The coexistence of sarcopenia and obesity has been established as a pivotal factor driving the pathological progression of metabolic dysfunction-associated steatotic liver disease (MASLD). This study systematically evaluates the prevalence and risk of MASLD in patients with sarcopenic obesity (SO). A comprehensive literature search was conducted in PubMed, Cochrane Library, EMBASE, Web of Science and SCOPUS up to March 2025. All studies investigating the association between SO and MASLD were included in this meta-analysis. Two independent reviewers performed screening and data extraction. ORs and 95

Intestinal fibrosis is a prevalent complication of IBD that that can frequently be triggered by prolonged inflammation. Fibrosis in the gut can cause a number of issues, which continue as an ongoing challenge to healthcare systems worldwide. The primary causes of intestinal fibrosis are soluble molecules, G protein-coupled receptors, epithelial-to-mesenchymal or endothelial-to-mesenchymal transition, and the gut microbiota. Fresh perspectives coming from in vivo and in vitro experimental models demonstrate that fibrogenic pathways might be different, at least to some extent, independent of the ones that influence inflammation. Understanding the distinctive procedures of intestinal fibrogenesis should provide a realistic foundation for targeting and blocking specific fibrogenic pathways, estimating the risk of fibrotic consequences, detecting early fibrotic alterations, and eventually allowing therapy development. Here, we first summarize the inflammatory and non-inflammatory components of fibrosis, and then we elaborate on the underlying mechanism associated with multiple cytokines in fibrosis, providing the framework for future clinical practice. Following that, we discuss the relationship between modernization and disease, as well as the shortcomings of current studies. We outline fibrosis diagnosis and therapy, as well as our recommendations for the future treatment of intestinal fibrosis. We anticipate that the global review will provides a wealth of fresh knowledge and suggestions for future fibrosis clinical practice.

目的 调查吸入性糖皮质激素使用过程中会引起嗓音障碍情况,探寻原因和干预策略.方法 检索从建库至2022年12月万方数据库(Wanfang)、中国期刊全文数据库(CNKI)、维普数据库(VIP)、PUBMED等数据库收集有关吸入性糖皮质激素与嗓音障碍的文献.结果 吸入性糖皮质激素会引起嗓音障碍,主要表现为声音嘶哑、发声困难等.与很多因素相关,包括药物颗粒的尺寸、激素的活性成分、药物的用量、药物的使用疗程、药物的输送装置、患者的使用技术等原因.结论 临床医务人员在为患者开具吸入性糖皮质激素时要注意加强患者教育,尤其是对声音有职业需求的患者,以最大限度地减少不良反应的影响,同时注意早期识别激素的不良反应,排除疾病影响,如果发生相关不良反应及时寻找影响因素,必要时需要进行药物治疗方案的调整.

目的 探讨儿童细菌性脑膜炎药物治疗相关指南的现状与质量,为儿童细菌性脑膜炎药物治疗方案选择提供参考.方法 系统检索PubMed、Embase、CNKI、万方数据、CBM等国内外各大医学和行业机构网站数据库,检索时间为建库起至2021年4月,收集儿童细菌性脑膜炎药物治疗相关指南.应用指南研究与评价(AGREE Ⅱ)工具对纳入指南进行质量评价与分析.结果 共纳入来自5个国家和1个地区的9部指南.4名评价员对每个领域的组内相关系数—致度中等(ICC范围0.700～0.766).AGREE Ⅱ评价结果显示,纳入指南在"范围与目的"(平均领域分值为86.11％±7.12％)、"参与人员"(80.56％±5.68％)、"制定的严谨性"(78.01％±10.46％)、"清晰性"(77.30％±9.64％)和"编辑的独立性"(72.69％±18.00％)方面得分较好,均超过70％.各指南疾病诊断和治疗方案选择的整体推荐意见类似,在新生儿用药、糖皮质激素辅助用药等领域循证证据不足,推荐尚存争议.结论 纳入儿童细菌性脑膜炎药物治疗相关循证指南的整体质量中等偏上,在新生儿用药领域的证据尚有待提高.

抗菌药物给药剂量是业界关注的焦点.传统方式以经验、药动学(pharmacokinetic,PK)参数为基础.近年来逐渐纳入最低抑菌浓度(min-imum inhibitory concentration,MIC)、药效学(pharmacodynamics,PD)参数综合考虑,并开始用于临床实践.本文基于MIC的计算方法,分为3个层次进行研究.第1层:单纯MIC确定给药剂量.第2层:MIC结合1个PK参数确定给药剂量和给药方式.第3层:基于MIC并综合多个参数计算给药剂量和给药方式.结果表明,通过MIC和PD参数的剂量确定方式优于单纯基于PK参数的方式,且临床可行.

