODS The recommended drugs for the treatment and prevention of acute angina pectoris in guidelines and consensuses， as well as traditional Chinese patent medicines for acute angina pectoris in the Drug Wisdom Database， were collected to establish a database. WPS Office was used to statistically analyze the number of traditional Chinese medicine varieties， dominant flavors， flavor proportion， syndrome classification， and compatibility structure， organ location， etc. The compatibility principles of representative drugs for Qi stagnation and blood stasis type， cold coagulation and Qi stagnation type， and Qi deficiency， cold coagulation and blood stasis type were analyzed. RESULTS A total of 16 traditional Chinese patent medicines and simple preparations were included， involving 34 kinds of drugs. The main compatibility structure was “pungent-salty-bitter”， with pungent-flavored drugs as the dominant flavor. The usage rate of pungent， salty， and bitter flavors in the formulas was 100.00%， 87.50%， and 93.75%， respectively. The organ positioning was liver and heart. In the distribution of TCM syndromes， the main involved syndrome factors were blood stasis （87.50%） and Qi stagnation （56.25%）. Representative drugs of different syndromes showed different flavor emphases in the formula compatibility. Suxiao Jiuxin Pill （1 pungent， 0.5 salty and 0.5 bitter）， as the representative drug for Qi stagnation and blood stasis type， had a relatively balanced proportion of the three flavors. Kuanxiong Aerosol （4.5 pungent and 0.5 bitter）， as the representative drug for cold coagulation and Qi stagnation type， emphasized the pungent flavor to warm and invigorate the liver and Qi. Shexiang Baoxin Pill （4 pungent， 1.5 salty， 1 bitter and 0.5 sweet）， as the representative drug for Qi deficiency， cold coagulation and blood stasis type， emphasized the “pungent-salty” flavor to tonify Qi and strengthen the heart， and warm and dispel cold. CONCLUSION Through the “Tangye Jingfa Map” theory， the compatibility characteristics and formula composition rules of traditional Chinese patent medicines for acute angina pectoris can be clearly analyzed， providing a reference for rational drug use by physicians and pharmacists， and ideas for the future development of traditional Chinese patent medicines for acute angina pectoris.
OBJECTIVE To establish a “1+7” off-label drug use management model for children led by pediatric resident pharmacists， and to explore the role of this model in pediatric pharmaceutical services. METHODS Based on evidence-based research， resident pharmacists were responsible for collecting， evaluating， and explaining evidence before off-label drug use. They assisted medical staff in filing for off-label drug use revising prescription rules， establishing prescription sets， completing pharmaceutical consultations， and answering questions from patients’ families about off-label drug use. When starting off-label drug use in clinical practice， resident pharmacists conducted real-world research to create evidence and establish standard pharmaceutical care pathways. RESULTS A “1+7” off-label drug use management model for children was established， with resident pharmacists as the core and evidence-based support. Thirty off-label medications were assessed， and personalized prescription rules were established. Meanwhile， real-world research was conducted， and pharmaceutical monitoring pathways were improved. In 2024， a total of 200 cases of off-label medication and pharmaceutical monitoring were completed， with an increase of 65% compared to 2023. At the same time， the monitoring rate of adverse reaction warning indicators for off-label drugs has increased， among which the monitoring rate of IgG indicators for the use of off-label rituximab has increased from 85.7% to 100%. CONCLUSION The “1+7” off-label drug use management model for children led by resident pharmacists further ensures the safety of pediatric off-label medication， fully utilizes the professional value of resident pharmacists， and promotes the high-quality development of pediatric pharmaceutical services.
Danggui Shaoyao Powder， as a classic prescription under the traditional Chinese medicine （TCM） theory of simultaneous treatment of blood and water， shows a close interaction of its mechanism in treating different diseases with the same treatment with the synergistic intervention effect of metabolic homeostasis remodeling and ferroptosis. The results showed that Danggui Shaoyao Powder could realize the systemic treatment from lipid metabolism reprogramming to ferroptosis threshold intervention through multi-component synergistic regulation of metabolism-ferroptosis interaction network. Based on the study of core components and pharmacological substance basis of Danggui Shaoyao Powder， the mechanism of treating blood and water simultaneously was analyzed via the prospective of molecular targets. In the metabolic dimension， tissue microenvironment reprogramming by Danggui Shaoyao Powder was explored via remodeling the material metabolism network and intervening energy metabolism homeostasis. In the mechanism of programmed cell death， the regulatory mechanism of Danggui Shaoyao Powder in ferroptosis was explored via regulating the homeostasis of iron metabolism， targeting core signaling pathways of ferroptosis， and mediating anti-oxidation and lipid peroxidation. Finally， based on the clinical application scope of Danggui Shaoyao Powder， a systematic explanation of the clinical application was illustrated based on the cross-disease treatment. This study proposed a dual-dimensional framework of metabolism-ferroptosis in Danggui Shaoyao Powder， systematically reviewed the role of Danggui Shaoyao Powder in improving the microenvironment homeostasis through simultaneous treatment of blood and water， and coordinated the metabolic network and ferroptosis signaling， thus providing a new paradigm for revealing the multi-target action mechanism of TCM.
Unique low-pressure and low-oxygen environments in high-altitude areas decrease the blood oxygen supply， and insufficient oxygen supply to various tissues in turn leads to oxidative stress， inflammation， mitochondrial damage， energy metabolism disorders and cell apoptosis. Eventually， multiple organs like the heart， brain and lungs are damaged， severely threatening well-being of people who suddenly travel or long-term live in high-altitude areas. Traditional Chinese medicine （TCM） has a long history of medicinal use and broad development prospects in the prevention and treatment of high-altitude diseases. Diverse active components in TCM have definite therapeutic effects， and minimal adverse effects. In recent years， they have been widely used to intervene in low-pressure， low-oxygen damage. This article comprehensively summarized the protective effects of active components in TCM on low-pressure， low-oxygen damage， as well as their pharmacological pathways and mechanisms of action， providing a theoretical basis for the further development of drugs to prevent and treat low-pressure， low-oxygen injuries.
To clarify the key points of individualized treatment plans for patients with granulocytopenia and fever secondary to myelodysplastic syndrome， and to explore the importance of therapeutic drug monitoring in tumor medication. A typical case of newly diagnosed myelodysplastic syndrome who was treated with the VA regimen （Venetoclax plus Azacitidine） was analyzed to analyze the rational use of drugs using pharmaceutical knowledge. The patient suffered from grade Ⅳ bone marrow suppression during the chemotherapy of VA regimen， which was restored by corresponding treatment. The patient suffered from granulocytopenia， fever and pulmonary and oral infections. The body temperature and infection indicators returned normal after anti-infection treatment. Adverse drug reactions and abnormal blood drug concentration results were analyzed. The individualized treatment plan for patients with granulocytopenia and fever secondary to myelodysplastic syndrome， and monitoring of Venetoclax and Posaconazole in tumor patients are of significance. Anti-infection regimens should be modified based on the disease state and pathogen type. Clinical pharmacists should do a good job in pharmacological monitoring to reduce or avoid adverse drug reactions.
