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  • PAN Kunming, LI Yanli, XU Chenqi, LI Ranyi, XU Qing, LI Xiaoyu
    Herald of Medicine. 2024, 43(2): 184-189. https://doi.org/10.3870/j.issn.1004-0781.2024.02.006

    Objective To analyze the achievement of target vancomycin concentration and the risk factors affecting the concentration to reach the target,providing a reference for the rational use of vancomycin and the implementation of therapeutic drug monitoring (TDM). Methods Patients who were hospitalized and received vancomycin TDM from January 2016 to June 2019 at Zhongshan Hospital,Fudan University were selected.Clinical data,vancomycin blood concentrations,and occurrences of acute kidney injury (AKI) during the hospitalization were collected.Factors affecting the attainment of target vancomycin concentrations were analyzed using logistic regression and grouped according to whether the target concentrations were attained.The correlation between drug concentration and the occurrence of AKI was analyzed. Results A total of 1 106 patients were included,with 70.7% being males and a median age of 60.0 (IQR=20) years.Surgical departments accounted for 76.4% of the distribution.The median duration of vancomycin therapy was 10.8 d (IQR=9.0).A total of 21.6% of patients had their first concentration monitored before administration of doses 4 and 5.The drug concentration monitoring results of 46.8% (518/1 106) of patients were in the range between 10-20 μg·mL-1,reaching the target concentration range.The incidence of vancomycin-associated AKI was 25.9%.The incidence of AKI varied among patients with different vancomycin concentrations:when the concentrations are <10,10-<15,15-20,and >20 μg·mL-1,the AKI rates are 15.8%,20.5%,25.8%,and 39.4%,respectively.Multivariate logistic regression analysis showed that target concentrations were more likely to be reached with a dosing course of >7-14 d (OR=1.688,P=0.001) and >14 d (OR=1.744,P=0.002) than with a dosing course of ≤7 d. Patients receiving conventional daily doses were more likely to achieve target concentrations than those receiving the non-conventional daily dose (OR=1.540,P=0.003). Conclusion The current status of vancomycin TDM in China still suffers from deficiencies,such as delayed timing of monitoring and low rate of target concentration attainment.Higher vancomycin concentrations are significantly associated with AKI,and the factors affecting the vancomycin concentration to reach the target mainly include treatment duration and the complexity of the dosing regimen.

  • LU Ping, WANG Jie, YIN Xiaoli, ZHANG Shunzhi, WU Wei
    Herald of Medicine. 2024, 43(2): 203-207. https://doi.org/10.3870/j.issn.1004-0781.2024.02.009

    Objective To assess the pharmacokinetic characteristics of two types of tofacitinib citrate tablets in healthy individuals and evaluate their bioequivalence and safety. Methods A randomized,two-period,self-crossing design was used with 36 subjects in two groups in both fasting and postprandial conditions.Each group received 5 mg tofacatile citrate tablets of either generic tofacitinib citrate tablets (T) or the reference product (R) per period,and the plasma concentration of tofacatile tablets was detected by LC-MS/MS.Phoenix WinNonlin software was used to calculate pharmacokinetic parameters and evaluate its bioequivalence. Results After single oral administration of test and reference preparations,the main pharmacokinetic parameters were as follows:Cmax values in fasting group were (57.54±13.95) and (59.17±12.31) ng·mL-1,respectively;AUC0-t values were (143.83±34.58) and (142.13±33.00) ng·h·mL-1,respectively;AUC0-∞ values were (147.39±35.27) and (146.15±34.64) ng·h·mL-1,respectively;tmax was 0.5 h for both;Cmax values in the postprandial group were (57.16±17.56) and (55.19±21.98) ng·mL-1;AUC0-t values were (165.47±41.63) and (162.04±41.84) ng·h·mL-1;AUC0-∞ values were (171.88±44.15) and (168.05±44.21) ng·h·mL-1;The t max was 1.0 h for both.The 90% confidence intervals for the geometric mean ratios of Cmax,AUC0-t and AUC0-∞ in fasting group and postprandial group were 96.35% (90.11%-103.03%) and 105.91% (95.20%-117.83%),101.02% (98.76%-103.34%) and 102.23% (99.67%-104.86%),100.77% (98.53%-103.06%) and 102.40% (99.81%-105.06%),all within the range of 80.00%-125.00%. Conclusion Both types of generic tofacitinib citrate tablets are bioequivalent and safe in Chinese healthy individuals.

