This article systematically reviewed the progress in the application of the Integrative Theory of Health Behavior Change （ITHBC） in chronic disease management. By integrating core elements of multiple health behavior theories， ITHBC establishes a systematic theoretical framework that provides scientific guidance for promoting positive behavioral changes in patients with chronic diseases. The theory centers on three key models—knowledge and beliefs， self-regulation skills and abilities， and social facilitation—emphasizing a dynamic， cyclical process of behavioral change. Through the delineation of short-term and long-term outcomes， it enhances patients' self-management capabilities and fosters sustained improvements in health status. Empirical evidence demonstrates that ITHBC delivers significant efficacy across interventions for various chronic diseases， which effectively improves medication adherence， disease control outcomes， and quality of life. However， its clinical implementation remains constrained by challenges like fragmented systemic integration and insufficient social support. Future research should prioritize further theoretical refinement and the strengthening of social support networks to advance the broader application of ITHBC in chronic disease management.

Type 2 inflammatory diseases impose substantial burdens on patient health and quality of life. Advances in understanding the underlying immunopathology have led to the approval or clinical development of multiple targeted agents，expanding options for precision therapy. Despite these therapeutic advances，real-world clinical experience with many targeted agents remains limited； long-term safety data are incomplete，and evidence on efficacy and safety in pediatric，geriatric，pregnant and breastfeeding patients is insufficient. This expert consensus provides a systematic review of targeted therapies across ten common type 2 inflammatory conditions and summarizes guidance on their use in special populations. The consensus aims to raise the standard of clinical application for type 2 inflammation-targeted therapies by promoting standardized，evidence-based，and rational prescribing practices，thereby maximizing patient benefit while minimizing potential risks.

Intractable pulmonary infections （IPI） are pulmonary infectious diseases that fail to respond adequately to guideline‑recommended standard therapies， resulting in persistent or progressive illness. Amikacin has demonstrated activity against certain drug‑resistant pathogens that cause IPI； however， systemic administration is limited by poor pulmonary tissue penetration and notable systemic adverse effects. Nebulized Amikacin （NA） shows promise in IPI treatment because of favorable local pharmacokinetic/pharmacodynamic （PK/PD） properties. This review summarizes current evidence on the efficacy， safety， resistance development， and limitations of nebulized amikacin in multiple clinical settings of IPI， including hospital‑acquired pneumonia and ventilator‑associated pneumonia （HAP/VAP）， nontuberculous mycobacterial （NTM） lung disease， cystic fibrosis （CF）， non‑CF bronchiectasis， and chronic obstructive pulmonary disease （COPD）， to inform clinical decision‑making.

We report a case of severe immune-related multi-organ and endocrine toxicity associated with cadonilimab， a bispecific programmed death 1 （PD-1）/cytotoxic T lymphocyte antigen 4 （CTLA-4） antibody. Through a retrospective literature review， a clinical pharmacist summarized the adverse events linked to cadonilimab therapy and related PD-1/CTLA-4 dual-targeted agents. The patient’s symptoms improved gradually after prompt administration of adequate doses of systemic glucocorticoids. We recommend that patients considered for cadonilimab receive comprehensive baseline evaluations and undergo proactive monitoring throughout treatment.

Radioligand therapy（RLT）drugs are radiopharmaceuticals that use targeting ligands to deliver therapeutic radiation in vivo and have been approved for the treatment of various tumors. Compared with conventional drugs，RLT agents pose unique challenges in clinical use，safety management，and quality control，yet standardized clinical application and management requirements are lacking. As an increasing number of RLT drugs enter clinical trials and the market，there is an urgent need to standardize end-to-end management of their clinical use to ensure rational prescribing，optimize oncologic outcomes，and maximize patient benefit. This consensus was jointly initiated by the Committee of Hospital Pharmacy of the Chinese Pharmaceutical Association and the Chinese Society of Nuclear Medicine. Drawing on domestic and international research，policy documents，guidelines，existing consensuses，and expert opinion，it provides recommendations on clinical application and management of RLT drugs from multiple perspectives. Topics covered include whole-process pharmaceutical management（drug selection and introduction，stock reservation，receipt/acceptance，intrahospital transport，storage，regimen determination，and radioactive waste disposal）； a multidisciplinary management pathway detailing roles and responsibilities of participating departments and personnel for patient treatment，monitoring，and follow-up； and comprehensive clinical evaluation criteria addressing safety，efficacy，cost-effectiveness，innovation，suitability，and accessibility. The consensus aims to promote the safe，effective，and rational clinical implementation of RLT drugs.

OBJECTIVE To investigate prescription compatibility rules for treating Huangshui Disease（a Tibetan-medical disorder of body fluids）as recorded in The Medical Notes of Gtsang Stod. METHODS Prescriptions for Huangshui Disease were extracted from the text and compiled into a database using Excel. The Tibetan Medicine Informatization Platform（TMIP）series software was employed to conduct frequency analysis，Apriori association-rule mining，and partial-order-structure analysis. The medicinal properties of high-frequency herbs were also analyzed. RESULTS After screening，87 prescriptions comprising 237 herbs were included. The seven most frequently used medicines were Frankincense，Terminalia chebula，Phyllanthus emblica，seeds of Abelmoschus manihot（L.）Medikus，Terminalia bellirica，Piper longum fruit，and Semen Cassiae. The strongest herb associations were Terminalia chebula-Terminalia bellirica，Phyllanthus emblica–Terminalia bellirica，seeds of Abelmoschus manihot-Semen Cassiae，and Frankincense-Semen Cassiae. These combinations form classical formulas such as San Guo Tang and San Huang Shui Drug，which constitute core prescriptions for treating Huangshui Disease. Partial-order-structure analysis revealed three major prescription subgroups with prominent common nodes：San Huang Shui Yao centered on Frankincense，San Re San centered on Piper longum，and San Guo Tang centered on Terminalia chebula. San Huang Shui Yao serves as the core group； San Re San primarily targets “white”（cold）Huangshui syndromes，while San Guo Tang addresses “black”（heat）Huangshui syndromes. Analysis of medicinal properties showed that tastes were mainly bitter，pungent，and sweet，with the bitter transformed taste being most prevalent. Among the seventeen properties，coolness，bluntness，and liquidity predominated，counteracting the “heat-sharpness-viscosity” etiology and pathology of the Bilious heat syndrome. CONCLUSION The prescription rule is embodied as “San Huang Shui Yao eliminating dampness-San Re dispelling cold-San Guo Tang clearing heat，” with San Huang Shui Yao at the center and San Re San and San Guo Tang adjusting for cold and heat patterns respectively. This dynamic compatibility strategy modulates pathological Huangshui and aims to restore clarity（“turbid yellow turning clear-returning to the origin”），offering a theoretical foundation for modernizing Tibetan medicine and advancing its application toward precision medicine.

