Objective In order to improve the rationalization of medication use for thrombosis prevention and treatment in children,the guideline aims to develop a comprehensive and practical guideline for pharmacy practice in the prevention and treatment of thromboembolic diseases in children.Through a systematic review of the available evidence-based medical evidence,specific recommendations for drug prevention and treatment are presented. Methods The World Health Organization (WHO) guideline development manual was used for the study design of the guideline.A systematic search and extensive collection of common medication problems for the prevention and treatment of thrombosis in children existed nationwide,and the Delphi method was used to research experts and determine the final clinical problems to be included.Then,a systematic literature search was conducted to comprehensively assess the existing original studies,systematic evaluations,and guidelines or consensus of professional organizations.Quality evaluation was conducted according to the grades of recommendations assessment,development and evaluation(GRADE) method,and consensus on the recommendations and level of evidence was reached again through the Delphi method,which ultimately led to the formation of the pharmacy practice guidelines for the prevention and treatment of thromboembolic diseases in children. Results A total of 29 clinical problems assessed by 74 experts in clinical pharmacy and clinical medicine were collected during the development of the guideline;15 clinical problems were screened through two rounds of questionnaires;and 15 clinical medication recommendations were developed under the supervision of two methodologists. Conclusion By comprehensively evaluating the feasibility and safety of clinical practice,the guideline will provide specific antithrombotic medication recommendations for pediatric healthcare professionals,which will help improve the prevention and treatment of thrombosis in children and promote more standardized and effective medical practice.

The lack of preoperative guidelines for the management of drugs for psychiatric disorders will affect the quality of surgical management of psychiatric patients and increase the probability of perioperative complications.To standardize the preoperative management of medications for the treatment of mental disorders,the Perioperative Assessment and Quality Improvement Society issued 《Preoperative Management of Medications for Psychiatric Diseases: Society for Perioperative Assessment and Quality Improvement Consensus Statement》 in February 2022 to provide clinicians with recommendations for the preoperative management of psychotropic medications.This article interpreted the consensus,summarized the perioperative interactions,special precautions,and auxiliary examination precautions,and provided corresponding preoperative suggestions on antidepressants,mood stabilizers,anxiety,antipsychotics,and attention deficit hyperactivity disorder drugs,to provide a reference for the standardized management of perioperative drugs.

To promote the development of the prescription-based processing of Chinese herbal pieces,the China Association of Chinese Medicine published the social organization standard of the Standard for Prescription-based Processing of Chinese Herbal Pieces (T/CACM 1367-2021)in June 2021.The standard was led by the First Affiliated Hospital of Henan University of Chinese Medicine and Jiangsu Province Hospital of Chinese Medicine.It was jointly drafted by 28 Traditional Chinese medical institutions across the country.This paper introduced the standards in detail to promote the implementation and propel the inheritance and innovation of the processing of Chinese herbal pieces.

Objective To explore the enrichment method of the crude alkaloid of Zanthoxylum nitidum (Roxb.) DC.(Z.nitidum),which can inhibit the proliferative activity of human erythroid leukemia cells (HEL cells) in vitro,and to provide a scientific basis for the antitumor activity of Z.nitidum. Methods Z.nitidum was extracted using different concentrations of ethanol (60%,70%,80%,90%,and 100%) to determine the optimum extraction conditions according to the highest extraction rate.Static and dynamic adsorption determined the adsorption capacity of different macroporous resins (HPD 100,XDA-5,D101,HPD 722,HPD 400) on the ethanol extracts from Z.nitidum.The effects of crude alkaloids on the proliferation activity of HEL cells in each group were studied by the MTT method. Results Z.nitidum was extracted from 60%,70%,80%,90%,and 100% ethanol,and the extract with 60% ethanol concentration had the highest yield (11.937±0.002)%.Static and dynamic adsorption experiments showed that the adsorption capacity of the above five kinds of macroporous resins was 1:500 (extract of Z.nitidum :macroporous resin).The crude alkaloids enriched by different macroporous resins have different effects on the proliferation activity of HEL cells.The inhibition rates (%) at a concentration of 80 μg·mL^-1 of Z.nitidum were (59.62±3.46)% (XDA-5),(55.81±5.16)% (HPD 100),(59.33±1.33)% (D101),(79.63±1.02)% (HPD 722),and (83.97±0.38)% (HPD 400),respectively.HPD 400 macroporous resin-enriched crude alkaloids inhibited the proliferation of HEL cells most significantly (P<0.01). Conclusion The process of enriching the crude alkaloids of Z.nitidum using macroporous resin was simple and feasible,and the crude alkaloids enriched by HPD 400 showed significant inhibitory effects on HEL cells with good anti-leukemic activity.

