This study aims to investigate the safety profile of Esketamine, with a particular focus on comparing adverse events (AEs) between adults (< 65 years) and older adults (≥ 65 years) using data from the FDA Adverse Event Reporting System (FAERS). We conducted a comprehensive analysis of FAERS data from 2019 to 2024, identifying 6,452 Esketamine-related AE reports. After removing data without age information, these reports were categorized into two age groups: 536 from older adults and 3,566 from younger adults. Reporting odds ratios (RORs) were calculated to determine the relative risk of specific AEs in each age group. At system Organ Class (SOC)level, the Esketamine-related AEs of both adults group and older adults group were seen in 17 organ systems. The analysis revealed significant differences in AE profiles of psychiatric disorders between the two age groups. Older adults had a higher incidence of dissociation, suicidal ideation, depression, and anxiety, compared to younger adults. Additionally, older adults reported more general and administration site conditions, suggesting a greater susceptibility to systemic and local reactions. Gastrointestinal and respiratory disorders were less frequent in older adults, but their potential impact remains critical. The findings highlight a higher risk of severe psychiatric and general AEs in older adults treated with Esketamine, necessitating careful patient selection, monitoring, and tailored treatment protocols.

Objective:To evaluate the current state and determinants of medication safety knowledge, attitudes, and practices (KAP) among residents in Hubei Province, and to offer guidance for targeted educational initiatives. Methods:A standardized questionnaire from the Science and Technology Development Center of the Chinese Pharmaceutical Association was utilized. Responses were scored systematically. Univariate and multivariate Logistic regression analyses, along with machine learning (ML) techniques, were applied to identify risk factors associated with medication safety KAP. Results:Out of 1,065 distributed questionnaires, 1,042 were valid (91.8% response rate). The study revealed that 30.2% of residents demonstrated 'excellent' medication knowledge, while attitude and practice scores were lower 10.3 and 46.3%, respectively. Univariate analysis indicated that age, monthly income, employment status, and occupation significantly influenced KAP. Multivariate analysis further identified age (≥65 years: OR = 0.27), education level (Middle school: OR = 0.36, Primary school: OR = 0.16), occupation (Healthcare workers: OR = 3.67), and medical insurance coverage (Basic social medical insurance: OR = 17.48, Out-of-pocket medical care: OR = 7.44, Publicly-funded medical care: OR = 11.92) as independent risk factors affecting the total KAP score. In evaluating ML models for predicting KAP, the eXtreme Gradient Boosting (XGB) model showed the best performance for predicting knowledge (training accuracy: 0.7014, Kappa: 0.3045; validation accuracy: 0.6186, Kappa: 0.1004). The Fully Connected Neural Network (FCNN) was optimal for attitude prediction (training accuracy: 0.7205, Kappa: 0.0778; validation accuracy: 0.7019, Kappa: 0.0008). The Ordered Multinomial Logistic Regression model was most accurate for practice prediction (training accuracy: 0.6471, Kappa: 0.3421; validation accuracy: 0.6302, Kappa: 0.3153). And the Deep Neural Network (DNN) model demonstrated the highest accuracy for predicting the total score (training accuracy: 0.7387, Kappa: 0.3211; validation accuracy: 0.7074, Kappa: 0.1902). Conclusion:Residents of Hubei have a fundamental grasp of medication safety but also harbor certain misconceptions. Effective pharmaceutical science communication should take into account the characteristics of the residents and the identified risk factors.

Introduction This study explored the state of rational drug use among older adults in central China, aiming to unveil factors influencing their medication literacy and proposing targeted improvement measures. Methods A cross-sectional study involving 454 participants aged 60 and above was conducted in Hubei province between February 1 and May 30, 2023, with data collected through face-to-face interviews by pharmacists. Multiple logistic regression analysis was conducted to determine factors that affected medication literacy. Results Of the 412 valid questionnaires, findings revealed inadequate knowledge of rational drug use among older adults in central China. Those who fully understood (105, 25.49%, OR = 9.349, p < 0.001, 95%CI = 3.884–22.502) or partially understood (228, 55.34%, OR = 3.295, p = 0.002, 95%CI = 1.548–7.013) drug instructions exhibited significantly higher medication literacy than those who did not understand (79, 19.17%). Subsequent research revealed a lack of awareness in reading drug instructions or difficulty in understanding them. Most older adults seldom heard of but exhibited high acceptance of medication guidance services. Discussion In conclusion, the ability to comprehend drug instructions significantly influenced the medication literacy of older adults. Initiatives such as revising age-appropriate drug instructions could effectively enhance rational drug use among this demographic.