  • XU Yuehua, QIAN Zhouyi, ZHAO Yang, HUANG Qiongye, SUN Luning, WANG Yongqing, SUN Zhiming, TANG Wenwen
    Herald of Medicine. 2023, 42(12): 1779-1784. https://doi.org/10.3870/j.issn.1004-0781.2023.12.006

    Objective A simple,specific and rapid LC-MS/MS method was established to determine flumatinib and its two major metabolites in human plasma for clinical therapeutic drug monitoring. Methods The determination was performed on an ACQUITY UPLC HSS T3 column (2.1 mm×50 mm,1.8 μm) with mobile phases consisting of acetonitrile and 10 mmol·L-1 ammonium formate (containing 0.1% formic acid) with gradient elution at the flow rate of 0.5 mL·min-1.The elution time was 6 min.The temperature of the column was 38 ℃.The ion source was electrospray ion source and the scanning mode was multiple reaction monitoring scanning in positive ion mode. Results The mass concentrations of flumatinib and its metabolites (flumatinib M1 and flumatinib M3) have a good linear relationship within the concentration range investigated.The precision and stability of the method are good.The precision is less than 15%,and the relative deviation is within±15%.The extraction recoveries of flumatinib and its metabolites approach nearly 100%. Conclusion The method is simple and sensitive,and can accurately determine the plasma concentration of flumatinib and its metabolites,providing a basis for clinical rational drug use.

  • ZHANG Xuenong, WANG Yanyan, LI Lie, ZHANG Min, SONG Liping, YI Mengjuan, WU Xiandi, YOU Hui
    Herald of Medicine. 2023, 42(12): 1785-1790. https://doi.org/10.3870/j.issn.1004-0781.2023.12.007

    Objective To study the pharmacokinetic characteristics of clobazam tablet in Chinese healthy subjects and evaluate the bioequivalence of test preparation (T) and reference preparation (R) under fasting or fed conditions. Methods A randomized,open-label,single-dose,two-period,two-way crossover bioequivalence trial was performed.34 healthy subjects were enrolled in fasting study and 30 in fed study.Each subjects received a single dose of T 20 mg or R 20 mg with a washout period of 28 days.Plasma concentrations of clobazam and its active metabolite,N-desmethylclobazam were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS).The pharmacokinetic parameters of clobazam and N-desmethylclobazam were calculated by non-compartment model.Geometric mean values for the T/R ratios of clobazam's main pharmacokinetic parameters and their corresponding 90 percent confidence intervals (CI) were evaluated to assess bioequivalence of the two preparations. Results In fasting study,the 90 percent CI of the geometric mean values for the T/R ratios were 94.46 to 103.82 percent for Cmax,99.64 to 103.62 percent for AUC0-t and 99.39 to 103.51 percent for AUC0-∞,respectively.In fed study,the 90 percent CI of the geometric mean values for the T/R ratios of were 93.86 to 106.02 percent for Cmax,100.37 to 104.51 percent for AUC0-t and 100.71 to 104.63 percent for AUC0-∞,respectively. Conclusion In this study,the 90 percent CI of the geometric mean values of Cmax,AUC0-t and AUC0-∞ for T/R ratios were all within the acceptable bioequivalence limits of 80 to 125 percent for clobazam.Therefore two formulations were considered bioequivalent.