Objective To study the effect and mechanism of paeonol (PAE) on renal interstitial fibrosis in rats. Methods The rats were randomly divided into sham operation (Sham) group,unilateral ureteral obstruction (UUO) group,PAE low dose (PAE-L) group, PAE medium dose (PAE-M) group, PAE high dose (PAE-H) group and irbesartan (IRB) group. Except for the Sham group,the UUO model was established in other groups. Each group was given a corresponding intervention for two weeks. Serum creatinine (Scr),blood urea nitrogen (BUN),serum 8-hydroxydeoxyguanosine (8-OHdG) levels,renal tissue superoxide dismutase (SOD),glutathione peroxidase (GPX) activities,α-smooth muscle actin (α-SMA), type Ⅰ collagen (Col-Ⅰ),fibronectin (FN),silent information regulator 1 (SIRT1), nuclear factor E2-related factor 2 (Nrf2) protein expression were detected;observe pathological changes of kidney tissue and calculate collagen volume fraction (CVF). Results Compared with the UUO group,the serum levels of Scr,BUN,and 8-OHdG in each dose group of PAE were decreased,the activities of SOD and GPX in kidney tissue were increased,the positive expressions of α-SMA,Col-Ⅰ and FN in kidney tissue were decreased,and the protein expressions of SIRT1 and Nrf2 were increased. Masson staining showed a decrease of CVF in renal tissue (all P<0.05),and HE staining showed a different degree of improvement in pathological changes such as inflammatory cell infiltration and tubular dilatation in renal tissue;PAE improves renal interstitial fibrosis in rats in a dose-dependent manner (P<0.05),and the effect of large dose PAE on renal interstitial fibrosis in rats was similar to that of IRB. Conclusion PAE can alleviate UUO-induced rat renal interstitial fibrosis and oxidative stress,and improve rat renal function. And this mechanism may be related to the activation of the SIRT1/Nrf2 signaling pathway.

Pharmacy practice in e-hospital is an innovative form that greatly enhances the accessibility, efficiency, and convenience of medical services, providing continuous health management and chronic disease drug treatment management for patients.To ensure the quality of pharmacy practice in e-hospitals, the standard formulation team for pharmacy practice in e-hospitals adhered to the principles of scientific, universal, instructive, and operability.They comb through key management content from national policy documents, domestic and international standards and regulations, and literature analysis.Combined with the actual work situation of pharmacy practice in e-hospitals, the standard is formulated through multiple rounds of opinion collection and expert verification.This paper interprets the key content of the standard, including basic requirements, service content and processes, and quality management and evaluation improvement, to provide guidance and reference for managers and pharmacists to deeply understand the standard and further enhance the quality of pharmacy practice in e-hospitals.

Off-label use means that the intended use of the drug is not included in the instructions approved by the National Medical Products Administration,including unapproved indication,dosage,the course of treatment,route of administration,or population.The formulation of Pharmaceutical Supply Services-Key Medications Management-Off-label Uses is based on relevant laws,regulations,normative documents,guidelines,literatures,and expert opinions,and follows the principles of scientificity,versatility,instructiveness,and operability.This standard regulates and standardizes the institutional and organizational construction,process management,and the whole process of quality management and evaluation improvement of off-label uses,which is the basis for medical institutions to carry out off-label uses management.This article introduced the formulation process of the off-label uses standard and analyzed the key contents of the standard,which would help medical institutions to better comply with and meet the requirements of this standard in the practice of off-label use management.

