OBJECTIVE To identify potential active ingredients and mechanism of Jiangfang Baoxin Capsules （JFBX） in the treatment of hypertension through network pharmacology and animal experiments. METHODS Chemical compounds of JFBX and their targets were searched in the Traditional Chinese Medicine Systems Pharmacology （TCMSP）， Swiss Target Prediction， UniProt and other databases， and annotated. Hypertension-associated targets were searched in the Online Mendelian Inheritance in Man （OMIM）， DrugBank and GeneCards. The protein-protein interaction （PPI） was predicted by the STRING database， and the key components and targets of JFBX in the treatment of hypertension were screened. Then， Gene Ontology （GO） biological process and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis were performed to study the possible mechanism of JFBX in the treatment of hypertension. The efficacy and mechanism of JFBX in the treatment of hypertension were studied in a rat model with spontaneous hypertension. The levels of tumor necrosis factor-alpha （TNF-α）， interleukin-1beta （IL-1β） and interleukin-6 （IL-6） in myocardial tissue were detected by enzyme-linked immunosorbent assay （ELISA）. The protein expressions of PTGS-2， MMP9 and SRC were detected by Western blot. RESULTS Network pharmacological screening identified 76 active ingredients and 186 intersection targets of JFBX for the treatment of hypertension. According to the PPI network， there were 20 active ingredients of JFBX in treating hypertension， such as the 3，9，10-trimethoxy-6a，11a-dihydro-benzofuran［3，2-c］ coumarin-4-ol， kaempferol， quercetin， benzoyl paeoniflorin and luteolin. There were 24 key targets， such as PTGS-2， SRC， MMP9. The results of GO biological process and KEGG pathway enrichment analysis showed that JFBX target was significantly enriched in lipid and atherosclerosis， advanced glycation end-products （AGE）-receptor for AGE （RAGE） signaling pathway， fluid shear stress and atherosclerosis， TNF and IL signaling pathway. Molecular docking results showed that 3，9，10-trimethoxy-6a，11a-dihydro-benzo［f］furo［3，2-c］coumarin-4-ol， luteolin， benzoylpeonidin， quercetin and kaempferol had strong affinity with PTGS-2， SRC and MMP9 targets. The in vivo results showed that JFBX could effectively reduce the systolic and diastolic blood pressure， significantly increase serum superoxide dismutase （SOD） activity and serum nitric oxide （NO）， decrease malondialdehyde （MDA） and serum endothelin-1 （ET-1） in rats with spontaneous hypertension. It significantly reduced the levels of TNF-α， IL-1β and IL-6 in rat myocardial tissue. JFBX could significantly downregulate PTGS-2 and MMP-9 in a dose-dependent manner （P<0.05）. Morphological results showed that JFBX could significantly inhibit the occurrence of myocardial hypertrophy induced by hypertension in rats. CONCLUSION Network pharmacology analysis suggested that JFBX has multi-component and multi-target effects against blood pressure and myocardial injury in rats. Its mechanism of action is related to promoting the repair of vascular endothelial cytokines， enhancing the scavenging ability of free radicals in rats， and reducing the level of inflammatory factors.
OBJECTIVE To study the effect of simulated weightlessness on the tissue distribution of verapamil in Sprague-Dawley （SD） rats， and to investigate the potential effect of weightlessness on the drug’s distribution properties in vivo. METHODS Rats were randomly divided into the normal and simulated weightlessness groups （1， 4， 8 weeks）. After gavage of verapamil， samples were collected at specific time points （0.167， 1， 6 h）. The distribution of the drug in heart， liver， spleen， lung， kidney， brain and muscle tissues was analyzed using the high-performance liquid chromatography-mass spectrometry （HPLC-MS/MS）. The concentrations of verapamil and norverapamil in each rat tissue of simulated weightlessness groups were compared using the normal weight as a control. RESULTS Verapamil was rapidly absorbed and widely distributed to various tissues， and the distribution of verapamil slowed down in simulated weightlessness tissues. Moreover， verapamil was rapidly metabolized to norverapamil in the liver， and norverapamil also showed a slowed distribution in simulated weightlessness tissues. The concentrations of verapamil and its metabolites in the heart， liver and brain tissues increased significantly in the 8-week simulated weightlessness group. CONCLUSION Simulated weightlessness significantly affects the distribution of verapamil and its metabolites in various tissues， especially in the long-term simulated weightlessness （8 weeks） with more complex changes in drug distribution. Future studies are needed to explore the specific mechanisms of these changes to optimize drug treatment regimens during long-term space missions.