  • YU Xiaxia, ZENG Yutong, YANG Jiahong, WU Jing, XU Yan, HUANG Yin
    Herald of Medicine. 2023, 42(12): 1796-1801. https://doi.org/10.3870/j.issn.1004-0781.2023.12.009

    Objective To establish a high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the simultaneous determination of seven vitamin Bs (VBs) in rat plasma. Methods The plasma samples were pretreated using the protein precipitation method.The chromatographic separation was achieved using an Agilent ZORBAX SB-Aq column (2.1 mm×150 mm,3.5 μm),with a mobile phase composed of 0.01% formic acid (A) and methanol (B) in a gradient elution mode.The flow rate was set at 0.3 mL·min-1 and the column temperature was maintained at 30 ℃.Mass spectrometric detection was performed using positive ion mode in multiple reaction monitoring.2,4,5,6-Deuteronicotinamide was used as the internal standard. Results Methodological validation results showed that the lowest limits of quantitation (LOQs) for the seven VBs ranged from 7.5 to 300 ng/mL,while the highest LOQs ranged from 1 000 to 20 000 ng·mL-1.Within a certain concentration range,all compounds showed a good linearity (r2>0.992 2).The accuracies ranged from 86.0% to 117.6%,and both intra- and inter-batch precision were less than 20%.Additionally,all analytes demonstrated extraction recoveries greater than 86.1%.No significant matrix effects were observed,and the stability was good.The established validation method was successfully applied to the pharmacokinetics study of single intragastric administration of VB solution in SD rats. Conclusion The analytical method established in this study is simple,rapid,sensitive,and exclusive for the simultaneous determination of VB in real plasma samples.This LC-MS/MS method provides a new analytical tool for further exploring the physiological and pathological effects of VB.

  • ZHANG Xiaoying, YE Zhenjie, WU Lingjie, YUAN Jinjin, YU Xiaoling
    Herald of Medicine. 2024, 43(2): 207-214. https://doi.org/10.3870/j.issn.1004-0781.2024.02.010

    Objective To develop an ultra-performance liquid chromatography-mass spectrometry (UPLC-MS /MS) method for the simultaneous quantification of dolutegravir,raltegravir,efavirenz,lamivudine and tenofovir in human plasma and to apply it to the therapeutic monitoring. Methods Dolutegravir-D5,raltegravir-D4,efavirenz-D5,lamivudine-13C-15N2and tenofovir-D7 were used as internal standard,respectively.All samples were extracted using the protein precipitation method with acetonitrile and then diluted for analysis.Chromatographic separation was performed on Shim-pack XR-ODS Ⅲ(2.0 mm×50 mm,1.6 μm)column.Mobile phases A and B consisted of 0.1% formic acid in water and acetonitrile respectively.A programmed mobile phase gradient was used at a flow rate of 0.3 mL·min-1and column temperature of 40 ℃.The tandem mass spectrometer was equipped with an electrospray ionization (ESI) source operating in multiple reaction monitoring (MRM) modes.After methodological validation,it can be used for therapeutic drug monitoring in HIV patients. Results There was good linearity in the validated concentration ranges of 62.5-3 000 ng·mL-1for dolutegravir,10-500 ng·mL-1for raltegravir,125-6 000 ng·mL-1for efavirenz,10-500 ng·mL-1for lamivudine and 10-500 ng·mL-1for tenofovir with the linear correlation coeffificients of determination(R2) of all higher than 0.998.The accuracy of both intra-day and inter-day studies ranged from 94.0%-109.3%,and the relative standard deviations were less than 7%.The IS-normalized matrix factor and extraction recoveries of all analytes were 95.7%-106.0%and 98.7%-104.5%at all concentrations.All analytes were stable in plasma at a certain storage environment.The trough blood concentrations of dolutegravir,efavirenz,lamivudine and tenofovir were 107.7-2 366.0,740.0-3 410.0,38.5-1 229.3,31.6-224.4ng·mL-1in HIV patients,respectively. Conclusion The method is highly aceurate,easy to perform,low-cost,and suitable for therapeutic drug monitoring of dolutegravir,raltegravir,efavirenz,lamivudine and tenofovir in HIV patients.