Transarterial chemoembolization (TACE) has been widely used for hepatocellular carcinoma. Reducing hypoxia in the tumor microenvironment after TACE remains a challenge as tumor progression is common in post-TACE patients due to the hypoxic tumor microenvironment. In this study, melatonin loaded on p(N-isopropyl-acrylamide-co-butyl methylacrylate) (PIB-M) was used for tumor embolism. Two types of human hepatoma cell lines were used to explore the mechanism by which melatonin prevents the growth and metastasis of cancer cells in vitro. A VX2 rabbit tumor model was used to evaluate the efficacy, mechanism, and safety of PIB-M in vivo. We found that under hypoxic condition, melatonin could inhibit tumor cell proliferation and migration by targeting hypoxia inducible factor-1 & alpha; (HIF-1 & alpha;) and vascular endothelial growth factor A (VEGF-A) in vitro. In vivo, PIB-M inhibited tumor growth and metastasis in rabbit VX2 tumors by promoting apoptosis of tumor cells and targeting related angiogenic proteins and vascular permeability proteins. A high concentration of melatonin in the PIB-M group could be maintained in tumor tissue for 72 h after embolization. The liver and kidney functions were most damaged on the first day but recovered to normal on the seventh day after embolization in the PIB-M group. This novel method may open avenues for reduction of tumor growth and metastasis after TACE and is efficacy and safety, which may be used for treatment for other solid tumors and clinical translation.

目的 评价唑来膦酸治疗骨质疏松症的有效性、安全性和经济性。方法 系统检索PubMed、Embase、the Cochrane Library、Web of Science、CNKI、VIP、万方数据库和卫生技术评估（HTA）相关的网站及数据库，根据纳入和排除标准筛选文献，提取数据和评价文献质量，对文献的结果进行定性综合比较与分析。结果 共纳入22篇文献，包括3篇HTA报告、9篇SR/Meta、11篇经济学研究（其中1篇文献同时包含Meta分析和经济学研究）。唑来膦酸能提高患者的骨密度，降低骨转换标志物浓度，显著改善患者的骨痛症状。唑来膦酸对骨密度的改善作用不弱于阿仑膦酸钠。唑来膦酸的常见不良反应发生率高于安慰剂组；但严重不良反应的发生率与安慰剂组无显著差别。相较于基础治疗，唑来膦酸具有成本效果优势；与其他类型的双膦酸类药物相比，在大多数情况下唑来膦酸具有较好的经济性。结论 唑来膦酸治疗骨质疏松症具有较好的有效性、安全性和经济性。

1 病例介绍患者,男,55岁,2018年6月16日因"间断心慌、气促12年,加重1个月余"入住华中科技大学同济医学院附属协和医院,外院心电图示心房颤动（房颤）伴快速心室率,冠状动脉造影示冠状动脉粥样硬化,入院后初步诊断"阵发性房颤,冠状动脉粥样硬化",血红蛋白157 g·L-1,血小板149×109·L-1,食道超声检查提示:左房及左心耳未见血栓,于2018年6月21日行房颤射频消融术,手术成功,并于2018年6月23日出院,

新一代测序技术的迅猛发展为个性化医学提供前所未有的潜力,生物医学和癌症基因组学在大数据时代也随之发生巨大的变革。随着生物科学技术和计算机处理数据能力的不断提高,高通量测序在多组学生物数据的获取和挖掘中发挥了关键作用。如今,它已经成为了生物学家进行科学研究不可或缺的工具,并在抗癌药物精准治疗领域做出了重要贡献。该文将针对不同测序方法在抗癌药物精准治疗中的作用进行阐述,探讨新一代测序技术在其中的指导意义。

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

目的 建立HPLC-MS/MS测定刺五加提取物、贯叶连翘提取物主要活性成分在大鼠血浆中药物浓度的方法,应用于刺五加提取物、贯叶连翘提取物及其联用时主要活性成分在大鼠体内的药动学研究,并使用DAS3.2.8软件对主要活性成分的药动学参数进行非房室模型拟合.方法 以Welch Ultimate XB-C18(2.1 mm×100 mm,4.6 μm)为色谱柱,乙腈(含0.1％甲酸)-0.1％甲酸水溶液(含5 mumol·L-1乙酸铵)为流动相,以300 μL·min-1的流速进行梯度洗脱,采用电喷雾离子源进行正负离子同时扫描,多反应监测模式进行监测.结果 所建立的方法精密度、准确度良好,提取回收率基本符合生物样品分析方法要求.结论 药动学结果表明,相比于单独给药,联合用药后刺五加苷Etmax缩短,金丝桃素ρmax升高、t1/2延长.该药动学结果表明,刺五加提取物、贯叶连翘提取物联用时,很可能通过增加金丝桃素血药浓度、缩短刺五加苷E 的达峰时间,从而在体内产生协同抗抑郁作用.