The pharmacy department of medical institutions assumes important responsibilities in the emergency response work.The standard of pharmacy administration in emergencies is formulated based on the principles of scientificity,versatility,instructiveness,and operability,through sorting out problems,collecting opinions and expert argumentation.This standard has 49 standards of 9 key elements from three aspects:emergency mechanism,emergency support,and emergency services.This article aims to introduce the construction method and formulation process of the pharmacy administration in emergency standards,and analyzes the content,to guide for improving emergency response ability of the medical institutions' pharmacy department in emergency events.

To improve patient-centered pharmaceutical management and pharmaceutical service capabilities in the pharmaceutical department of medical institutions,automation and information technology are indispensable.The Pharmacy Administration-Automation and Information Technology is one of the social organization standards of the Chinese Hospital Association as part 4-4 of Pharmaceutical Administration and Pharmaceutical Practice in Healthcare,which standardizes 32 key elements in four aspects:basic requirements for automation construction in medical institutions,construction of automation hardware equipment,construction of intelligent information platform,and quality management and continuous improvement.It can be used to guide medical institutions at all levels to select and optimize pharmacy automation equipment and information platforms.This article introduced the construction methods and contents of the pharmacy automation and information technology standards,to deepen the understanding of peers on this standard and promote its implementation.This article aimed to promote the modernization,informatization,and intelligence of pharmaceutical services in medical institutions,and improve the quality and efficiency of overall medical pharmaceutical administration and service.

The construction of a medication safety culture is important for medication safety management and rational drug use.The construction of medication safety culture standards is formulated based on relevant national policies and regulations,accreditation standards for hospitals,expert opinions,the current situation,and the development trend of the healthcare industry.With scientificity,general applicability,instructive guidance,and practicality,they standardized basic requirements,management processes,and improvement of the construction of medication safety culture.To facilitate understanding and the implementation of the standards,we describe the process of standards formulation and explain the key points of the standards.

Extracellular vesicles (EV) are a group of membrane-bound structures that originate from the endosomal system or are shed from the plasma membrane of cells.EVs can carry a heterogeneous set of molecules,including proteins,lipids,nucleic acids,and membrane receptors from their cell of origin.EV can cross the blood-brain barrier,allowing brain-derived EV (BDEV) to be specifically extracted from peripheral blood using surface markers on neuronal cells.Due to the presence of signals from the central nervous system,such as proteins,lipids,and nucleic acids,BDEV has emerged as a promising tool for exploring the central nervous system.This article provided an overview of the feasibility of BDEV as biomarkers for neurological and psychiatric disorders,as well as their potential for monitoring therapeutic efficacy in the treatment process.

Objective To explore the effects of drug therapy combined with multi-dimensional psychological intervention on the insomnia of shift medical staff in "sunshine hospital" mode,and to provide a reference for improving the physical and mental health of shift medical staff. Methods A total of 140 cases of medical staff with insomnia in shifts in Wuhan were included and divided into study group and control group by random number table method,70 cases in each group.The control group was given drug treatment,and the study group was treated combined with multi-dimensional psychological intervention.based on "sunshine hospital" model.The scale and questionnaire of PSQI,ISI,ESS and FAS were used to evaluate sleep status and HAMD,HAMA,PHQ-9 and SAS were used to evaluate psychological status,at baseline,visit 1 (baseline + intervention for 1 month) and visit 2 (baseline + intervention for 3 months),respectively. Results (1) Sleep status:There were differences in 7 dimensions of PSQI score,ISI,ESS,and FAS score between the study group and the control group at different periods (P<0.05);Among them,the PSQI scores of the two groups showed significant difference between the two groups at interview 2 (P<0.05);There were significant differences in sleep quality,sleep efficiency scores,ESS and FAS between the two groups at visit 1 and visit 2 (P<0.05).(2) Psychological status:HAMD,HAMA,PHQ-9 and SAS scores of the study group and the control group were different in different periods (P<0.05).At interview 2,there were significant differences in HAMA and SAS scores between the two groups (P<0.05). Conclusion Based on the "sunshine hospital" model of drug therapy combined with multi-dimensional psychological intervention,it can significantly improve sleepiness,fatigue symptoms,sleep quality,sleep efficiency,and anxiety and depression of first-line shift medical staff in the short term,and significantly alleviate overall insomnia and anxiety in the long term.