OBJECTIVE To compare the lipid‑lowering effectiveness and economic outcomes of innovator and generic atorvastatin calcium in real‑world clinical practice. METHODS We conducted a retrospective study using data from the Hospital Information System （HIS） and the Prescription Automatic Screening System （PASS） of Qinzhou Second People's Hospital. Patients treated with atorvastatin calcium between January 1， 2017， and December 31， 2021， were identified and categorized into an innovator （brand name： Lipitor） group and a generic （brand name： Youliping） group. Baseline imbalances were addressed by 1∶1 propensity score matching （PSM）. We compared changes in lipid parameters， overall effectiveness rate， and cost‑effectiveness between groups before and after PSM. RESULTS A total of 224 patients were included （innovator n = 94； generic n = 130）. After 1∶1 PSM， 76 matched pairs remained. There was no statistically significant difference in overall effectiveness rate between the two groups （P > 0.05）. In the innovator group， total cholesterol （TC） and low‑density lipoprotein cholesterol （LDL‑C） decreased significantly both before and after PSM （P < 0.05）. In the generic group， TC， triglycerides （TG）， and LDL‑C decreased significantly before PSM （P < 0.05）， and HDL‑C improved further after PSM （P<0.05）. After PSM， the magnitude of lipid reductions did not differ significantly between groups （P>0.05）. Cost analysis showed mean per‑patient costs of ¥1，544.15 for the innovator and ¥98.75 for the generic， with corresponding cost‑effectiveness ratios of 19.62 and 1.14 （¥ per unit of effectiveness）， respectively. CONCLUSION In this real‑world cohort， the lipid‑lowering efficacy of the generic atorvastatin （Youliping） was comparable to that of the innovator product （Lipitor） after adjustment for baseline differences， while the generic exhibited substantially greater economic value.

OBJECTIVE To develop an intelligent drug traceability code scanning system in response to national policy， aiming to enhance medication safety and reduce dispensing errors. METHODS An intelligent scanning interface was integrated into the dispensing and return modules of the hospital information system. During drug warehousing， the system dynamically maintains drug identification codes. At the outbound stage， the scanner recognizes only traceability codes， automatically filters out invalid information， and supports flexible single， multiple， and mixed scanning modes to accommodate different workflow scenarios. A real-time error-prevention feedback mechanism was implemented to provide intuitive prompts （e.g.， duplicate-scan alerts， excessive drug quantity highlighted in red， and mandatory confirmation for incorrect picks） to help pharmacists detect and correct errors promptly. RESULTS After implementation， the drug scanning rate increased to 98.20%， and the dispensing error rate decreased by 69.23%. Drug pick-up time was not significantly affected by the system （P>0.05）， indicating that the system enhances drug safety and dispensing accuracy without compromising dispensing efficiency. CONCLUSION The intelligent drug traceability code scanning system substantially improves medication safety and dispensing accuracy. This study offers a practical reference for other medical institutions building traceability systems and supports broader adoption and ongoing optimization of drug information traceability.

OBJECTIVE To synthesize the evidence on etomidate’s clinical safety profile and potential for misuse， and to develop a pharmacist‑led， closed‑loop management pathway to mitigate risks. METHODS Following PRISMA‑S guidance， we systematically searched six databases for studies published between January 1， 2000 and August 1， 2025. Two reviewers performed duplicate screening and de‑duplication. Key findings were graded by evidence strength （high， moderate， low）. RESULTS We included 429 records （371 English， 58 Chinese）. High‑quality evidence indicates that etomidate confers a clear short‑term hemodynamic stability advantage in settings of hemodynamic compromise and during rapid sequence intubation； furthermore， premedication and slow bolus administration over ≥30 seconds substantially reduce the incidence of induction‑related myoclonus. Moderate‑quality evidence shows that even a single dose can transiently suppress the hypothalamic‑pituitary‑adrenal （HPA） axis， with longer suppression observed in patients with septic shock or existing endocrine abnormalities. Low‑quality evidence raises concern that illicit addition of etomidate to e‑liquids may elevate abuse risk. We piloted a pharmacist‑led closed‑loop model for risk stratification， process monitoring， adverse event management， and re‑exposure prevention and found it feasible with positive impacts on process adherence and selected safety metrics. CONCLUSION Etomidate retains a role for induction in specific clinical scenarios due to its short‑term hemodynamic advantages， but clinicians must remain alert to adrenal suppression and potential misuse. We recommend phased implementation of a pharmacist‑led closed‑loop management pathway integrated with computerized provider order entry/clinical decision support systems （CPOE/CDSS） to enable dynamic surveillance and inter‑institutional benchmarking.

OBJECTIVE To comprehensively evaluate the clinical value of Xuanyunning， and to explore its clinical advantages， thus promoting the clinical rational drug use for treating vertigo. METHODS The clinical values of Xuanyunning and related control drugs were comprehensively evaluated for their safety， effectiveness， economy， suitability， accessibility and innovation through analyzing data from literature review and expert questionnaire survey. RESULTS Xuanyunning was superior to other monotherapies in the effectiveness， showing superb performances in improving the total symptom efficiency and the velocity of the basilar artery. Xuanyunning was also recommended by guidelines to treat vertigo with stagnation of phlegm-dampness， and deficiency of liver and kidney. Safety evidence showed that the overall safety of Xuanyunning was similar with other drugs， with mild adverse events in a low incidence. Xuanyunning was superior to other traditional Chinese medicines in the economy， displaying a cost-effectiveness advantage. In dimensions of suitability and accessibility， Xuanyunning was superior to other traditional Chinese medicines. Xuanyunning could balance both the inheritance of traditional Chinese medicines and the innovation of modern drugs. CONCLUSION A comprehensive evaluation of Xuanyunning based on evidence-based medical evidence， clinical investigation， open data and pharmacoeconomic evaluation proved its high clinical comprehensive values in treating vertigo.

OBJECTIVE To evaluate adherence， persistence， and determinants of use of different classes of glucagon-like peptide-1 receptor agonists （GLP-1 RAs） in patients with type 2 diabetes mellitus （T2DM） using real-world data， and to provide evidence for individualized clinical management. METHODS We conducted a retrospective cohort study using a provincial healthcare database from eastern China， including adults with T2DM who received a first prescription for a GLP-1 RA between January 2018 and October 2024. Adherence was assessed using the proportion of days covered （PDC）， with PDC ≥ 80% defined as good adherence. Persistence was evaluated by the 1-year discontinuation rate and the number of days of continuous use before discontinuation. Logistic regression was applied to identify factors associated with good adherence， and Cox proportional hazards models were used to analyze factors associated with treatment discontinuation. RESULTS The cohort included new users of five GLP-1 RAs： Liraglutide， exenatide， semaglutide， loxenatide， and dulaglutide. Mean PDC ranged from 0.30 to 0.46 across agents， with semaglutide exhibiting the highest mean PDC （0.46±0.32） and exenatide the lowest （0.30±0.26）. The 1-year discontinuation rate ranged from 83.1% to 92.9% （exenatide 92.9% highest； dulaglutide 83.1% lowest）. In multivariable analyses， compared with liraglutide users， semaglutide （OR=1.640， P<0.01） and dulaglutide （OR=1.409， P<0.01） were significantly associated with higher odds of good adherence. Both semaglutide （HR=0.829， P<0.01） and dulaglutide （HR=0.943， P<0.01） were associated with lower risk of discontinuation. CONCLUSION Adherence to and persistence with GLP-1 RAs among patients with T2DM remain suboptimal in real-world practice. Semaglutide demonstrated relatively better adherence and persistence compared with other agents. Patient characteristics such as age， insurance coverage， baseline blood glucose， and comorbid conditions are important determinants of medication use； targeted management strategies are warranted to improve adherence and long-term persistence.