目的:探讨振荡溶解速率对注射用重组人促红素溶解后体内外活性的影响,为临床应用提供参考。方法:参照中国药典2015年版三部,按酶联免疫法试剂盒说明书测定高、中、低(800,1 600 2 300 min -1 )不同振荡速率下注射用重组人促红素及对照药品重组人促红素注射液B和C体外活性;参照通则3522方法,采用近交系6～8周龄雌性BALB/C小鼠测定不同振荡速率注射用重组人促红素及注射液的体内活性;采用单因素方差分析或非参数检验对各组体内外活性结果进行比较。结果:注射用重组人促红素在低速振荡频率时的体内外活性均显著低于其他各组（P＜0.01）;中、高速振荡速率组与注射液B和C组的体外活性相当但体内活性仍存在显著差异（P＜0.01）。结论:临床配置注射用重组人促红素时应尽量采用中、高速的振荡频率,以尽可能获得更佳的体内生物学活性。

目的:新冠肺炎疫情期间为慢性病复诊患者提供治疗用药和药学服务,降低非新冠肺炎患者的死亡率并减缓病情进展,积极探索门诊药学服务线上线下相结合（online to offline,O2O）模式。方法:基于我院线上问诊平台,增加线上处方和药品邮寄模块,统计分析2020年2月19日-2020年3月7日线上门诊药学服务实践中患者年龄、就诊科室以及处方审核、药品调剂等相关数据。结果:开展线上药学服务后,线上问诊10 269人次,就诊科室主要为心内科、神经内科、感染科、内分泌科等慢性病科室;医院药师调剂线上处方6 880张,调剂药品总数125 864盒/瓶,有效缓解了慢性病患者用药困难。患者就诊年龄集中于20～70岁,35岁以上患者达到74.30%,表明中老年患者可通过自身或他人帮助享受慢性病线上就诊服务。药师处方审核率100%,审核不通过处方483张,不合格率7.02%,主要不合理因素为用法用量不适宜。结论:新冠肺炎疫情期间,开展线上门诊药学服务对防控疫情和救治慢性病患者具有重要作用,也表明公立医院和患者已具备共同参与"互联网+医疗"的能力。门诊药师应积极探索药学服务O2O模式,借助"互联网+"重构药品供应保障服务体系,挖掘和重塑药师的专业价值。

目的:对290名新型冠状病毒患者在"方舱医院"的用药现状进行分析并提出建议,以期为医疗机构针对新型冠状病毒肺炎的防控提供参考。方法:收集290名在"方舱医院"确诊患者资料,针对目前的用药现状进行整理分析,对存在的问题结合临床实践经验提出建议。结果:当前"方舱医院"的治疗用药存在疗程过长、过度使用抗菌药物等问题,应规范"方舱医院"的治疗用药,加强药师队伍的参与,协助医护共同抗击疫情。结论:针对"方舱医院"目前用药现状,药师队伍参与到新型冠状病毒肺炎的防治工作中,对保证患者用药的有效性和安全性具有积极的意义。

新型冠状病毒感染肺炎重症患者的营养不良状态会对其疾病预后产生重要影响。根据相关指南及共识,提出新型冠状病毒感染肺炎重症患者的营养支持及监护建议。

2019年12月以来,武汉暴发新型冠状病毒肺炎疫情。随着疫情蔓延,全国范围内确诊病例和疑似病例均呈上升趋势。华中科技大学同济医学院附属协和医院医、护、药、技人员奋战在抗击疫情的一线,治疗药物监测（TDM）药师每天处理大量血样标本,人员职业暴露保护及实验室生物安全管理显得非常重要。该文总结该院TDM药师在新型冠状病毒肺炎疫情下的感染防控策略和经验,以期为同行提供参考和帮助。