Hemophilia B (HB) is a recessive congenital bleeding disorder with X-linked inheritance.The treatments for HB have made tremendous progress during past decades.Treatment paradigm shifting from prothrombin complex to plasma-derived coagulation factor IX (FIX) significantly improved the safety of patients.Bioengineered recombinant FIXs (rFIXs) with extended half-life compared to rFIXs ameliorat patient's compliance and clinical outcomes.Non-factor replacement therapies could reduce the burden of treatment through subcutaneous injection and avoid the risk of developing inhibitors to FIX.Meanwhile,these molecules could provide effective prophylaxis in the presence or absence of inhibitor.Genetically modified adeno-associated virus engineered to deliver FIX gene to the liver has heralded a new era of HB treatment.A comprehensive intelligence tracking of the treatments for HB,including currently marketed pharmaceuticals,pipelines of molecules under development and related research results is the focus of this paper.

Notch signaling pathway regulates cell development,differentiation,proliferation,and apoptosis,one of the most important pathways that determine cell fate.Research has found that the Notch pathway is involved in developing rheumatoid arthritis (RA).In this article,we reviewed the composition,activation pathway,function,and role of the Notch pathway in RA,and analyzed the research progress of the Notch pathway in macrophages,osteoclasts,vascular endothelial cells,lymphocytes,and fibroblast-like synovial cells.Further exploration of the mechanism of the Notch pathway in RA can provide direction for clinical drug development and new targets for treating RA.

The research on taste masking of traditional Chinese decoction is mostly focused on the use of taste or intelligent sensory equipment in macroscopic view,which makes it difficult to explain its internal mechanism microscopically.Computer simulation ( CS ) can describe the mechanism of material action from a microscopic or mesoscopic perspective and has been widely used in materials science and other fields.The decoction is a complex system composed of various types of bitter or non-bitter small molecules.Although it is difficult to apply CS directly,CS can still be used to study the taste masking mechanism based on the current decoction taste masking technology.In this paper,the general situation of taste masking of decoction and CS technology is briefly introduced.Based on the application of CS in other fields,the advantages and future application directions of CS in the research field of bitter mechanism and taste masking mechanism of traditional Chinese medicine decoction are discussed from the perspective of the interaction between the bitter molecule and taste masking molecule,bitter molecule,and bitter receptor,taste masking molecule and bitter receptor,bitter molecule / taste-masking compound and bitter receptor.It provides ideas for exploring new methods of taste masking of traditional Chinese medicine decoction and enriches the research of taste masking of traditional Chinese medicine.

Objective To evaluate the differences in chemical composition and pharmacological effects between Angelica-Astragalus medicine pair decoction (DGD) and traditional decotion,and to provide a reference for the rational clinical application of Danggui Buxue decoction. Methods With the two comparison methods of unified and non-uniform raw material source batches,we set up different sample groups,established characteristic maps by HPLC,and evaluated the chemical components based on the similarity of characteristic maps,component types,index component content,common peak area,and other factors.The efficacy of the drug was evaluated in the hemorrhagic blood deficiency model mice. Results ①The similarity of the feature map between the DGD and TD was high (similarity was greater than 0.87).②The number of chromatographic peaks was inconsistent.Traditional decoction from self-purchased decoction pieces,or traditional decoction-Factory A decoction pieces had a total of 12 chromatographic peaks each.The DGD of Factory A had a total of 15 chromatographic peaks.There were 10 chromatographic peaks in the DGD of Factory B.③The contents of ferulic acid and calycosin 7-O-glucoside (CG) in DGD of Factory A were higher than those in traditional decoction (P<0.05,n=3).There was no significant difference between DGD and TD ferulic acid content in Factory B,but the content of CG was lower than that in traditional decoction (P<0.05).④The total area of common peaks in DGD was different from that in TD.The relative total ratios of the contents of the components in the self-purchased traditional decoction pieces,the traditional decoction pieces of Factory A,the formula granules of Factory A,and the formula granules of Factory B were 1.00,0.96,2.14,0.60,respectively.⑤Both DGD and traditional decoction could significantly promote the recovery of hemoglobin and red blood cells in hemorrhagic anemia model mice (P<0.01);Compared with the model control group,there was a significantly difference (P<0.05) except for the DGD group of Plant B.There was no significant difference between DGD and TD of Plant A,but there was a very significant difference between DGD and TD of Plant B (P<0.01). Conclusion Whether the raw material source batch is consistent or not,DGD and TD have certain differences in chemical composition.In terms of pharmacological effect,DGD,prepared from a unified batch of decoction pieces,has similar efficacy to traditional decoction in alleviating hemorrhagic anemia.There are certain differences in the pharmacological effects between DGD prepared from different batches of decoction pieces and traditional decoctions.The differences caused by the different preparation processes of the same source batch of prepared slices were compared,and the quality differences of the formula granules from different manufacturers were caused by the different source batches of prepared slices and different preparation processes,indicating the necessity and urgency of the country to formulate a unified quality standard for formula granules and related process specifications.