OBJECTIVE To analyze the song formula of “Eighteen Incompatible Medicaments” in Zhang Zihe’s Ru Men Shi Qin，and to identify core drug pairs using Apriori and MIE algorithms and explore their potential toxicity based on network toxicology，thus guiding rational drug use in clinical practice. METHODS Using the ancient Chinese medical books as a main reference and in combination with literature review，a database of prescriptions containing the contents of “Eighteen Incompatible Medicaments” was created. Apriori algorithm and MIE algorithm in IBM SPSS ModelerV18.0 software were applied to analyze the frequency，medicinal properties，association rules，and correlation of pairs. The anti-drug pair with higher confidence，support and MIE value in the association rule analysis was selected. The TCMSP （Traditional Chinese Medicine Systematic Pharmacology Database and Analysis Platform） was used to obtain the components of Pinellia Rhizoma and Aconitum carmichaelii. Their toxicity was predicted by introducing their components into the ADMETlabV2.0 database. The disease targets of respiratory toxicity were obtained using the GeneCard and OMIM databases. The intersecting targets were screened using the online mapping of VennyV 2.1.0，and subjected to the plotting of a protein-protein interaction （PPI） network using the STRING database. A TCM-component-pathway-target network was created using Cytoscape V3.9.0 to screen the core targets. Gene Ontology Function Enrichment （GO） and Kyoto Encyclopedia of Genes and Genes Pathway Enrichment （KEGG） analyses were performed. RESULTS A total of 82 formulas were included，containing 121 groups of anti-drug pairs. Drug pairs with the highest support in the aconite，licorice，and veratrum groups were Pinellia Rhizoma-Aconitum carmichaelii，Flos Genkwa-Radix et Rhizoma Glycyrrhizic，and Ginseng Radix et Rhizoma-Veratri Nigri Radix et Rhizoma. Anti-drug pairs with the largest MIE values were Ampelopsis Radix-Aconitum carmichaelii，Kansui Radix-Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle，and Asari Radix et Rhizoma-Veratri Nigri Radix et Rhizoma. The high-frequency drug pairs of Pinellia Rhizoma-Aconitum carmichaelii had a total of 28 active ingredients and 127 intersecting targets. KEGG pathway enrichment analysis yielded 128 related pathways，which were mainly enriched in the pathways of cancer，PI3K-Akt，tuberculosis，IL-17，etc. CONCLUSION “Eighteen Incompatible Medicaments” in TCM are widely used in ancient clinics，among which the frequency of use of Pinellia Rhizoma-Aconitum carmichaelii drug pairs is the highest. For the clinical application，the use of anti-drug pairs should be treated dialectically and rational under the safety. Network toxicology research on the core anti-drug pairs of Pinellia Rhizoma-Aconitum carmichaelii indicates that the core targets of its potential respiratory toxicity are AKT1 and IL-6，with key signaling pathways including the cancer pathway and the AGE-RAGE pathway. The research results provide new insights into the toxicity mechanism of Pinellia Rhizoma-Aconitum carmichaelii and offer a feasible approach for exploring the modern scientific implications of TCM contraindications through a combination of classical text analysis and modern informatics methods.

Vine tea has a history of several hundred years of “dual-use as medicine and tea” and has been approved as a new food raw material. It has the effects of clearing heat and detoxifying， promoting diuresis and reducing swelling， purging fire and soothing the liver， activating blood circulation and transforming turbidity， and relieving alcohol toxicity. In recent years， with the improvement of people’s health awareness and the continuous exploration of the value of vine tea in disease prevention and treatment as well as health preservation， an increasing number of vine tea-related health products have been developed and applied， and the vine tea industry has also become a pillar industry for economic development in many parts of China. This paper systematically reviews literature on vine tea from ancient times to the present， summarizes its historical evolution as both medicine and tea， chemical constituents， pharmacological effects and mechanisms of action， clinical practice applications， and the current status of R&D of medicinal and health products， and systematically analyzes the key bottlenecks faced by the current development of the vine tea industry. Combined with nearly 20 years of survey， application foundation， and development research practice results of our research group， this paper proposes， for the first time， to fix the origin of vine tea in Laifeng County， Hubei Province， and analyzes and prospectively discusses the vine tea industry chain， development trends， and strategies from three aspects： quality assurance， clinical application， and innovation-driven development， with the aim of providing important scientific evidence for the high-quality development of vine tea medicinal material.

Cyclin-dependent kinase 4/6 （CDK4/6） inhibitors in combination with conventional endocrine therapy significantly enhance progression-free survival and overall survival in hormone receptor （HR）-positive，human epidermal growth factor receptor 2 （HER-2）-negative breast cancer patients，showing a wide range of applications. CDK4/6 inhibitors are metabolized by cytochrome P450 enzymes and transported by some drug transporters. They are susceptible to drug-drug interactions （DDIs） mediated by drug-metabolizing enzymes and drug transporters with other drugs. To ensure the efficacy and safety of CDK4/6 inhibitors in clinical use，this consensus systematically summarized the data on drug-drug interaction of CDK4/6 inhibitors that have been marketed in China for the treatment of breast cancer，and formed relevant consensus opinions to provide references for clinical medical professionals in managing the drug-drug interactions of CDK4/6 inhibitors.

We report a case of interstitial lung disease （ILD） occurring during treatment with furmonertinib in a patient with advanced non‑small cell lung cancer （NSCLC） harboring an epidermal growth factor receptor （EGFR） exon 19 deletion. A patient with advanced EGFR‑mutant （exon 19 deletion） NSCLC received furmonertinib for four months， after which radiographic and clinical findings were consistent with ILD. By reviewing the medication timeline， documenting dynamic imaging changes， and excluding alternative etiologies， the event was judged most likely to be drug‑induced ILD attributed to furmonertinib （grade 4 adverse event）. Furmonertinib was discontinued and systemic glucocorticoid therapy was initiated， after which the patient's condition improved. The patient was subsequently transitioned to a different EGFR‑directed agent （Almonertinib） for maintenance antitumor therapy without recurrence of severe pulmonary toxicity. To our knowledge， this is the first reported case of ILD associated with furmonertinib. The case highlights the need for vigilance regarding potential pulmonary toxicity during furmonertinib treatment and provides a reference for management and subsequent therapeutic decision‑making.