逝者如斯夫,不舍昼夜.从踏上工作岗位至今,14年间我经历了药师工作从单纯提供药品保障到提供专业药学服务的转型.虽然蜕变的过程很艰辛,但是确实值得.对我来说,患儿和家长不仅是我的服务对象,也是我的老师. 2020年至2022年间,我随访了很多患儿的家长,与其中一位患儿家长的互动让我印象深刻,至今难忘.

The efficacy of probiotic strains of Lactobacillus acidophilus to manage acute gastroenteritis in children is still not established. We searched the Cochrane Library, PubMed, EMBASE, and three Chinese literature databases (CNKI, WanFang, and CBM) from their inception to February 2021 for RCTs that compared the use of Lactobacillus acidophilus with no Lactobacillus acidophilus. The grey literature was searched through Google Scholar. Authors of the original papers were contacted for additional data. The study included a total of 15 RCTs involving 1765 patients. Compared with placebo or no treatment, Lactobacillus acidophilus was associated with a reduced duration of diarrhea (moderate quality of evidence), but the effect was not statistically significant when only the individual probiotic strain was provided. Lactobacillus acidophilus was effective when used at a daily dose ≥ 109 CFU. There was no difference in the effect of Lactobacillus acidophilus on diarrhea duration among Asian, European, or American countries. Lactobacillus acidophilus reduced the frequency of diarrhea on day 2 to day 5. However, it was statistically significant on day 3. When administered at a dosage of more than 109 CFU to children with acute gastroenteritis, moderate- to low-quality data showed that Lactobacillus acidophilus reduced the duration of diarrhea and conferred a benefit for frequency of diarrhea.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

目的:通过回顾性数据分析,探讨皮肤T细胞淋巴瘤在中国的发病情况.方法:通过检索公开发表的有关淋巴瘤和皮肤T细胞淋巴瘤的发病情况研究文献,应用聚类分析法对符合纳入标准的文献进行纳入并统计其中皮肤T细胞淋巴瘤的发病率.经过汇总整理与《中国淋巴瘤亚型分布国内多中心性病例10002例分析》进行对比.结果:本研究共纳入17篇文献,涉及13个省市自治区,共计16885例患者.分析结果显示,中国皮肤T细胞淋巴瘤从1993年到2017年发病率约为0.69/105,与《中国淋巴瘤亚型分布国内多中心性病例10002例分析》中的结果一致,与国外文献报道中美国皮肤T细胞淋巴瘤发病率0.64/105也基本一致.结论:皮肤T细胞淋巴瘤在中国和有关国家都是发病率很低的一种恶性肿瘤,属于WHO定义的罕见病.

目的:探讨孟鲁司特钠致儿童药品不良反应的特点,为临床合理用药提供指导.方法:检索中国知网、万方数据库和PubMed,时间为建库至2021年10月,收集有关孟鲁司特钠在儿科人群使用中的药品不良反应案例报道.采用文献计量学方法进行统计分析,研究孟鲁司特钠的药品不良反应发生情况和特征.结果:数据库中初筛得到文献12748篇,经过阅读文献摘要,提取个案报道,删除成人数据,排除不确定疾病因素后,纳入儿童的药品不良反应个案报道文献共23篇(30例患儿).其中,涉及精神神经系统不良反应文献13篇(20例患儿),主要表现包括噩梦、梦游、兴奋、情绪行为障碍、攻击性和抽搐等;消化系统不良反应文献3篇(3例患儿),主要表现为肝功能损伤;泌尿系统不良反应文献3篇(3例患儿),主要表现为遗尿;皮肤系统不良反应文献1篇(1例患儿),主要表现为天疱疮;听觉系统不良反应文献1篇(1例患儿),主要表现为耳痛;视觉系统不良反应文献1篇(1例患儿),主要表现为头痛;骨骼肌肉系统不良反应文献1篇(1例患儿),主要表现为关节痛、肌肉僵直.结论:孟鲁司特钠在儿童中的药品不良反应主要集中于精神神经系统不良反应(占比>66％),包括噩梦、焦虑、攻击性和情绪行为障碍等,用药停止后短时间内症状消失.最需要警惕的主要是自杀.综合上述文献分析,孟鲁司特钠在临床使用过程中,若出现精神神经系统方面的症状,需要及时考虑药物相关性并且做好相应的处理.