Objective To establish a quantitative analysis of multi-components by single-marker (QAMS) method for the simultaneous determination of 11 components in Fazhi Banxia Qu (including Pinelliae Preparata, Fritillariae Cirrhosae Bulbus, and Exocarpium Citri Grandis), and combined with grey relational analysis (GRA) and entropy weight-technique for sequencing by approximate ideal solution or technique for order preference by similarity to ideal solution (EW-TOPSIS) analysis to comprehensive evaluate the quality of Fazhi Banxia Qu. Methods The Shimadzu C₁₈ column was used, and the mobile phase consisted of acetonitrile-0.5% glacial acetic acid in a gradient elution manner,the flow rate was 1.0 mL·min^-1,and the detection wavelength were set at 254 nm and 290 nm.Ethyl-p-methoxycinnamate was used as an internal reference substance to calculate the other ten components’ relative correction factors (RCF),after which the content determination was made.The GRA combined with the EW-TOPSIS model were used to evaluate the comprehensive quality of Fazhi Banxia Qu. Results Eleven components of Fazhi Banxia Qu showed good linear relationships within their ranges,and the correlation coefficients were greater than 0.999.The average recoveries were 96.94% -100.12% (RSD<2.0%,n=9).There was no significant difference between QAMS and external standard method (ESM).The relative correlation degree of the GRA model was 0.290 3-0.618 7, and the relative proximity in the EW-TOPSIS model was 0.211 4-0.634 3.The comprehensive evaluation results of the GRA and EW-TOPSIS models were the same. Conclusion The HPLC-QAMS method is convenient and accurate, and can be used for quantitative control of multi-index components in Fazhi Banxia Qu.The GRA combined with EW-TOPSIS models can be used to evaluate the comprehensive quality of Fazhi Banxia Qu.

Objective To analyze the research hotspots and trends in the field of cancer pain drugs based on literature. Methods This article included research literature related to cancer pain and drugs published in the China National Knowledge Infrastructure (CNKI) and Web of Science databases.The visual analysis of the literature was performed by software of VOS-viewer 1.6.18 and CiteSpace 6.2.R3,including drawing the graphs and comparing the number of published articles,journals,institutions,authors and keywords were also analyzed. Results A total of 4 774 literatures were included.The journals with the largest number of articles published were the Chinese Journal of Pain Medicine and the Journal of Pain and Symptom Management.The authors with the highest number of articles published were Liu Duanqi and Bruera Eduardo.The institutions with the highest number of publications were Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,and the University of Texas Anderson Cancer Center.The most frequent keyword was cancer pain.The keywords with the strongest citation bursts included Clinical efficacy average daily cost,and primary care. Conclusion Since the beginning of the 21st century,the research on cancer pain drugs has gradually heated up,and the number of papers has shown an upward trend.From 2019 to 2022,the research on cancer pain drugs at home and abroad mainly focused on the clinical efficacy and average daily cost.This article has clarified the research hotspots of cancer pain drugs in recent years to a certain extent and has certain reference significance for future research.