  • ZHUANG Weiping, HU Qin, JIANG Hongliang, HUANG Jiangeng, WU Dongcheng
    Herald of Medicine. 2023, 42(12): 1791-1795. https://doi.org/10.3870/j.issn.1004-0781.2023.12.008

    Objective To develop an accurate,rapid and sensitive flow cytometry method for the determination of anti-mesenchymal stem cell antibody in cynomolgus monkey serum. Methods After the solutions of mesenchymal stem cell were centrifuged and washed,and the suspension was taken,positive controls or actual samples were added and incubated with mesenchymal stem cell,then were incubated with protein L-PE solution.After the removal of the free protein L-PE,the mean fluorescence intensity of the PE was detected by flow cytometry. Results The method sensitivity is 115.54 ng·mL-1,far higher than the non-clinical research recommended sensitivity of 250-500 ng·mL-1.The precision of intra-assay and inter-assay were less than 20%.Assay cut points,low positive control concentration determination,sensitivity,precision and stability were validated in this study. Conclusion The method is proved to be sensitive,specific,rapid and suitable for the determination of anti-mesenchymal stem cell antibody in monkey serum and immunogenicity study.

  • XU Guojia, JIANG Xin, XIA Bin, SI Luqin, HUANG Jiangeng, LI Dan, ZHANG Yongjun
    Herald of Medicine. 2023, 42(12): 1772-1778. https://doi.org/10.3870/j.issn.1004-0781.2023.12.005

    Objective The metabolites of tolvaptan in rats were identified by ultra-performance liquid chromatography-quadrupole-exactive orbitrap high-resolution mass spectrometry (UFLC-Q-Exactive Orbitrap MS),and the possible metabolic pathways of tolvaptan in rats were discussed. Methods Plasma,urine and fecal samples from rats were collected after a single oral administration of 60 mg·kg-1 tolvaptan solid dispersion solution.The protein in the samples was precipitated with acetonitrile.UFLC-Q-exactive orbitrap MS technology was adopted for the sample analysis and the data were processed by Xcalibur 2.0 software. Results According to the retention time,precise relative molecular mass,characteristic fragment ions and related literature reports of each compound,35 metabolites were identified in rat biological samples.Moreover,23,26 and 30 metabolites in the plasma,urine and feces were identified,respectively.The major metabolic pathways of tolvaptan were identified as hydroxylation,carboxylation,hydrolysis,dehydrogenation,glucuronidation and acetylation. Conclusion Our study confirmed the major metabolites of tolvaptan in rats,enriched the metabolite spectrum of tolvaptan in vivo,and provided an experimental basis for the in-depth study of the pharmacodynamic substance basis of tolvaptan.

  • HUANG Xuan, XIE Han, GE Weihong, ZHOU Yujie
    Herald of Medicine. 2024, 43(2): 215-220. https://doi.org/10.3870/j.issn.1004-0781.2024.02.011

    Originally used as an antimalarial drug,hydroxychloroquine is now widely used in the treatment of rheumatic immune diseases due to its cost-effectiveness,safety,and efficacy.In addition to its immunomodulatory effects,hydroxychloroquine also exhibits antithrombotic,anti-hypolipidemic,and anti-hypoglycemic properties.Hydroxychloroquine blood levels are correlated with clinical outcomes and adverse reactions,and can reflect patient compliance.However,due to the complex pharmacokinetic profile of hydroxychloroquine,significant inter-individual differences in blood concentration exist even with the administration of the same dosage.This study investigates the factors affecting the blood concentration of hydroxychloroquine in terms of physiological factors,pathological factors,metabolic enzyme gene polymorphisms,and drug-related factors.The aim is to provide a reference for rational clinical use and the development of individualized dosing.