OBJECTIVE By integrating fingerprint profile analysis with quantitative determination of multicomponent contents and transference rates， this study employed network pharmacology approaches to systematically predict potential quality marker （Q-marker） for Yupingfeng（YPF）standard decoction through combined experimental and computational methodologies. METHODS High-performance liquid chromatography （HPLC） was employed to establish the chromatographic fingerprint and quantify multiple bioactive components in YPF standard decoction. Network pharmacology combined with molecular docking techniques were utilized to investigate the therapeutic mechanisms of these components. RESULTS The chromatographic fingerprint analysis identified 12 characteristic peaks in YPF standard decoction， with six chromatographic peaks unambiguously characterized. The similarity of the fingerprint spectra of 15 batches of YPF standard decoction samples was all greater than 0.90. The transfer rate ranges of the measured components of YPF standard decoction were as follows： cimicifugoside 14.40%–26.74%， calycosin-7-O-β-D-glucoside 12.19%–22.65%， cimifugin 17.21%–31.95%， sec-O-glucosylhamaudol 54.94%–102.02%， formononetin 9.92%–8.42%， and atractylenolide Ⅲ 13.68%–25.40%. Network pharmacology and molecular docking verified that astragaloside， cimicifugoside， calycosin-7-O-β-D-glucoside， cimifugin， sec-O-glucosylhamaudol， formononetin， and atractylenolide Ⅲ in YPF exerted their therapeutic effects through pathways such as the tumor necrosis factor signaling pathway and the serotonergic synapse. CONCLUSION The integrated application of chromatographic fingerprinting and network pharmacology successfully identified potential Q-markers for YPF standard decoction， establishing a multi-dimensional framework for systematic quality assessment and pharmacological validation of this traditional formulation.
OBJECTIVE To compare the effects of different yam varieties on exercise endurance， energy supply， metabolites， and antioxidant-related indicators in exercise-induced fatigued mice. METHODS Mice were randomly divided into 7 groups： control group， model group， and 5 yam variety group （Tiegun， Taigu， Xiaobaizui， Mao yam and Jiujinhuang）. After 28 consecutive days of intragastric administration， exhaustive swimming time was recorded. After the weighted swimming， hemoglobin （Hb） in whole blood， along with serum metabolic indicators including glucose （Glu）， lactate dehydrogenase （LDH）， creatine kinase （CK）， lactic acid （LD）， blood urea nitrogen （BUN）， and blood ammonia levels were measured. Muscle glycogen content was quantified in muscle tissue. Hepatic analyses included hepatic glycogen content and antioxidant-related parameters： superoxide dismutase （SOD）， catalase （CAT）， glutathione peroxidase （GSH-Px）， malondialdehyde （MDA）， and reactive oxygen species （ROS） levels in liver tissue. RESULTS All yam varieties demonstrated varying degrees of improvement in exercise endurance by prolonging exhaustive swimming time. These interventions significantly increased Hb， Glu， muscle glycogen， hepatic glycogen， LDH， SOD， CAT， and GSH-Px levels， while effectively reducing CK， LD， BUN， blood ammonia， MDA， and ROS levels. Among the tested varieties， Tiegun yam exhibited the most pronounced enhancement effects on fatigue resistance parameters. CONCLUSION Five varieties of yam enhance the anti-fatigue capacity in terms of exercise endurance， energy supply， metabolic products， and antioxidant capacity. They all have varying degrees of improvement on the body’s aerobic exercise capacity and antioxidant ability， and they reduce the fatigue level of mice. Among them， the anti-fatigue effect of Tiegun Yam is superior to that of other yam varieties.