Objective To investigate the content stability of polymyxin B sulfate in high concentration solution and its finished infusion,and to provide a scientific basis for clinical administration. Methods Polymyxin B sulfate was dissolved in 0.9% sodium chloride injection and 5% glucose solution to the concentrations of 0.5 mg·mL^-1,1 mg·mL^-1 and 5 mg·mL^-1,respectively.The content of polymyxin B was determined at 0,2,4,6,8,12,16,20 and 24 h by high-performance liquid chromatography under storage conditions of 4 ℃ and 25 ℃. Results Polymyxin B sulfate was stable in the concentrations of 0.5 mg·mL^-1,1 mg·mL^-1 and 5 mg·mL^-1,respectively,in 0.9% sodium chloride injection or 5% glucose injection.Under the storage conditions of 4 ℃ and 25 ℃,the content of polymyxin B1 and polymyxin B2 ranged from 97.23% to 101.26% and 97.30% to 102.63%,respectively. Conclusion Polymyxin B sulfate was stable within 24 h dissolved either in 0.9% sodium chloride injection or in 5% glucose injection with the concentrations of 0.5 mg·mL^-1,1 mg·mL^-1 and 5 mg·mL^-1 under the storage condition of 4 ℃ and 25 ℃.

Objective To summarize the clinical characteristics of children with drug-induced hypersensitivity syndrome (DIHS) complicated with herpesvirus reactivation,and to promote the early and accurate identification,diagnosis,and treatment of DIHS in children. Methods The medication history,clinical manifestations,treatment,and prognosis of 12 children confirmed DIHS complicated with herpesvirus reactivation in Guangzhou Women and Children's Medical Center between January 2018 and March 2023 were retrospectively analyzed.The changes in hematological parameters,inflammatory indexes,and hepatic and renal function within 5 d before the eruption,5 d,and 6-10 d after eruption were compared. Results Of the 12 patients,the male-to-female ratio was 5:1,with a median age of 27 (interquartile range 20.50-34.75) months.Two or more antibiotics were used at least two to six weeks before onset,with a combination of 3 or more antibiotics in 7 children,and a combined or sequential application of 2 antibiotics in 5 children.The antibiotics included cephalosporins (n=12),semisynthetic penicillins (n=5),vancomycin (n=4) and azithromycins (n=7).All 12 patients presented fever,rashes,and multiple organ involvement.The rashes were red maculopapules in the early stage and then gradually developed into massive fusion exceeding 50% of the whole body.Among them,seven children were accompanied by facial edema,and two had purplish-red facial rashes. 11 children suffered from exfoliative dermatitis in the later stage. 12 children presented obviously enlarged lymph nodes.Liver involvement was the most common (100%,simple increase of transaminase in four children,cholestasis in six children,and hepatic failure in two children),and lung involvement was found in nine children.Laboratory examination showed no significant increase in leukocytes or eosinophils within 5 d before the eruption,but low levels of atypical lymphocytes.After the eruption,leukocytes,eosinophils,and atypical lymphocytes increased progressively.Inflammatory indexes of hypersensitive C-reactive protein (CRP),procalcitonin (PCT) increased dramatically before and after the eruption.All the children received intravenous immunoglobulin (IVIG) and methylprednisolone,two children were given antiviral therapy,and nine children were treated with multiple plasma exchanges.After treatment,nine children were cured,one developed immune reconstitution syndrome,and two died of hepatic failure. Conclusions Antibiotics are common allergenic drugs for DIHS in children.Its clinical manifestations include fever and rashes,accompanied by multiple organ involvement,such as the liver and lung.When leukocytes,eosinophils,and atypical lymphocytes are progressively elevated after the eruption,DIHS should be highly suspected,herpesvirus activation should be monitored,medication history should be traced,and early active immunotherapy and antiviral therapy should be conducted if necessary.