  • ZHONG Like, MI Xiufang, SHU Qi, XU Gaoqi, HE Chaoneng, ZHU Junfeng
    Herald of Medicine. 2024, 43(2): 196-202. https://doi.org/10.3870/j.issn.1004-0781.2024.02.008

    Objective To establish a quality control method for monitoring the blood concentrations of cyclosporin A and tacrolimus by HPLC-MS/MS,and to evaluate the quality control samples using the Westgard multi-rule theory. Methods HPLC-MS/MS was used to determine the concentration of cyclosporin A and tacrolimus in human whole blood.The quality control samples of low,medium and high concentration levels in the therapeutic drug monitoring process were statistically analyzed,Levery-Jennings and Z-score quality control charts were drawn,and the Westgard multi-rule theory was applied for in-house quality control evaluation. Results The established method was fully validated with linear ranges of 10.40-1 040.00 ng·mL-1and 0.50-49.50 ng·mL-1,the quantification limits were 10.40 and 0.50 ng·mL-1,respectively.The extraction recoveries were 108.61%-113.24%and 101.99%-109.37%,respectively.The matrix factors normalized by internal standard were 106.68%-111.27%and 95.70%-97.81%for cyclosporin A and tacrolimus,respectively.The intra-day and inter-day accuracy and precision were less than 15.0%.Other parameters were also validated and met the acceptance criteria.Levery-Jennings and Z-score quality control charts showed that there were 4 warnings (violation of the 12s rule) in the results of the 26 groups of quality control samples in the third quarter of 2022,and no phenomenon was observed to be out of control. Conclusion The established in-house quality control system for therapeutic drug monitoring of cyclosporin A and tacrolimus can effectively ensure the accuracy of blood drug concentration detection.

  • FAN Jing, TANG Haoxiang, WANG Yinghui, FAN Weibin, XIE Jiao, LIN Bin
    Herald of Medicine. 2024, 43(2): 190-195. https://doi.org/10.3870/j.issn.1004-0781.2024.02.007

    Objective To establish a highly sensitive,stable,and universally applicable ultra-high-performance liquid mass spectrometry tandem method (UPLC-MS/MS) for simultaneous determination of nirmatrelvir and ritonavir blood concentrations in human plasma. Methods The separation was performed on an ACQUITY UPLC BEH C18 column (2.1 mm×50 mm,1.7 μm) with gradient elution,and the mobile phase consisted of 0.1% formic acid-water and 100% acetonitrile at the flow rate of 0.3 mL·min-1.The column temperature was 45 ℃,and the injection volume was 2 μL.Electrospray ionization as ion source (ESI+) was used as the ion source and multiple reactions monitoring mode (nirmatrelvir m/z 500.20→319.10,nirmatrelvir-D9 m/z 508.59→328.10,ritonavir m/z 721.30→426.10,13C,2H3-ritonavir m/z 725.30→426.10) was adopted.Thirty patients with coronavirus disease 2019(COVID-19) treated with nirmatrelvir and ritonavir at the People's Hospital of Changxing County in Jan.2023 were selected to measure their steady-state trough concentrations of nirmatrelvir and ritonavir after 3 days of treatment. Results The linear range of nirmatrelvir was 0.100-10.0 μg·mL-1 (R2=0.997 2),and the linear range of nirmatrelvir was 0.050-5.00 μg·mL-1 (R2=0.995 2).The recovery rates of nirmatrelvir and lopinavir were both >90% and the intra-batch and inter-batch precision relative standard deviations (RSDs) were both <10%.Additionally,the recovery ranges for nirmatrelvir and lopinavir were 91.5%-97.0%,and the matrix effects ranged from 92.4% to 97.7%.The results of clinical samples showed that the plasma concentrations of nirmatrelvir and ritonavir in patients with COVID-19 varied greatly among individuals. Conclusion The method for simultaneous determination of nirmatrelvir and ritonavir concentrations in human plasma established in this study is convenient,highly specific,highly accurate,with high precision,which is suitable for monitoring the concentrations of nirmatrelvir and ritonavir in patients.