In the epicenter of the coronavirus outbreak, Wuhan, the severe shortage of medical resources had resulted in a large number of undiagnosed and untreated patients. Failed to be timely quarantined by designated hospitals, these patients were forced to become the primary source of infection. In response, starting on February 3, 2020, Wuhan began to build a series of makeshift "square cabin" hospitals to treat patients with mild coronavirus infections. The activation of 17 square cabin hospitals had effectively enhanced the city's ability to admit patients and offer medical treatment. The purpose of this article was to share our experience of square cabin hospitals with the countries and regions that are currently suffering from the epidemic. The guidelines include the preparation work for the opening of square cabin hospitals and the management of personnel and medical supplies in the square cabin hospitals.Funding: The study was funded by the National Natural Science Foundation of China (71704024, 81801778), National Key R&D Program of China (2018YFC0910700), and The Fundamental Research Funds for the Central Universities (CXTD11-01).Conflict of Interest: We declare no competing interests.

细胞色素P450酶在生物体内参与多种化合物的生物转化.除肝脏外,细胞色素P450酶也在脑内分布,参与脑内多种内源性物质的合成及代谢,对维持神经系统内环境的稳态具有重要的作用.此外,脑内细胞色素P450酶广泛参与曲马多等中枢药物的脑内代谢,其活性或表达的变化可能会影响药物在脑内的药效和不良反应.鉴于细胞色素P450酶在脑内内源和外源性物质生物转化中的重要作用,其活性及表达的变化在神经精神疾病中的重要性也逐渐被发现.因此,笔者查阅了近年来关于脑内细胞色素P450酶的功能及其在神经精神疾病中的研究进展,以期为深入探索脑内细胞色素P450酶是否可能作为中枢疾病的治疗靶点,及开发相关的靶向治疗药物提供理论基础.

新型冠状病毒肺炎(COVID-19)来势汹汹,而合并其他基础疾病的COVID-19患者更属于高危人群.血糖控制水平直接影响身体免疫应答和状态,其导致的免疫力低下状态极易增加患病几率,已感染的患者则更易加重感染,进一步继发细胞因子风暴.因此COVID-19合并2型糖尿病患者在疫情期间需要在治疗新型冠状病毒感染的同时做好血糖控制和管理.结合糖尿病合理用药相关研究,对COVID-19现有临床数据特征进行分析,探讨COVID-19合并糖尿病患者的药学实践模式和用药监护策略,以期对这类患者提供更为优化合理的用药方案,改善临床用药水平.

Objective: This paper explores the management of donated drugs in public health emergencies, and establishes a set of operational management methods for donated drugs, so as to provide reference for the following similar events. Methods Review the relevant literature and management methods of donated drugs, summarize the management models and problems of donated drugs in other medical institutions, and formulate the selection list and management methods of donated medicines for New Crown Pneumonia to guide the donated medicines management work in our hospital by referring the new coronavirus pneumonia prevention and control program issued by the General Office of the National Health and Health Commission and our hospital's outpatient diagnosis and treatment program. Results A set of operational management measures for donated drugs was established, It includes the establishment and improvement of covid-19 donation drug management team, the development of donation drug selection catalog, donation drug receiving and qualification verification, the storage, distribution and use of donated drugs, donation drug accounting management and publicity, and the treatment of some remaining donated drugs. The total utilization rate of donated drugs was 86.64%. Conclusion In public health emergencies, Chinese pharmacists have accumulated a lot of experience in the management of donated drugs, and put forward some good management strategies. The development of guidelines for the selection and use of donated drugs and the informatization and systematization of the management of donated drugs need to be further strengthened and promoted.

为缓解医院收治床位紧张,遏制新型冠状病毒肺炎疫情扩散,武汉市建设了数家方舱医院集中收治轻症患者。方舱医院患者人数众多,部分患者合并基础疾病,大大增加了其用药的难度与复杂性。药师参与新型冠状病毒肺炎的防治,为患者提供及时的药学监护,对确保患者用药安全有效尤为重要。笔者所在医院作为2所方舱医院的牵头单位,药师在保障方舱患者药品供应的同时,积极探索患者药学监护模式及监护要点,以期为其他方舱医院患者药物治疗提供参考。

原发性肝癌是我国第4位常见恶性肿瘤和第3位恶性肿瘤致死病因,严重地威胁我国人民的生命及健康.2015年,我国肝癌有46.6万新发癌症病例和42.1万死亡病例[1].原发性肝癌的病理类型,主要是肝细胞癌(hepatocellular carcinoma,HCC),肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)和HCC-ICC混合型,其中肝细胞癌占85％以上.三者在发病机制、生物学行为、临床表现、治疗方法、预后等方面存在较大差异.本共识中“肝癌”指肝细胞癌[2].