Objective To analysis the effectiveness and cost of Internet-based anticoagulation clinic versus traditional anticoagulation clinic treatment at Nanjing Drum Tower Hospital during the COVID-19 pandemic. Methods We reviewed and analyzed the clinical data of patients receiving anticoagulation management through Internet-based outpatient care and traditional outpatient care in Nanjing Drum Tower Hospital,from June 1,2020 to June 30,2021.Variability in time in therapeutic range (TTR) and international normalized ratio (INR) were calculated for enrolled patients.Patients meeting TTR ≥ 60% and INR variability <0.65 were considered optimal anticoagulation quality.Cost-effectiveness analysis was conducted from the patients' perspective,with results expressed using the incremental cost-effectiveness ratio (ICER). Results In the "Internet-based anticoagulation outpatient care" and "traditional face-to-face anticoagulation outpatient care" groups,19 individuals (67.86%) and 67 individuals (76.14%) met the criteria for optimal anticoagulation quality,respectively.The mean TTR was (71.83±19.17)% in the Internet-based group and (71.74±23.41)% in the traditional face-to-face group,indicating similar levels of warfarin anticoagulation quality between the two groups.The ICER was calculated as 327.17 yuan,less than the per capita gross domestic product (GDP) of 2021. Conclusion During the COVID-19 pandemic,Nanjing Drum Tower Hospital's Internet-based anticoagulation outpatient care effectively complemented the government's epidemic control policies.It ensured equivalent anticoagulation outcomes and significantly reduced patients' financial burdens.This approach offers new insights and guidance for optimizing healthcare services in the post-pandemic era.

Objective To explore how information pharmacists optimize the outpatient automatic dispensing system through technology-empowered process reengineering to enhance efficiency and accuracy. Methods This research utilized user journey mapping and root cause analysis to identify reasons for the low utilization rate of intelligent retrieval systems within the automatic dispensing system.Subsequently, a data-driven decision-making process was executed using the Apriori algorithm written in Python 3.12 to reengineer the process.The effects of the optimization measures were assessed by comparing data before and after the implementation of the restructured process. Results The results of the restructuring process indicate that the utilization rate of intelligent access devices has increased from 24.71% to 100%.The proportion of medication congestion has decreased by approximately 29.02%.Pharmacists have experienced a certain degree of improvement in usability,work efficiency,and overall satisfaction with intelligent access devices. Conclusion Technology-driven process reengineering and optimization led by information pharmacists can effectively resolve operational efficiency issues in outpatient pharmacy's automatic dispensing systems.Strategies for data-driven decision-making and process redesign improved the equipment utilization rate and the efficiency of medication dispensing enhanced pharmacists' job satisfaction.These achievements have significant reference value for optimizing automated systems in other hospital outpatient pharmacies.

Objective To standardize the management of narrative pharmaceutical documents,and to promote the standardization of narrative pharmaceutical services. Methods With the help of PaaS cloud computing technology design and development,and with the help of OpenAI technology,narrative material writing and narrative communication activities were assisted. Results The functions of narrative prescription,management of narrative activities,narrative writing and parallel medical records were realized and the resource database of narrative materials was established. Conclusion PaaS cloud computing technology has the advantages of rapid deployment and development of narrative pharmaceutical management forms,and it is combined with OpenAI technology.It can help clinical pharmacists quickly complete the search and writing of clinical cases and narrative materials,and greatly improve the efficiency of narrative pharmaceutical services.

Objective To summarize experience of anti-cancer drug management for clinical trials,and to explore a more efficient and standardized management model of anti-cancer drugs used in clinical trials. Methods Based on our current work in central pharmacy,the particularity and complexity of anti-cancer drug management for clinical trials were analyzed.In the meantime,we identified high-risk parts in the drug management process.Based on those risks,feasible measures were taken and presented in detail. Results Management of anti-cancer drugs used in clinical trials has its characteristics,such as long cycle,low error-tolerant rate,closed-loop model,etc.Recognizing these representative high-risk parts during the trials and making responses,including standardization of drug management records and disposition of drugs and packaging returned by subjects,should be achieved as soon as possible. Conclusion Establishing and observing strict rules and regulations,improving the hardware and software performance of the central pharmacy as well as implementing risk-based drug management is beneficial to conduct clinical trials normatively.