OBJECTIVE To evaluate the efficacy and safety of generic and originator formulations of esomeprazole for treating upper gastrointestinal bleeding. METHODS We searched CNKI，Wanfang Data，VIP，CBM，PubMed，Embase，Web of Science，and the Cochrane Library from inception to October 2024 for clinical studies comparing generic and originator esomeprazole. The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale（NOS）were used to evaluate quality in randomized controlled trials（RCTs）and non-RCTs，respectively. Meta-analyses were performed using RevMan 5.4. Mean difference（MD）was used for continuous outcomes and odds ratio（OR）for binary outcomes. Outcomes not suitable for meta-analysis were described narratively. RESULTS Fifteen studies（13 RCTs and 2 retrospective cohort studies ［RCSs］）including 1 362 patients were eligible. Meta analyses indicated comparable marked response rate between generic and originator groups：OR 0.75，95%CI 0.57–1.00，P=0.05. Overall response rate was also similar：OR 0.64，95%CI 0.39–1.05，P=0.08. Generic formulations appeared to have similar or greater effects on hemoglobin increase and vomiting improvement compared with originators. Subgroup analysis by manufacturer showed no significant difference in hemostatic effect at day 3 for generics produced by Jiangsu Aosaikang Pharmaceutical Co.，Ltd. versus originator：OR 0.87，95%CI 0.60–1.26，P=0.45. However，generics manufactured by CHIA TAI Tianqing Pharmaceutical Group Co.，Ltd. demonstrated a weaker hemostatic effect at day 3 compared with originator：OR 0.63，95%CI 0.41–0.97，P=0.03. Narrative synthesis corroborated similar outcomes for hemostatic efficacy，time to hemostasis，length of hospital stay，and blood loss on day 3 between generics and originators. Safety analysis showed no difference in overall adverse event incidence：OR 1.10，95%CI 0.68–1.78，P=0.69. CONCLUSION Generic esomeprazole formulations demonstrate efficacy and safety broadly comparable to the originator product. However，one manufacturer's generic（CHIA TAI Tianqing）showed a modestly reduced hemostatic effect at day 3. Given limitations in the included studies，these findings should be interpreted with caution.

OBJECTIVE To develop an intelligent， closed-loop traceability management system for narcotics and psychotropic drugs using information technologies and smart devices， enabling dynamic data tracking and accountability-based management. METHODS Leveraging medical Internet technologies， we independently designed and developed three core modules： （1） a dedicated outpatient electronic record system for narcotics and psychotropic drugs to streamline medical record management； （2） an intelligent pharmacy management system for these controlled substances to enable automated dispensing and data-centric control； and （3） a clinical-department information platform to digitize and manage drug ledgers. RESULTS Compared with conventional manual supervision， the intelligent system reduced average dispensing time from （25.24±1.36） minutes to （6.00±0.52） minutes （P<0.05）， increased ledger documentation efficiency by 88%， and achieved 100% data accuracy. CONCLUSION The intelligent traceability system addresses the shortcomings of traditional fragmented management models， enables real-time data monitoring， and establishes a comprehensive closed-loop management framework for narcotics and psychotropic drugs.

OBJECTIVE To construct a whole-dimensional working mode of intensive care unit （ICU） resident pharmacists based on medical teaching and management，evaluate its effectiveness in improving the quality of pharmaceutical services and promoting rational drug use，thus providing references for clinical practice of ICU resident pharmacists. METHODS Selecting the Hepatic ICU of Beijing Tsinghua Changgung Hospital as the pilot ward，a whole-dimensional working mode was created by a deep incorporation of pharmacists into the clinical practice，teaching，research and management，as well as delivering specialized pharmaceutical services. An evaluation system was preliminarily developed to assess the pharmacist’s performance across clinical practice，pharmaceutical indicators，and educational/research activities. RESULTS After once year of exploration，a working mode of ICU resident pharmacists meeting the disease characteristics in our hospital was initially established，and a quantitative index evaluation system for resident pharmacists was formulated. Evaluations showed that all pharmaceutical quality control metrics in the Hepatic ICU significantly improved and met targets，including antimicrobial use intensity，antimicrobial utilization rate，rational prescription review rate，drug cost proportion of total medical expenses，and average drug cost per hospitalization. The standardization of the medication in the department was improved. Resident pharmacists assisted the clinical department in establishing two standards for pediatric medications in ICU and the perioperative anti-infection treatment path of liver transplantation. Dynamic scores of the work of resident pharmacists were all full marks. CONCLUSION This study established a whole-dimensional working mode of ICU resident pharmacists characterized by comprehensive participation and specialized service，demonstrating its effectiveness in improving pharmaceutical care quality and advancing rational drug use. An evaluation system for resident pharmacists has been initially established to promote the work of resident pharmacists in a standardize and quantitative way.

OBJECTIVE To evaluate the present status of Mongolian medicine preparations used in healthcare institutions in the Inner Mongolia Autonomous Region and to identify future development directions. METHODS We collected data from the Inner Mongolia Autonomous Region Drug Administration on Mongolian medicine preparations in medical institutions and compiled information on product types， quantities， dosage forms， and therapeutic indications. Relevant regional policies governing the registration and use of institutional Mongolian medicine formulations were also reviewed and analyzed. RESULTS Institutional Mongolian medicine formulations are predominantly in pill， powder， and decoction forms and are most frequently employed for the management of gastrointestinal disorders. Regional policy measures that favor registration and dispensing of Mongolian medicine preparations have provided substantial support for their development. CONCLUSION As a key branch of ethnic medicine， Mongolian medicine warrants focused research and development. Healthcare institutions should capitalize on their strengths to develop characteristic Mongolian formulations， rediscover and validate classic prescriptions， and promote advancement toward higher‑level outcomes such as standardization and clinical translation.

Postpartum depression spans from pregnancy through 1 year after delivery. Selective serotonin reuptake inhibitors （SSRIs） are guideline-recommended treatments， but prolonged SSRI therapy can precipitate a treatment-emergent manic switch in susceptible patients. We report a case of fluoxetine-associated mania in a patient with a history of postpartum depression and describe the role of clinical pharmacy interventions in managing the event. The clinical pharmacists used medication interviews， pharmacy rounds， and pharmacy follow-up， cooperating with clinicians to analyze disease triggers， risk of manic switching， and drug selection， and provided pharmaceutical monitoring and medication education during diagnosis and treatment. This case offers a warning and reference for medical staff in managing the potential for manic switching during pharmacotherapy of postpartum depression patients.

OBJECTIVE To evaluate the cost-effectiveness of trilaciclib for preventing myelosuppression associated with etoposide/platinum（E/P）first-line chemotherapy in patients with extensive-stage small-cell lung cancer（ES-SCLC），and to provide economic evidence for clinical decision-making. METHODS A Markov model was built in TreeAge Pro 2022 from the perspective of medical institutions. The model simulated the first six cycles of E/P chemotherapy in ES-SCLC patients and compared trilaciclib plus E/P versus long-acting granulocyte-colony stimulating factor（G-CSF，pegfilgrastim）plus E/P for prevention and management of chemotherapy-induced myelosuppression. One-way deterministic and probabilistic sensitivity analyses were performed to assess the impact of parameter uncertainty and model robustness. RESULTS Over the six-cycle horizon，trilaciclib + E/P yielded total costs of ¥53 057 and 4.66 quality-adjusted life years（QALYs），whereas long-acting G-CSF + E/P yielded costs of ¥45 852 and produced 4.02 QALYs. The incremental cost-effectiveness ratio（ICER）for trilaciclib versus long-acting G-CSF was ¥11 299 per QALY. Using a willingness-to-pay（WTP）threshold of ¥95 797（China's 2024 GDP per capita），trilaciclib + E/P was cost-effective. One-way sensitivity analysis identified the costs of trilaciclib，pegfilgrastim，and the E/P regimen as key drivers. Probabilistic sensitivity analysis showed trilaciclib + E/P had the highest probability of being cost-effective once WTP exceeded ¥11 100. CONCLUSION Compared with long-acting G-CSF，trilaciclib added to E/P chemotherapy is likely to be a cost-effective option for preventing chemotherapy-induced myelosuppression in patients with ES-SCLC within the evaluated setting.