  • 规范、指南、共识
    ZHAO Zhigang,DONG Zhanjun,LIU Jianping
    Herald of Medicine. 2023, 42(4): 447-456. https://doi.org/10.3870/j.issn.1004-0781.2023.04.001

    With the gradual promotion of drug selection and evaluation in some provinces and cities in China,it is urgent for medical institutions to establish a complete and quantifiable drug selection and evaluation system. Based on the development of pharmacy and the adjustment of national drug policies in recent years,this guideline has revised and refined the evaluation indicators of drug evaluation and selection in medical institutions on the basis of the first version,so that the quantitative scoring can better reflect the priority of drugs in medical institutions,and also more fulfill the requirements of the national policy. Moreover,the scoring items are more detailed,clear and easy to use. In this guideline,five dimensions of pharmaceutical properties (28 points),effectiveness (27 points),safety (25 points),economy (10 points) and others (10 points) were quantified and scored,so as to objectively conduct selection and evaluation of drugs in medical institutions.

  • Expert Panel of Beijing Pharmaceutical Association Smart Pharmacy and Intelligent Management Professional Committee,Branch of Rational Drug Use and Comprehensive Evaluation,Expert Panel of Chinese Pharmacists Association Regional Pharmaceutical Care Promotion Working Committee,Expert Panel of China Smart Pharmaceutical Alliance
    Herald of Medicine. 2024, 43(1): 1-4. https://doi.org/10.3870/j.issn.1004-0781.2024.01.001

    Ensuring the rational drug use in healthcare institutions is an important instruction issued by the National Health Commission to strengthen the comprehensive supervision of health care.With the rapid improvement of the healthcare services in China and the continuous expansion of outpatient and emergency treatment scale,the number of prescriptions has increased sharply.The prescription information review system based on rational drug use database has become an important tool for pharmaceutical care.Supported by the Beijing Pharmaceutical Association Smart Pharmacy and Intelligent Management Professional Committee,Branch of Rational Drug Use and Comprehensive Evaluation,Chinese Pharmacists Association Regional Pharmaceutical Care Promotion Working Committee and China Smart Pharmaceutical Alliance,experts from healthcare institutions work on the expert consensus on the information audit of outpatient and emergency prescriptions in healthcare institutions.This consensus aims to promote the standardization and unification of outpatient and emergency prescription information audit from medical institutions at all levels,help build a standardized prescription information audit system and a rational drug use database with all-around information,enhance the accuracy of prescription and acceptance by doctors and patients,and further improve the level of rational drug use in healthcare institutions in China and promote the informatization and intelligent development of hospital pharmaceutical care.

  • LYU Ziyan, BIAN Yuan, CAI Linxuan, TONG Rongsheng, CHEN Min
    Herald of Medicine. 2024, 43(1): 5-12. https://doi.org/10.3870/j.issn.1004-0781.2024.01.002

    Objective To formulate a pharmaceutical service pathway to standardize the pharmacists' whole process of pharmaceutical services for breast cancer patients in medical institutions,promote the standardization of pharmacists' work and improve the rationality of drug use for breast cancer patients in medical institutions. Methods The editorial committee aimed at several challenging problems in the whole process of pharmaceutical services for breast cancer patients in medical institutions through systematic search,referring to the latest domestic and international guidelines and expert consensus of breast cancer and under the relevant drug administration regulations in China,collected and sorted out the professional opinions of doctors,pharmacists,and methodological experts,developed questionnaires and held two rounds of expert argumentation meetings,and finally screened out the most valuable results.The whole process management pathway of pharmaceutical care for breast cancer patients was formulated,and the referral principles of hospitals at different levels and the contents of pharmacist training and assessment were clarified. Results The whole process management pathway of pharmaceutical services for breast cancer patients was developed,including information collection,analysis,evaluation,development implementation of intervention plans,and follow-up. Conclusion This pharmaceutical service pathway can standardize and guide pharmacists in hospitals at different levels to carry out pharmaceutical services for breast cancer patients,achieve the whole process of monitoring drug use,and ensure rational drug use and treatment effectiveness for patients.