目的:了解北京儿童医院和首都儿科研究所附属儿童医院(以下简称"2家儿童医院")益生菌制剂在门急诊儿童炎症性肠病(inflammatory bowel disease,IBD)中的应用现状,探讨益生菌制剂在IBD中使用的合理性.方法:采用回顾性分析方法,抽取2019年8月至2020年7月2家儿童医院门急诊IBD处方516张,结合国内外指南,对其中益生菌制剂处方进行合理性分析.结果:2家儿童医院516张门急诊IBD处方中,药品金额共78376.03元.其中,益生菌制剂处方147张,药品金额12980.74元;涉及的益生菌制剂包括酪酸梭菌二联活菌散(68张)、复方嗜酸乳杆菌片(42张)、双歧杆菌四联活菌片(34张)、酪酸梭菌活菌散(14张)和布拉氏酵母菌散(5张);益生菌制剂不合理处方45张,涉及药品金额5166.4元,不合理类型包括遴选药品不适宜(42张)和联合用药不适宜(3张).结论:门急诊儿童IBD患者益生菌制剂的使用存在一定问题,需加强管理,促进合理用药.

Aripiprazole, metformin, and paeoniae-glycyrrhiza decoction (PGD) have been widely used as adjunctive treatments to reduce antipsychotic (AP)-induced hyperprolactinemia in patients with schizophrenia. However, the comparative efficacy and safety of these medications have not been previously studied. A network meta-analysis of randomized controlled trials (RCTs) was conducted to compare the efficacy and safety between aripiprazole, metformin, and PGD as adjunctive medications in reducing AP-induced hyperprolactinemia in schizophrenia. Both international (PubMed, PsycINFO, EMBASE, and Cochrane Library databases) and Chinese (WanFang, Chinese Biomedical, and Chinese National Knowledge infrastructure) databases were searched from their inception until January 3, 2019. Data were analyzed using the Bayesian Markov Chain Monte Carlo simulations with the WinBUGS software. A total of 62 RCTs with 5,550 participants were included in the meta-analysis. Of the nine groups of treatments included, adjunctive aripiprazole (<5 mg/day) was associated with the most significant reduction in prolactin levels compared to placebo (posterior MD = -65.52, 95% CI = -104.91, -24.08) and the other eight treatment groups. Moreover, adjunctive PGD (>1:1) was associated with the lowest rate of all-cause discontinuation compared to placebo (posterior odds ratio = 0.45, 95% CI = 0.10, 3.13) and adjunctive aripiprazole (>10 mg/day) was associated with fewer total adverse drug events than placebo (posterior OR = 0.93, 95% CI = 0.65, 1.77) and other eight treatment groups. In addition, when risperidone, amisulpride, and olanzapine were the primary AP medications, adjunctive paeoniae/glycyrrhiza = 1:1, aripiprazole <5 mg/day, and aripiprazole >10 mg/day were the most effective treatments in reducing the prolactin levels, respectively. Adjunctive aripiprazole, metformin, and PGD showed beneficial effects in reducing AP-induced hyperprolactinemia in schizophrenia, with aripiprazole (<5 mg/day) being the most effective one.

目的:通过分析1例抽动症患儿使用氟哌啶醇导致神经阻滞剂恶性综合征的不良反应,为合理用药提供参考建议.方法:判断该神经阻滞剂恶性综合征和氟哌啶醇的相关性,并分析发生的原因和易感因素.结果:氟哌啶醇很可能是引起了该患儿神经阻滞剂恶性综合征的药物,经过药物的调整,病情已得到控制.结论:在使用氟哌啶醇时应密切监测患儿症状、体征,避免过快调整剂量,以免发生严重不良反应.

目的 分析疫情时期基于信息化平台对应用孟鲁司特钠的患儿进行全程持续化药学服务的意义.方法 通过医院信息系统调取2020年3月至6月我院门诊患儿使用孟鲁司特钠的处方,统计患儿年龄、性别、临床诊断、药品用法和用量及科室分布等临床资料.利用微信平台随机对100例使用孟鲁司特钠的患儿进行院外随访,定期发布科普知识,监测不良反应.结果 本研究共纳入5 842张处方,在所有处方中,患儿年龄以2～5岁居多(52.48％),其次为6～14岁(41.34％).在规格和剂型方面,2岁以下患儿使用咀嚼片处方79张,1岁以下患儿使用颗粒剂及咀嚼片处方67张.孟鲁司特钠适应证的临床诊断以过敏性鼻炎为主(45.67％),其次为过敏性鼻炎/哮喘合并其他疾病(33.26％),哮喘(16.54％),咳嗽变异性哮喘(3.75％),闭塞性细支气管炎占0.77％.随访的107例家属中,有100例愿意接受临床药师监测随访.随访中,1例家属反馈患儿在用药后出现了脾气暴躁.结论 我院孟鲁司特钠处方基本合理,但在剂型选择、并发症、跨科室开处方等方面仍存在部分用药风险.依托微信平台进行院外随访的模式符合大多数家属意愿,进一步开通专线自主报告的方式可扩大使用,实现对孟鲁司特钠的全程持续化药学服务,为临床合理用药提供依据.