Hospital-based traditional Chinese medicines （TCMs） preparations， which integrate TCM theory with clinical practice， represent a crucial source for the development of new TCM drugs. Amid healthcare system reforms and TCM revitalization， transforming hospital preparations into new drugs is crucial for optimizing pharmaceutical resource allocation， enhancing industrial innovation， and ensuring national pharmaceutical strategic security. By integrating China’s healthcare and TCM policies， pharmacoeconomic evidence， and real-world data， this study proposes a “policy-economy-evidence” collaborative model in which policy provides institutional support， economic evaluation establishes a value-assessment system， and real-world data generate actionable evidence. Grounded in this framework， strategic recommendations targeting policy coordination， methodological innovation， and platform development provide theoretical foundations and practical insights into the inheritance， innovation， and high-quality development of TCMs.

To optimize the pharmaceutical service evaluation system and improve service quality， this study systematically searched CNKI， WanFang， VIP， PubMed， Embase， and Medline databases from their inception to November 2024 using Chinese keywords （“pharmaceutical service” “medication therapy management” “service quality” “model”） and their corresponding English terms. After rigorous screening， 46 valid literatures （1 260 initially retrieved） were included for comprehensive analysis. The results showed that the current mainstream pharmaceutical service evaluation models include Markov model， SPO model， 5-GAP model， SERVQUAL model， ECHO model， and ECHQO model. These models are mainly applied in China and the United States， focusing on hospitals and community pharmacies， with core application areas covering medication therapy management of chronic diseases such as hypertension and diabetes， pharmacoeconomic evaluation， service system construction， and quality evaluation （including dimensions such as treatment economy， improvement of clinical indicators， and patient satisfaction）. The study found that although pharmaceutical service evaluation models have been widely applied， foreign research has accumulated more in-depth achievements with more mature evaluation systems， while domestic research faces problems including insufficient quantity， single evaluation indicators， and imperfect systems. Accordingly， it is proposed that medical institutions in China should learn from advanced international experience， construct a diversified and systematic pharmaceutical service evaluation standard system combined with national conditions， give full play to the professional functions of pharmacists， and promote the high-quality development of pharmaceutical services.

Amid ongoing healthcare reform in China， the multi‑campus hospital model operating under a group‑based strategy has emerged as an important pathway for the high‑quality development of public hospitals. Integrated， standardized pharmaceutical management is essential to the efficient operation of such systems； however， challenges persist in extending the pharmaceutical supply chain， scaling pharmacy service coverage， and strengthening quality assurance across multiple campuses. To address these issues， the Department of Pharmacy at the First Affiliated Hospital of the University of Science and Technology of China （Anhui Provincial Hospital） convened a drafting committee comprising experts from more than 60 medical institutions nationwide to develop the Expert Consensus on Pharmaceutical Management in Multi‑Campus Public Hospitals under a Group‑Based Strategy. Using a Delphi process， the consensus proposes a comprehensive framework for pharmaceutical management in multi‑campus hospital systems. The framework spans eleven domains： Pharmacy and Therapeutics （P&T） Committee governance； pharmacy department organization； medicines supply management； dispensing operations and logistics； clinical pharmacy services； pharmacy human resources； pharmacy education and training； pharmaceutical research； pharmacy informatics； pharmaceutical quality control； and professional culture and disciplinary development in pharmacy. The document presents 35 evidence‑based recommendations to provide practical guidance for optimizing pharmaceutical governance， operations， and outcomes in multi‑campus public hospitals across China.

OBJECTIVE To evaluate the cost‑effectiveness of sugemalimab combined with chemotherapy as a first‑line treatment for advanced gastric cancer from the perspective of the Chinese healthcare system. METHODS A three‑state partitioned survival model （progression‑free， progressed disease， death） was constructed to perform a cost‑utility analysis. Clinical inputs were drawn from the GEMSTONE‑303 trial； cost and utility parameters were obtained from relevant databases and published literature. Quality‑adjusted life years （QALYs） were used as the health outcome. We calculated the incremental cost‑utility ratio （ICUR） of sugemalimab plus chemotherapy versus placebo plus chemotherapy and compared it with a willingness‑to‑pay （WTP） threshold of three times China’s per‑capita gross domestic product （GDP）. Model robustness was assessed by one‑way sensitivity analysis （tornado diagram） and probabilistic sensitivity analysis using Monte Carlo simulation with 1 000 iterations. RESULTS Compared with chemotherapy alone， the sugemalimab combination yielded an ICUR of ¥1 437 622.45 per QALY， which far exceeds the WTP threshold of three times per‑capita GDP. One‑way sensitivity analysis identified the per‑cycle cost of sugemalimab as the most influential parameter. Probabilistic sensitivity analysis indicated that the probability of the sugemalimab regimen being cost‑effective at the 3 × GDP WTP threshold was 0%. CONCLUSION At current pricing， sugemalimab combined with chemotherapy is not cost‑effective as first‑line therapy for PD‑L1 high‑expressing （CPS ≥ 5） advanced gastric cancer patients in China.

OBJECTIVE To provide an evidence-based，comprehensive clinical assessment of Sanjin Tablets for urinary tract infections（UTIs）to inform rational drug selection and clinical use. METHODS We combined systematic literature review，expert questionnaire surveys，and decision-analytic modeling to evaluate Sanjin Tablets and comparator therapies across six domains：safety，effectiveness，cost-effectiveness（economy），appropriateness，accessibility，and innovation. RESULTS Safety：No statistically significant differences in adverse events were observed between Sanjin Tablets and comparator drugs. Effectiveness：In the general，diabetic，and female subgroups，Sanjin Tablets administered either alone or in combination with levofloxacin demonstrated clinical equivalence to comparator regimens（no significant differences in primary clinical endpoints）. Economy：Treatment costs for Sanjin Tablets were RMB 618.41，RMB 969.50，and RMB 766.59 in the three respective populations，representing the lowest costs among evaluated options. Appropriateness：Sanjin Tablets ranked highest on expert assessments for tolerability，off-label/excess-label use considerations，medication adherence，and clinical utility. Accessibility：Sanjin Tablets showed clear advantages in product availability and supply stability. Affordability：The cost of a standard treatment course with Sanjin Tablets corresponded to 0.17% of 2024 GDP，the smallest share among the evaluated drugs. CONCLUSION Across multiple domains，Sanjin Tablets exhibit high overall clinical value for treating UTIs，most notably in economic advantage，clinical appropriateness，and accessibility，supporting their consideration for rational clinical use and inclusion in relevant policy decisions.