Objective To construct an integrated pharmaceutical care model for chronic respiratory system disease patients,and to provide policy recommendations. Methods A field survey,a semi-structured interview,and a questionnaire survey were comprehensively used to investigate the effect of the reform and the status quo of pharmaceutical care for chronic respiratory diseases after the medicine consistency reform in the medical alliance of Chongqing.Subsequently,the rainbow model was used to assess the challenges in the macro,meso,micro,and supporting element's dimensions,and the integrated pharmaceutical care model was established as a consequence. Results The primary issues involved in the medical alliance were as followed: insufficient joint reformation for public health services,medical insurance,and medical production and circulation (JRPMM);deficient supporting policies;a dearth of information support;an inadequately list of medications;insufficient collaboration among chronic disease specialties;and unstandardized pharmaceutical care.Consequently,the following recommendations were : in the macro dimension,to strengthen the JRPMM to enhance the service capacity of primary hospitals and to develop suitable human resource coordination mechanisms.In the meso dimension,to intensify the reform of pharmaceutical care in the medical alliance and enhance specialty collaboration horizontally.In the micro dimension,to establish a pharmaceutical management committee in the medical alliance,to formulate pharmaceutical technical specifications for the hierarchical medical system,and to combine “talent and technology” training innovatively.In the supporting elements dimension,to bolster information support in the area and to develop suitable incentives and assessment institutions. Conclusion This paper reported an integrated pharmaceutical care model for chronic respiratory diseases,which could serve as a reference for standardizing the hierarchical medical system for chronic diseases.

Objective To evaluate the second catalog of the key monitoring and rational use drugs(KMRUD),and to provide a reference framework for medical institutions to develop their own KMRUD catalogs and management policies. Methods A comprehensive search on official websites of national and provincial health administrative departments was conducted using the keywords “key monitoring”,“rational drug use”,and “the second catalog”.Announced catalogs and related policy documents pertaining to KMRUD use were collected and systematically organized.Comparative analyses were performed between the national KMRUD catalogs of the first and second batches,as well as between the second batch of provincial KMRUD catalogs and the national standard.Additionally,the adoption and variation of national KMRUD drug management policies across provinces,as well as the uniformity and divergence of provincial KMRUD management policies,were examined. Results The second national KMRUD catalog maintained 7 drug varieties from the first batch,eliminated 13,and introduced 23 new varieties.Of the 24 surveyed provinces,9 modified their provincial catalogs relative to the national second batch KMRUD catalog,resulting in alterations to 66 drug varieties within 10 Anatomical Therapeutic Chemical(ATC)classes,primarily systemic anti-infectives.Several provinces,including Xinjiang,Inner Mongolia,Liaoning,Shanghai,and Qinghai,implemented additional management measures such as the establishment of clinical application guidelines and the clarification of application conditions and principles.Moreover,provinces like Inner Mongolia,Shandong,Jilin,and Heilongjiang expanded their KMRUD management toolbox by developing drug monitoring indicators.The revision of inclusion rules from the first to the second KMRUD catalog has led to the incorporation of numerous essential clinical drugs.The prior protocol of medical institutions excluding drugs unilaterally is no longer viable,as it may disrupt the standard medication supply,potentially raising treatment costs. Conclusion Medical institutions ought to assimilate the updated implications of KMRUD use,draw on established provincial monitoring and management methodologies,enhance clinical application guidelines,and articulate conditions and principles for clinical use.Furthermore,by employing prescription review mechanisms,in-hospital monitoring,evaluation,and advanced warning systems,medical institutions can strategically oversee KMRUD use.

Objective To compare and explore the differences between the eight batches of drugs in the centralized procurement list and the 2018 edition of the national essential medicine list,and to provide reference for updating and improving the national essential medicine list and the national centralized procurement list of drugs. Methods The category,generic name variety,specification,and other information of drugs included in the centralized drug procurement were collected and compared with the 2018 edition of the national essential medicine list,and the reasons for differences were analyzed. Results A proportion of 39% of centralized procurement drugs were listed in national essential medicines.Forty pharmacological classifications were not involved in the drugs of centralized procurement.Only anticoagulant and thrombolytic drugs with dual attributes accounted for a smaller variety proportion than the specification proportion. Conclusion There are some differences between the centralized procurement list and the 2018 edition of the national essential medicine list,which have some rationality,but also some problems to be solved.