OBJECTIVE To establish a high-performance liquid chromatography （HPLC） method for the simultaneous content determination of seven ginsenosides （ginsenoside Rg1， Re， Rf， Rb1， Rc， Rb2 and Rd） in Jianxin Granules， and to study the dynamic changes in their contents during the production process of Jianxin Granules. METHODS The analysis was performed on a thermostatic Nano Chromcore 300 C18 column （4.6 mm×250 mm， 5 μm） at 30 ℃， with the mobile phase comprising of acetonitrile-water flowing at 1.3 mL·min–1 in a gradient elution manner， and the detection wavelength of 203 nm. Content of seven ginsenosides in nine batches of production process “Red ginseng raw material-semi-finished products-Jianxin Granules finished product” was monitored. SPSS 26.0 software was used for statistical analysis of the results of each stage of production. RESULTS The methodological investigation and verification of seven components were all acceptable. The K values of seven components in nine batches of “Red ginseng raw material-semi-finished products-Jianxin Granules finished product” were 83%–135%， 79%–140% and 77%–133%， and the content transfer rates were 67.95%–90.68% and 63.44%–87.46%， respectively. Statistical analysis showed no significant differences among all groups （P>0.05）， indicating a good consistency among batches and stable components transfer in each process of Jianxin Granules. CONCLUSION HPLC-based dynamic analysis of ginsenosides components in Jianxin Granules via the formulation quality process control is a simple， accurate， repeatable method to achieve the real-time assessment of ginsenosides components and quality control of different batches. Our study provides an experimental basis for the subsequent research on the quality markers of its whole components.
OBJECTIVE To investigate the effectiveness， safety and correlation analysis with drug exposure in the treatment of multidrug-resistant bacterial pneumonia by comparing nebulised inhalation of polymyxin E versus nebulised inhalation combined with intravenous drip（IV） of polymyxin E. METHODS A total of 128 patients with multidrug-resistant bacterial pneumonia in Suzhou Municipal Hospital from December 2021 to March 2024 were retrospectively analyzed. They were divided into the nebulised inhalation group （59 cases）and nebulised inhalation combined with IV group （69 cases） according to the different ways of drug administration. The differences in efficacy and safety between the two groups were compared， and the correlation between acute kidney injury and blood drug concentration was analyzed. RESULTS The clinical cure rate （52.5% vs. 42.0%， P=0.235） and bacterial clearance rate （35.6% vs. 40.6%， P=0.563） were comparable between the nebulised inhalation group and the nebulised inhalation combined with IV group. Patients in the nebulised combined IV group had higher incidences of respiratory irritation （43.5% vs. 23.7%， P=0.019）， and acute kidney injury （40.6% vs. 11.9%， P<0.001）， and a lower 28-day survival rate （62.3% vs. 88.1%， P<0.001） compared to the nebulised group. Sixty-nine cases in the nebulised inhalation combined with IV group were divided into the renal injury group （n=28） and non-renal injury group （n=41）. The trough concentration was 3.58 （3.34，3.97） μg·mL–1 and peak concentration was 7.06 （6.01，9.60） μg·mL–1 in the renal injury group， which were 3.18 （2.93，3.29） μg·mL–1 and 5.56 （ 4.87， 5.98） μg·mL–1 in the non-renal injury group. Both trough and peak concentrations were significantly higher in the renal injury group than the non-renal injury group （P=0.002， and P=0.031， respectively）. CONCLUSION Nebulised inhalation combined with IV of polymyxin E has a higher risk of acute kidney injury compared with nebulised inhalation regimen， and is closely related to drug exposure. During its clinical application， close monitoring of blood concentrations and timely and optimally adjusted dosage are needed.