A patient with pulmonary mucormycosis and renal failure who failed from first-line isavuconazole monotherapy was stuck in the adjustment for antifungal regimen. Through literature review and analysis of pharmacokinetics （PK） and pharmacodynamics （PD） data of isavuconazole， clinical pharmacists systematically evaluated the advantages of local tissue penetration of nebulized amphotericin B. Based on the basic physical condition of the patient and the treatment willingness， a combination therapy of oral isavuconazole and nebulized amphotericin B deoxycholate was adopted to treat pulmonary mucormycosis. Adverse reactions were monitored and therapeutic efficacy was assessed during treatment. After 14 days of combination therapy， the patient’s symptoms markedly improved， manifesting as a significant reduction in pulmonary lesionson computed tomography （CT）. Isavuconazole monotherapy was continuously given for three months after discharge with no relapse after drug withdrawal. This case report demonstrated the efficacy of oral isavuconazole combined with nebulized amphotericin B deoxycholate in treating pulmonary mucormycosis， highlighting the critical role of clinical pharmacists in optimizing PK/PD-guided therapeutic strategies and providing comprehensive pharmaceutical care for complex fungal infections.

METHODS Drawing on the practical training objectives for clinical pharmacy undergraduates and the real-world duties of a pharmacist-managed clinic in a Grade-A tertiary hospital，we designed an assessment system that integrates the mini-clinical evaluation exercise（Mini-CEX）and the objective structured clinical examination（OSCE）. RESULTS A progressive，multidimensional，and comprehensive assessment system was piloted. Interns completed a baseline Mini-CEX before rotation，a repeat Mini-CEX two weeks into the rotation，and a post-rotation OSCE comprising six stations. The combined Mini-CEX/OSCE protocol supported interns’ understanding of outpatient pharmacy services and evaluates their ability to apply pharmaceutical knowledge and clinical reasoning to solve practice-based problems encountered in the pharmacist-managed clinic. CONCLUSION Integrating Mini-CEX and OSCE into a staged assessment system can enhance interns’ core practical skills and offers a practical，reproducible framework for evaluating the clinical competencies of pharmacy undergraduates. OBJECTIVE To develop and provide a reference framework for evaluating the practical competencies of clinical pharmacy undergraduates.

OBJECTIVE To delineate how ward-based pharmacists can operationalize evidence-based safety management for antineoplastic drugs and to map pathways that integrate practice with research， thereby advancing high-quality clinical pharmacy. METHODS We selected Bruton's tyrosine kinase （BTK） inhibitors as a model drug class. Guided by evidence-based medicine and the evidence-ecosystem framework， physician-pharmacist teams conducted a coordinated program comprising drug utilization evaluation， development of clinical prediction models， therapeutic drug monitoring， systematic evidence appraisal and synthesis， and development of an evidence-based consensus statement. RESULTS This study established an end-to-end evidence ecosystem for the safe use of BTK inhibitors， completing the cycle of evidence generation， synthesis， translation， and implementation. The resulting tools and guidance supported safety monitoring and decision-making for BTK inhibitors and strengthened clinical safety practices. CONCLUSION The physician-pharmacist collaborative evidence ecosystem effectively addresses key safety challenges associated with BTK inhibitors while integrating clinical pharmacy practice with research. This approach offers a transferable paradigm for the safety management of other high-risk drugs and is applicable across clinical specialties to advance high-quality clinical pharmacy.

Furmonertinib，a third-generation EGFR tyrosine kinase inhibitor，is increasingly used to treat non-small cell lung cancer. As its clinical use expands，recognition and characterization of adverse events have become important. We describe an elderly woman with a primary pulmonary malignancy who developed peripheral neuropathy following initiation of furmonertinib. By analyzing the development and progression of the adverse reaction，causality assessment，and potential mechanisms，we highlight the need to monitor patients' neurological function during clinical use.

OBJECTIVE From the perspective of the Chinese healthcare system， to evaluate the cost–utility of encorafenib plus cetuximab in combination with mFOLFOX6 （oxaliplatin， leucovorin， and fluorouracil） as first‑line treatment for patients with BRAF V600E‑mutant metastatic colorectal cancer. METHODS Based on data from the phase III BREAKWATER trial， a three‑state partitioned survival model （progression‑free survival， progressed disease， death） was developed to compare encorafenib plus cetuximab with mFOLFOX6 （experimental arm） versus mFOLFOX6 plus bevacizumab （comparator arm）. A 28‑day cycle length and a 10‑year time horizon were applied. Quality‑adjusted life years （QALYs） served as the effectiveness metric. Costs and outcomes were discounted at 5% annually. The incremental cost‑effectiveness ratio （ICER） was used as the primary decision metric. Deterministic （one‑way） and probabilistic sensitivity analyses， as well as scenario analyses， were performed. RESULTS The base‑case cost–utility analysis produced an ICER of ¥2 153 601.16 per QALY for the experimental arm versus the comparator， substantially exceeding the willingness‑to‑pay threshold of three times China's 2024 per‑capita GDP （¥287 247）. One‑way sensitivity analysis identified key drivers of the result as PFS estimates， utility values for the PFS and PD health states， the costs of encorafenib and cetuximab， and the discount rate. Probabilistic sensitivity analysis confirmed the robustness of the base‑case findings. Scenario analyses indicated that the regimen would become cost‑effective only under substantial price reductions， for example， when encorafenib is reduced to 10% of its current price while cetuximab is reduced to ≤20% of its current price. CONCLUSION Using three times China's 2024 per‑capita GDP as the willingness‑to‑pay threshold， encorafenib plus cetuximab combined with mFOLFOX6 is not cost‑effective as first‑line treatment for BRAF V600E‑mutant metastatic colorectal cancer compared with the standard mFOLFOX6 plus bevacizumab regimen.

The management of narcotic drugs and psychotropic substances （narcotic and psychotropic drugs） in medical institutions is characterized by strictness and complexity. In order to promote the standardized application of intelligent management equipment for psychotropic and narcotic drugs，the Intelligent Special Committee of China Narcotic Drugs Association and the Smart Pharmacy Special Committee of the China Human Health Science and Technology Promotion Association，along with relevant experts，based on multiple rounds of Delphi method and seminar，reached this expert consensus.The consensus clarified the core functional requirements of intelligent equipment in terms of system docking，drug safety assurance，inventory management，process optimization and full-process traceability. It emphasized the importance of data security，emergency plans，personnel training and multi-department collaboration，and put forward standardized management process suggestions for key aspects such as drug warehousing and acceptance，storage and supply，receipt and deployment，returned drug recycling and empty ampoule/waste patch disposal.This consensus is designed to provide reference for the configuration，application and maintenance of intelligent equipment for narcotic and psychotropic drugs in medical institutions，to promote the full-process closed-loop management of psychotropic and narcotic drugs and to improve the level of intelligent supervision.