  • CHENG Kai, WANG Huan, DU Chunxiao, MA Xue, SHANG Lei, HU Zhiqiang, QI Tingting
    Herald of Medicine. 2024, 43(1): 47-53. https://doi.org/10.3870/j.issn.1004-0781.2024.01.008

    Objective To analyze the problems of review of anti-tumor drug prescriptions and medical orders assisted by an information system to improve the review rules,and to provide a reference for improving review quality of anti-tumor drug prescription. Methods The problem with the pre-review of anti-tumor drug prescriptions and medical orders assisted by the information system in Sichuan Cancer Hospital during 2020-2022 were collected.The data came from the MEDICOM PASS system in Sichuan Cancer hospital.Clinical pharmacists made comments on relevant problems and analyzed the results. Results A total of 9 325 antitumor drug pre-approval problems,including 6 279 outpatient prescriptions (67.3%) and 3 046 inpatient orders (32.7%),among which 6 153 (66.0%) were unsuitable indications,1 933 (20.7%) were drug contraindications,449 (4.8%) were problematic routes of administration,345 (3.7%) were unsuitable drug compatibility,177 (1.9%) were inappropriate drug frequency,133 (1.4%) were problematic drug populations,74 (0.8%) were unsuitable single doses,39 (0.4%) were unacceptable drug interactions,22 (0.2%) were unsuitable drug total.The results of clinical pharmacists' comments were 4 459 reasonable cases,with a false positive rate of 47.8%.The false positive problems included 2 264 (50.8%) cases of unsuitable indications,1 933 (43.3%) cases of drug contraindications,231 (5.2%) cases of problematic routes of administration,and 31(0.7%) cases of unsuitable populations. Conclusion The review of anti-tumor drug prescriptions assisted by an information system can effectively intercept irrational drug use and improve the review quality of prescriptions and medical orders.However,the evidence-based medicine date of antitumor drugs is updated quickly.Pharmacists should constantly improve the prescription review rules based on the latest evidence-based medicine data.

  • ZENG Heng, SU Na, CHEN Zelian
    Herald of Medicine. 2024, 43(1): 34-40. https://doi.org/10.3870/j.issn.1004-0781.2024.01.006

    Objective To analyze the current status of medication therapy management (MTM) against the background of “Internet+” in China,to reveal its research hotspots and development trend through visual methods,and to provide a firm reference for promoting innovative pharmaceutical development and the transformation of pharmacists. Methods Using CiteSpace 6.2 R2,368 Chinese studies from the CNKI,CBM,and VIP databases were collected and analyzed. Relevant graphs were drawn,and the results were analyzed through post-trend,cooccurrence,cluster,and burst analysis. Results The number of articles issued in China's “Internet+” MTM field is on the rise. However,the cooperation network between authors and research institutions is relatively scattered. The research team led by tertiary hospitals has played an essential role in this field,but the medical consortium has not fully utilized its advantages. In addition,informatization and pharmacists are the research objects of continuous concern,while quality of life and diabetes are recent research hotspots. Conclusion “Internet+” MTM is a new medical service model involving multiple disciplines and fields.In this paper,CiteSpace 6.2 R2 performed a visual analysis of the literature on “Internet+” medication therapy management in China,revealing the research status,concerns,and development trends in this field,which has specific reference value for relevant policy formulation and research.

  • ZHANG Minquan, GONG Mingcheng, CHEN Zekai, CHEN Zhenhua, ZHOU Liangliang
    Herald of Medicine. 2024, 43(1): 78-84. https://doi.org/10.3870/j.issn.1004-0781.2024.01.013

    With the deepening of modern drug research,traditional computer simulation can not meet the needs of future drug design experiments.As a classic technology of standard computer simulation,molecular simulation can construct and analyze complex molecular models to study the dynamic processes of molecular motion.However,the simulation results are easy to be affected by human factors.In recent years,the integration of artificial intelligence and molecular simulation has become a new method of drug design research.Artificial intelligence technology uses big data to screen out the corresponding compounds for molecular simulation and feedback on the simulation results to the artificial intelligence system to optimize the artificial neural network.The combination of artificial intelligence and molecular simulation technology improves the efficiency of drug design research,reduces the influence of human factors on simulation results,and increases the credibility of simulation results.In this review,we summarized the progress of artificial intelligence and molecular simulation technology in drug design to provide a reference for the change from computer assisted drug design (CADD) to artificial intelligence-aided drug design (AIDD) in future pharmaceutical development.