OBJECTIVE To evaluate and compare the association between the use of bone-modifying drugs （BMAs） and adverse events of drug-induced oral reactions in patients with solid tumor bone metastases or multiple myeloma through data mining in the US Food and Drug Administration （FDA） Adverse Event Reporting System （FAERS）， so as to provide a reference for the rational use of drugs in clinical practice. METHODS FAERS data from the first quarter of 2004 to the first quarter of 2024 were downloaded and cleaned to extract adverse events of drug-induced oral reactions associated with the use of BMAs in patients with bone metastases from solid tumors or multiple myeloma. Signals were detected using the reporting odds ratio （ROR） method. RESULTS A total of 25 827 BMAs-associated drug-induced oral reactions adverse events were collected， including 11 355 cases of denosumab （DENO）， 10 549 cases of zoledronic acid （ZA）， 1 713 cases of pamidronate disodium （PAM）， 1 112 cases of alendronic acid （ALE）， 872 cases of ibandronic acid （IBA）， and 226 cases of risedronate sodium （RIS）. The number of signals detected was 80 for DENO， 92 for ZA， 82 for PAM， 57 for ALE， 44 for IBA and 42 for RIS， respectively. The most common adverse events were osteonecrosis of the jaw and jaw pain. The majority of patients were female and the predominant age range was 65-85 years. The median time of developing pamidronate disodium-associated adverse events was 934 days， which was the longest than other drugs. Significant differences existed in the clinical presentations and intensities of drug-induced oral reactions associated with distinct BMAs. In addition to BMAs， adverse events of drug-induced oral reactions were also associated with tyrosine kinase inhibitors， monoclonal antibodies， mTOR inhibitors， and immunosuppressants. CONCLUTION Drug-induced oral reactions adverse events are present in all 6 BMAs drugs， and the use of other anticancer drugs may also cause adverse reactions. Their combination may increase the incidence of adverse reactions. A comprehensive oral health assessment before starting the treatment and every 4-6 months after initiating therapy are recommended. If any related symptoms are detected， prompt medical attention should be sought.
OBJECTIVE To provide references for rational and safe clinical drug use through mining and analyzing the adverse events of trazodone. METHODS Trazodone-associated adverse event reports were retrieved through the FDA Adverse Event Reporting System （FAERS）from January 1， 2004 to September 30，2024， which were described according to the Medical Dictionary for Regulatory Activities （MedDRA）， and classified by the system organ class （SOC） and preferred term （PT）.The suspicious risk signals were mined and analyzed by the reporting odds ratio （ROR） and proportional reporting ratio （PRR）. RESULTS A total of 5 372 adverse events reports of trazodone were retrieved， among which the proportion of female patients was higher than that of male patients， and the age was mainly concentrated in 18-65 years old. Through screening and analysis， a total of 300 effective signals were obtained. The PT with high signal intensity mainly concentrated in reproductive system and cardiac disorders. The most frequent PT was mainly concentrated in psychiatric disorders， injury， poisoning and procedural complications， and reproductive system. Compared with the drug instructions and Side Effect Resource （SIDER） database， some adverse events signals were highly consistent， and 84 new suspected adverse reactions were found， including restless legs syndrome， dermatitis bullous and gestational diabetes. CONCLUSION The mining and analysis of real-world adverse event data of trazodone can help to discover new potential adverse event risk signals. It arises clinical attention to potential serious adverse events of trazodone， regulate clinical rational drug use， and ensure medication safety.
OBJECTIVE To develop a questionnaire for measuring the COVID-19 booster vaccination intention among healthcare workers in Guizhou Province and to understand their actual vaccination willingness. METHODS A snowball sampling method was employed. A questionnaire was designed， distributed， and collected through the Wenjuanxing platform. The reliability and validity of the questionnaire were evaluated from the following five dimensions： personal health status， psychological mood， short-term stress， COVID-19-related distress， and attitude toward the booster shot. RESULTS Most respondents had good health behavior habits， and their willingness to get vaccinated was largely influenced by policies. A total of 64.33% of respondents were willing to receive the booster shot. Primary concerns influencing vaccination willingness consisted of the safety and reliability of the vaccine. The questionnaire demonstrated good reliability and validity， with factor loadings of the measurement items all above 0.5. The average variance extracted and composite reliability values for each dimension were above the recommended thresholds， and the structural model fit indices were good. COVID-19-related distress and personal health status might have a direct impact on vaccination willingness， while psychological mood had a significant moderating effect on the relationship between attitude toward the booster shot and COVID-19-related distress. CONCLUSION COVID-19-related distress， personal health status， and psychological mood may influence respondents’ willingness to receive the booster shot. It is recommended that healthcare institutions focus on the mental health and health behavior habits of healthcare workers， and provide timely psychological counseling and interventions to improve vaccination willingness.