OBJECTIVE To compare the efficacy and safety of potassium‑competitive acid blockers （P‑CABs） and proton pump inhibitors （PPIs） for maintenance therapy of erosive esophagitis （EE） at ≥24 weeks after initial healing， and to evaluate the utility of DeepSeek in key systematic‑review tasks （screening， data extraction， risk‑of‑bias assessment）. METHODS We conducted a systematic search of PubMed， Web of Science， Embase， Wanfang， CNKI， and VIP from database inception through May 31， 2025. Meta‑analyses were performed using RevMan 5.4.1. Using DeepSeek’s “deep thinking” mode， we developed standardized prompts for literature screening， data extraction， and risk‑of‑bias evaluation； outputs were benchmarked against manual review to assess accuracy and efficiency. RESULTS Seven randomized trials met inclusion criteria. At 24 weeks of maintenance， vonoprazan 10 mg and 20 mg were both superior to lansoprazole 15 mg in preventing EE recurrence （RR 0.53， 95% CI 0.33–0.85 and RR 0.34， 95% CI 0.15–0.79， respectively）. The benefit was more pronounced in patients with severe EE （RR 0.51， 95% CI 0.36–0.73 for vonoprazan 10 mg； RR 0.23， 95% CI 0.08–0.66 for vonoprazan 20 mg）. Tegoprazan 25 mg did not differ significantly from lansoprazole 15 mg. Over extended follow‑up （up to 260 weeks）， lansoprazole was associated with a higher recurrence rate compared with vonoprazanas maintenance duration increased. Safety analyses showed a modestly higher overall adverse‑event rate forvonoprazan 20 mg versus lansoprazole 15 mg at 24 weeks （RR 1.10， 95% CI1.01–1.20）；vonoprazan 10 mg andtegoprazan 25 mg did not differ significantly from lansoprazole in total or serious adverse events. Vonoprazan treatment led to significantly elevated serum gastrin levels at both 24 and 260 weeks compared with lansoprazole， whereas tegoprazandid not produce a notable gastrin increase. Regarding DeepSeek performance， the tool returned standardized outputs for the prompt sets. Mean per‑article times were 3–5 seconds for screening， 1–3 minutes for data extraction， and 3–5 minutes for risk‑of‑bias assessment. Compared with manual review， DeepSeek achieved literature‑inclusion accuracy of 87.5%， data‑extraction completeness of 96.4%， extraction accuracy of 99.7%， and concordance with manual risk‑of‑bias judgments of 85.7%. CONCLUSION Vonoprazan 10 mg appears to offer superior maintenance efficacy for EE and may represent the most effective current option； however， clinicians should monitor for hypergastrinemia. Tegoprazan 25 mg showed comparable outcomes to lansoprazole. DeepSeek substantially accelerates core systematic‑review processes with acceptable accuracy， indicating potential utility as an assistive tool in evidence synthesis workflows.

Sintilimab，an anti-programmed death-1 （PD-1） immune checkpoint inhibitor，is increasingly used across multiple tumor types. While immune-related adverse events （irAEs） are well described with PD-1 inhibitors，severe （grade 4） immune-related liver injury is uncommon but can be life-threatening. Published data on grade 4 hepatotoxicity attributable to sintilimab remain sparse. We report a case of severe immune-related liver injury in a patient with lung squamous cell carcinoma after sintilimab therapy. We detail the patient’s clinical presentation，laboratory and imaging findings，and the diagnostic and therapeutic course. Integrating this case with a review of domestic and international literature，we summarize evidence-based treatment approaches and key elements of pharmaceutical monitoring and safety management for sintilimab-associated grade 4 liver injury，which may provide reference for clinical management of such drug adverse events.

OBJECTIVE To investigate the mechanism of Polygonatum sibiricum in the treatment of sarcopenia through network pharmacology， molecular docking， and experimental validation. METHODS Active ingredients of Polygonatum sibiricum and potential targets of sarcopenia were screened using relevant databases. Core targets were identified through topological analysis via Cytoscape and STRING. Gene ontology （GO） and Kyoto encyclopedia of genes and genomes （KEGG） pathway enrichment analyses were performed to elucidate the underlying mechanisms. Molecular docking was conducted using AutoDockTools to validate the interactions. The effects of Polygonatum sibiricum extract （PSE） on the proliferative activity of C2C12 cells were detected using the cell counting kit-8 （CCK-8） assay. Cell differentiation into myotubes was induced using 2% horse serum， and an in vitro sarcopenia model was established by inducing myotube atrophy with 100 μmol·L^–1 dexamethasone. The cells were divided into the control group， dexamethasone group， and low-dose， medium-dose， and high-dose PSE groups （0.3， 0.6， and 1.2 mg·mL^–1， respectively）. Protein levels of front fork transcription factor 3 （FOXO3）， muscle ring finger 1 （MuRF1）， and muscle atrophy F-box （Atrogin1） were detected by Western blot （WB）. Myotube atrophy was assessed by Giemsa staining. An in vivo sarcopenia mouse model was established by D-galactose （D-gal） induction. Forty male C57/BL6 mice were randomly assigned to the control group， model group， and low-dose and high-dose PSE groups （60 and 120 mg·kg^–1， respectively）. After 8 weeks of interventions， grip strength and exhaustive running time were measured. Histopathological changes in muscle tissue were observed by hematoxylin-eosin （HE） staining and Sirius red staining. The expression levels of MuRF1， Atrogin1， and epidermal growth factor receptor（EGFR）/phosphoinositol-3 kinase（PI3K）/protein kinase B （Akt） were detected by reverse transcription quantitative polymerase chain reaction （RT-qPCR） and WB. RESULTS A total of 10 active ingredients of Polygonatum sibiricum and 260 potential targets were identified. An intersection with sarcopenia-related targets consisted of 34 common targets. Topological analysis yielded 13 core targets， including EGFR， ESR1， and MMP9. KEGG enrichment analysis indicated the PI3K/Akt pathway as a key signaling involved in Polygonatum sibiricum in treating sarcopenia. Molecular docking confirmed stable binding between the active compounds and the core targets. CCK-8 assays demonstrated that PSE significantly promoted the proliferation of C2C12 cells. WB and Giemsa staining results indicated that PSE alleviated dexamethasone-induced myotube atrophy in C2C12 cells. Animal experiments showed that PSE significantly improved grip strength and exercise endurance in sarcopenic mice. HE staining revealed a significant increase in the cross-sectional area of muscle fibers， and Sirius red staining showed a significant reduction in collagen deposition. WB and RT-qPCR analyses further demonstrated that PSE significantly downregulated MuRF1 and Atrogin1， while activating the EGFR/PI3K/Akt pathway. CONCLUSION Polygonatum sibiricum can ameliorate sarcopenia by activating the EGFR/PI3K/Akt signaling pathway， thereby inhibiting the expression of muscle atrophy-related genes.