  • DI Junhong, GENG Zhou, QIU Qi
    Herald of Medicine. 2024, 43(1): 41-46. https://doi.org/10.3870/j.issn.1004-0781.2024.01.007

    Objective To establish an intelligent management system of operating room pharmacy,to promote the standardized management of drugs in the operating room,and to provide reference and experience for medical institutions. Methods Based on the failure mode and effect analysis (FMEA) method,the risk identification and assessment of the operating room pharmacy workflow were carried out of the Second Affiliated Hospital of Soozhou University. According to the risk priority index (RPN) value,the failure mode that needs to be improved was determined,the causes of failure were analyzed,intervention measures were formulated,and the improvement effect was evaluated. Results A total of 12 failure modes were found in the workflow of the operating room pharmacy.After the intelligent medicine cabinet and corresponding management system were used,the RPN value decreased by 337 in total,with a decrease rate of 67.8%.The level of narcotic drug management,the timeliness of patient medication,and the satisfaction of medical staff were significantly improved. Conclusions The FMEA method can effectively identify the risk links of the operating room pharmacy.The construction and application of the intelligent operating room pharmacy management system have significantly improved the drug management level of the operating room and the quality of medical services.

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  • WU Qingfang, LIU Kexin, YANG Shiwen, SU Na
    Herald of Medicine. 2024, 43(1): 68-77. https://doi.org/10.3870/j.issn.1004-0781.2024.01.012

    Objective To analyze and discuss the current research status,hotspots,frontiers,and progress in work practice of family pharmacists both in domestic and abroad by Citespace. Methods The database of Web of Science Core Collection and CNKI were selected for data extraction.They searched for literature from the database from establishment to April 1, 2023 using the topic words “family pharmacist” and “home pharmaceutical care” both in Chinese and English. The network diagrams of essential nodes such as authors,countries,institutions,and key words were analyzed and drawn Results A total of 439 Chinese and 572 English literatures were included in the study.Scholars such as Mei Shen,Shihui Bao,Zhongzhuang Wang,Hughes Carmel M,Jamieson Hamish A,and Chen Timothy F have significantly contributed.The UK and the United States were leading countries in family pharmacists. Most of China's top ten research institutions were from Shanghai, Beijing. The top five Chinese literature keywords were pharmaceutical care, community, pharmacist, rational drug use, family pharmacist. The top five English literature keywords were pharmaceutical care, care,management, older people, and impact. Conclusions According to keyword clustering and burst analysis,research hotspots in foreign countries mainly focus on pharmaceutical services,adverse drug reactions,adherence,etc.,which is consistent with the development direction of pharmaceutical services in China.However,domestic pharmacy's development and literature publication are slightly behind those of foreign countries,and there is still some development space for pharmaceutical services in China.

  • HUANG Yongliang, WU Ping, YANG Ting, ZHANG Min
    Herald of Medicine. 2024, 43(1): 59-63. https://doi.org/10.3870/j.issn.1004-0781.2024.01.010

    Objective To analyze the development status of intelligent pharmaceutical services for traditional Chinese medicine,to summarize the practical experience of intelligent pharmaceutical services for traditional Chinese medicine,and to explore its technical requirements and development direction. Methods The Affiliated Hospital of Chengdu University of traditional Chinese medicine launched the Smart Traditional Chinese Medicine Room project in January 2018 and established a Smart Traditional Chinese Medicine Pharmacy to undertake pharmaceutical services such as outpatient dispensing,decoction,and distribution of traditional Chinese medicine decoction pieces. Results A total of 5.572 million pairs of traditional Chinese medicine decoction pieces were delivered until May 2023,and 231 400 patients were served in 2022.The service process was more straightforward;there was no need to wait for medication or go to the hospital again.The service efficiency was high,improving the patient's medical experience. Conclusions Intelligent pharmaceutical services for traditional Chinese medicine are developing rapidly.A comprehensive intelligent service system will be established based on technological progress in the future.