OBJECTIVE Based on the establishment of the China Medicine Education Association’s pharmacy intravenous admixture services （PIVAS） training base， this study aims to analyze the key points of PIVAS pharmacist training to cultivate homogenized， standardized， and normalized PIVAS pharmacists. METHODS The TOWS （threats， opportunities， weaknesses and strengths） analysis was performed to analyze the opportunities and threats in constructing the PIVAS pharmacist training system at the Second Affiliated Hospital of Soochow University. Internal strengths and weaknesses were evaluated， and corresponding training management strategies were developed. Finally， based on the Kirkpatrick’s four-level evaluation method， evaluation indicators for the effectiveness of the PIVAS pharmacist training system were established， including student satisfaction， training assessment results and feedback on the job. RESULTS This study established a brand training course covering the special contents of PIVAS information construction， quality control， safety management， and performance evaluation. A “three-stage” PIVAS pharmacist training process and a Kirkpatrick’s four-level training effectiveness evaluation system were formed. The evaluation of the training effectiveness， including the response， learning， behavior， and result， was as follows： （1） Response level： The satisfaction rate of trainees was 87.88%； （2） Learning level： After the training， the trainees’ scores in the assessment of PIVAS system， environmental health cleaning and disinfection knowledge， and aseptic operation technology were significantly improved compared with those before the training （P<0.05）； （3）Behavior level： 90% of workplace leaders provided positive feedback on the improvement of trainees’ abilities after training； （4） Result level： Enrollment for the third PIVAS training session doubled compared to the first session， and the income of PIVAS instructor team increased by 982 Yuan per person per session compared with that before participating in the training work. CONCLUSION The PIVAS pharmacist training based on TOWS and Kirkpatrick evaluation method has achieved significant results， providing a referential training management model for cultivating applied PIVAS pharmaceutical talents.
OBJECTIVE To design a scientific and unified model of drug dismantling and billing unit to improve the rationality and convenience of the dismantle work， and to further improve the quality of medical service. METHODS Based on the data of doctor’s advice， and distinct drug characteristics， combinatorial algorithms were designed and optimized. Based on the data of previous doctor’s advice and targeting distinct drug characteristics， a model and an App of drug dismantling and billing unit were developed. RESULTS The use of the minimum unit of representative drugs obtained by the drug dismantling and billing unit model reduced the drug surplus by an average of 39.17%. CONCLUSION By breaking down drug prices into smaller amounts， we can reduce the amount of surplus drugs and lower the medical burden on patients.
OBJECTIVE To systematically introduce the regulatory experience in Japan， and to provide references for optimizing the supervision of investigator-initiated trials （IITs） in China. METHODS Based on the current regulatory status and challenges of IITs in China， this study summarized the management requirements and regulatory approaches of IITs in Japan. Then， the similarities and key differences between the two countries were compared to form specific suggestions for optimizing the regulation of IITs in China. RESULTS Japan has established clear regulatory foundations for IITs involving general products and regenerative medicine products， while also providing practical pathways for the application of IIT data. Its beneficial experience in data collection and quality control of investigational medicinal products for IITs served as a valuable reference for China. CONCLUSION Based on the regulatory experience in Japan， it is recommended to refine the domestic regulatory requirements for IITs， providing detailed guidance for healthcare institutions conducting such trials. Emphasis should be placed on data management in IITs and quality control of investigational medicinal products to comprehensively enhance the quality of IIT research and gradually facilitate its alignment with industry-sponsored trials （IST）.
OBJECTIVE To observe the effects of drug traceability code on the management of medicament in hospital. METHODS Data from 16 sub-dimensions and 3 major dimensions were collected in the Second Hospital of Shandong University from August 2023 to September 2023 （prior to the application of the drug traceability code）， May 2024 to June 2024 （prior to the application of the drug traceability code）， and August 2024 to September 2024 （after to the application of the drug traceability code）， with a 2-month interval in each group. Data were compared via the year-over-year， and month-over-month methods. RESULTS After the application of drug traceability code， the seven sub-dimensions within the dimension of the accuracy of hospital drug warehousing were significantly improved （P<0.01）. Under the dimension of dispensing error rate of outpatient pharmacy， the error of drug quantity （P<0.01） and internal error rate （P<0.05） were significantly improved. While the number of errors in the other five sub-dimensions was 0， there was no significant difference in statistics. In the dimension of efficiency in pharmacy work， the dispensing time of outpatient pharmacy was slightly extended （P<0.01）， while no significant difference was detected in the accuracy of drug warehousing. Unfortunately， the dispensing time for each box increased by about 5 seconds. CONCLUSION The application of drug traceability code significantly improves the accuracy of drug warehousing and avoids the risk of outdoor errors in hospital. Although it has a certain impact on the efficiency of pharmacy work， it has a positive effect on the overall drug management in hospital.