OBJECTIVE To assess the cost‑effectiveness of adjuvant atezolizumab versus standard supportive care in patients with resected stage Ⅱ-ⅢA non‑small cell lung cancer （NSCLC） who are EGFR/ALK mutation-negative and have PD‑L1 tumor expression ≥50%. METHODS We developed a Markov model grounded in the IMpower010 trial and adopted a societal perspective to estimate lifetime costs and health outcomes. Model inputs included progression‑free survival （PFS） and overall survival （OS） estimates， health state utilities， direct medical costs， and IMpower010‑derived treatment effects. We conducted scenario and sensitivity analyses （one‑way and probabilistic） to test the robustness of results and used Monte Carlo simulation for probabilistic sensitivity analysis. RESULTS In the base‑case lifetime analysis， adjuvant atezolizumab yielded higher effectiveness （3.81 QALYs vs. 3.36 QALYs） at increased cost （CNY 96 606 vs. CNY 79 819）， producing an ICER of CNY 37 304 per QALY gained. At a willingness‑to‑pay （WTP） threshold of three times the 2024 national per‑capita GDP， atezolizumab was cost‑effective. Scenario analyses produced consistent conclusions. One‑way sensitivity analysis identified patient age as the parameter with the greatest influence on the ICER. Probabilistic analysis indicated that at a WTP equal to one times per‑capita GDP， the probability that atezolizumab is cost‑effective was 78.2%. CONCLUSION For patients with resected stage II-IIIA NSCLC who are EGFR/ALK wild‑type and have PD‑L1 ≥50%， adjuvant atezolizumab appears to be a cost‑effective and economically favorable option compared with standard supportive care.

Obesity is recognized by the World Health Organization as one of the top ten chronic diseases and substantially increases the risk of metabolic and cardiovascular disorders compared with normal-weight individuals. Early management currently relies on lifestyle modification； although bariatric surgery produces significant and durable weight loss， its broader use is limited by perioperative risks and complications. There is therefore an urgent need for safe and effective pharmacologic options to help patients reduce body mass. Advances in understanding body-weight regulation and the gut-brain axis in appetite control have driven rapid progress in anti-obesity drug development. Glucagon-like peptide-1 receptor agonists （GLP-1 RAs） have demonstrated robust weight-loss efficacy and have been approved by the US Food and Drug Administration and National Medical Products Administration. Next-generation therapies focus on combining GLP-1 RAs with other gut-pancreatic hormone-targeting agents； at the same time， non-gut-pancreatic hormone targeted drugs and small-nucleic-acid therapeutics are under development. This review summarizes recent clinical research progress on single-target and multi-target gut-pancreatic hormone agents， non-gut-pancreatic hormone targeted drugs， and small-nucleic-acid therapies for obesity.

OBJECTIVE To investigate the protective effect of rebamipide on non-steroidal anti-inflammatory drug （NSAID）-associated small intestinal injury （SII） and its relationship with the gut microbiota. METHODS SII was induced in rats by oral gavage of diclofenac， followed by treatment with rebamipide. Fecal samples were collected for 16S rRNA sequencing to examine the changes in gut microbiota composition and their associations with proinflammatory cytokines. RESULTS Alpha diversity was significantly decreased in the diclofenac group but increased in the rebamipide group. At the genus level， the abundances of Bifidobacterium， Allobaculum and Adlercreutzia were significantly reduced， whereas Lactobacillus was increased in the diclofenac group. On the other hand， the rebamipide group showed increased abundance of Bifidobacterium. The most predominant genera were Corynebacterium， Candidatus Arthromitus and Staphylococcus in the diclofenac group， and Providencia， Helicobacter， Turicibacter， Veillonella， Clostridium in the rebamipide group. Functional prediction analysis revealed that the PWY-5741 metabolic pathway was significantly decreased in the diclofenac group， while the PWY-5677 and P381-PWY metabolic pathways were upregulated in the rebamipide group. Bifidobacterium abundance was negatively correlated with the expression of interleukin-6 （IL-6）， interleukin-1 beta （IL-1β）， and tumor necrosis factor alpha （TNF-α）， but positively correlated with the expression of zonula occludens-1 （ZO-1） and Claudin-1. Allobaculum abundance was negatively correlated with IL-6， IL-1β， and TNF-α expression. Turicibacter and Veillonella abundance were negatively correlated with IL-1β and IL-6， respectively. CONCLUSION Rebamipide may effectively attenuate NSAID-induced intestinal inflammation and stabilize the intestinal mucosal barrier by modulating the composition and function of the gut microbiota.

OBJECTIVE To obtain adverse drug event （ADE） information of mavacamten in the US Food and Drug Administration （FDA） Adverse Event Reporting System （FAERS） database，and to conduct a comprehensive and in-depth exploration and assessment of its safety，thus promoting its rational application. METHODS The original data about ADE reports related to mavacamten provided by the FAERS database was searched from January 1，2022 to September 30，2024 and analyzed using Python software. The signal detection indicators used were reporting odds ratio （ROR） and proportional reporting ratio （PRR），and the corresponding threshold value standards were set. The ADEs were statistically analyzed and systematically classified. RESULTS A total of 1 913 ADE reports of mavacamten were collected，and 119 effective signals were identified，involving 20 system organ classifications （SOC），mainly including cardiovascular diseases，systemic diseases，various reactions at the site of administration，and various examinations. ADEs with the leading frequency of reporting were atrial fibrillation （133 cases），dyspnea （132 cases），and fatigue （131 cases）. ADEs with the leading frequency of ROR involved cardiovascular symptoms （164.338），left ventricular ejection fraction reduction （63.244），and contractile function disorder （38.234）. At the same time，new ADEs were also discovered，such as atrial fibrillation，infectious diseases，gastrointestinal diseases，and hypertension. CONCLUSION In addition to the ADEs recorded in the instruction manual of mavacamten，ADEs outside the instruction manual，such as atrial fibrillation events and the risk of infection should also be concerned to promptly make clinical interventions.

This case report aimed to evaluate pharmacist-led medication monitoring and intervention for a patient with Chest Bi Disorder and Heart Pain， guided by the theoretical framework of the Tang-ye-jing-fa Map. An elderly woman was admitted with a chief complaint of dull chest pain lasting over one year. Traditional Chinese medicine （TCM） diagnosis indicated phlegm and blood stasis obstructing the meridians. Using the principles of “deficiency–excess of the five zang organs” and “tonifying and purgative functions of the five flavors” from Fuxingjue， the pathomechanism was differentiated as： heart deficiency with excess， liver deficiency with excess， kidney deficiency， spleen deficiency with dampness， and lung deficiency. A formula strategy emphasizing bitter and sour as primary flavors， with acrid （pungent）， salty， and sweet as auxiliaries， was adopted. The prescription was dynamically optimized by adjusting the flavor composition from "four acrid， three bitter， two sweet， and one salty" to "seven sour， four bitter， one sweet， and one salty，" refining the regimen over time. Symptoms including chest pain， dizziness， headache， and bilateral lower-limb numbness were markedly relieved， and the accompanying symptoms—such as poor sleep， dry mouth， and a bitter taste in the mouth—also improved substantially. The clinical pharmacist used the Tang‑ye‑jing‑fa Map as a decision-support tool， mapping changes in medicinal flavor composition onto the diagram. Visual comparison illustrated how adjustments in the five flavors aligned with shifts in principal therapeutic actions and with changes in the deficiency–excess states of the five zang organs， supporting iterative regimen refinement. The Tang‑ye‑jing‑fa Map can systematically guide the integration of TCM theory with pharmacist-led medication monitoring. By leveraging the correspondence between the five flavors and the five zang， it enables precise regulation of drug–disease dynamics and provides theoretical and methodological support for the treatment of complex， multi-symptom presentations.