To collect pharmacist-led comprehensive intervention papers from top medical journals and their sub-journals， and to analyze the role and significance of these interventions in clinical drug therapy. Papers related to pharmacist-led comprehensive interventions published in top-tier medical journals and their sub-journals were retrieved from the PubMed database and analyzed using the Arksey and O’Malley scoping review framework. A total of 42 papers were included， covering countries such as the UK， Australia， the US， and Canada. The studies involved patients with chronic diseases， those with medication-related problems， and specific populations. The main research methods were prospective studies， including randomized controlled trials and pre-post intervention studies. The pharmacist-led comprehensive interventions primarily consisted of medication education， medication reconciliation， and lifestyle interventions. These interventions could effectively enhance patients’ medication adherence， decrease the incidence of adverse drug reactions， improve treatment outcomes， and boost patient satisfaction. Pharmacist-led comprehensive interventions have demonstrated significant potential in promoting safe and rational drug use and enhancing the quality of medical care. Promoting and strengthening the practice and research of pharmacists in comprehensive interventions in our country is expected to benefit patients and highlight the value of pharmacists’ work.
Non-melanoma skin cancers have become one of the most common cancer types， significantly affecting patients’ physical and mental health. Current treatment strategies for non-melanoma skin cancers include surgery， photodynamic therapy， cryotherapy and immunotherapy. Among them， immune checkpoint inhibitor （ICI） therapy due to its remarkable efficacy， has become garnered increasing attention from researchers. This article reviewed the latest clinical research progress and future prospects of ICIs in the treatment of various subtypes of non-melanoma skin cancers.
Ficus pumila L. is a climbing plant of the genus Ficus in the family of Moraceae， and its roots， stems， leaves and fruits are used medicinally. Chemical constituents of Ficus pumila L. are mainly flavonoids， terpenoids and phenylpropanoids， showing anti-inflammatory and anti-bacterial， antioxidant， anti-tumor， hypoglycemic and other pharmacological effects. At present， Ficus pumila L. is not included in the Pharmacopoeia of the People’s Republic of China （2020 edition）， but included in the Prostatone Tablet Formulas. In addition， whether the medicinal use of Ficus lilacis fruit is the inflorescence receptacle of gall-flowered fruits or that of female-flowered fruits remains controversial across China， and the material basis and quality control of Ficus pumila L. are not clear. This article provided a comprehensive description of the herbal evidence， chemical composition and pharmacological effects of Ficus pumila L.， and predicted the quality-markers （Q-markers） of Ficus pumila L. from the aspects of plant affinity， traditional medicinal properties， measurability of the chemical composition， and different places of origin， aiming to provide useful references for the future quality control， clinical application， and in-depth research.
Chronic graft-versus-host disease （cGVHD） is a significant challenge that can arise following allogeneic hematopoietic stem cell transplantation （allo-HSCT）. It is marked by a wide range of clinical manifestations， intricate medication regimens， and considerable inter-patient variability， which underscores the need for individualized therapeutic strategies. This article delineated the pharmaceutical care provided by a clinical pharmacist in a case of cGVHD after hematopoietic stem cell transplantation. The pharmacist offered expert advice on managing the patient’s multi-organ rejection reactions， enhancing nutritional support， regulating blood sugar levels， and vigilantly monitoring drug interactions， adverse drug reactions， as well as the clinical efficacy of immunosuppressants and corticosteroids. By adopting a pharmaceutical perspective， the clinical pharmacist was able to refine the patient’s medication regimen， thereby ensuring both the safety and efficacy of the medication regimen.
Lecanemab is a new drug for the treatment of Alzheimer’s disease， which was launched in China in 2024. Currently， there is limited experience with its use in China. The most common adverse reactions documented in the prescribing information are infusion-related reactions and rash. To date， there have been no global reports of adverse reactions involving bilateral lower limb edema. This article reported a case of Alzheimer’s disease who developed a series of rare adverse drug reactions， including fever， rash， and bilateral lower limb edema， after intravenous infusion of lecanemab injection. The aim is to provide a reference for the clinical use of lecanemab.