目的 总结临床药师在呼吸科病房解答的部分药物咨询问题,为日后临床工作提供参考.方法 对2018年1月至12月间223例有临床药师参与、于我院呼吸科就诊并住院的患者用药相关问题进行回顾性分析.结果 223例问题来源按咨询问题者职称分布可分为主任医师15例(6.73％)、副主任医师26例(11.66％)、主治医师38例(17.04％)、住院医师124例(55.61％)、护士20例(8.97％).咨询问题内容按咨询药物种类分为抗菌药物107例(47.98％)、抗病毒药物14例(6.28％)、止咳平喘化痰药14例(6.28％)、保肝药10例(4.48％)、抗过敏药9例(4.04％)、抗凝药物7例(3.14％)、利胆药6例(2.69％)、其他类别56例(25.11％).咨询问题内容按咨询问题类别分为用法、用量类101例(45.29％)、药物选择类19例(8.15％)、药物不良反应类15例(6.73％)、其他类别占比88例(39.46％).结论 儿童呼吸科用药尤其是抗菌药物的合理用药是临床工作的重点.

目的:检索万古霉素和头孢哌酮钠/舒巴坦钠相关配伍禁忌文献,预防临床输注药物时配伍禁忌的发生.方法:通过1例万古霉素和头孢哌酮钠/舒巴坦钠序次输注产生白色沉淀的案例,检索两种药物相关配伍禁忌文献并进行分析,为临床合理使用万古霉素和头孢哌酮钠/舒巴坦钠提供参考.结果:万古霉素与12种药物有配伍禁忌,均出现白色浑浊或沉淀,其中只有1种药物(头孢地嗪)说明书提示有配伍禁忌.头孢哌酮钠/舒巴坦钠与21种药物有配伍禁忌,2种出现变色(红色),19种出现白色浑浊或沉淀,其中只有3种药物(依替米星、庆大霉素、亚胺培南/西司他丁钠)说明书有提示.结论:万古霉素与头孢哌酮钠/舒巴坦钠有配伍禁忌,必须分开输注;对于文献中提到的药物在与万古霉素或头孢哌酮钠/舒巴坦钠同时使用时需要科学安排输注顺序或者采用间隔冲管的方式.

Children medication has its specific characteristics because of growth and development.However,the irrational use of drug in children is still common in China.Pediatric pharmacists play an essential role in clinical treatment,thus it's very important to cultivate pediatric pharmacists.However,China has not established the training system of pediatric pharmacists at present.The quantity of pediatric pharmacists is insufficient and their qualifications need to be unified.The pediatric pharmacists in the United States are trained by multiple steps including PharmD education,residency program,on-the job training,and Board Certified Pediatric Pharmacy Specialists.The whole process is complete and systematic,which can be referred by our country.

OBJECTIVE To provide reference for pharmacists training in pediatrics in China through study on PGY2 pharmacy residency in pediatrics in the United States.METHODS The updated data in 2016 from the website of ASHP and official websites of pediatric pharmacy residency program providers was collected.The program titles,accreditation status,requirements,number of residents,training contents were also collected and analyzed by Excel.RESULTS Forty-nine pediatric pharmacy residency programs by the end of December 2016 were reviewed.The average number of residents for each program was 1.36.The preceptors should be qualified according to the requirements of ASHP.The training mode of pediatric pharmacy residency program included orientation,rotation and longitudinal.Teaching methods were various,including PBL,Journal Club,Workshop,TBL and etc.Evaluation of training includes initial assessment,formative assessment and summative evaluation.CONCLUSION PGY2 pharmacy residencies in pediatrics in the United States have a long history.In order to improve the pediatric pharmacists training in China,we should take reference from PGY2 pharmacy residency in pediatrics in the United States in the following aspects,improving preceptors' training,making individual training plans,using various teaching methods,monitoring the outcomes of formative evaluation and paying attention to mutual evaluation between teachers and students and student self-assessment.

Objective To explore the approaches and significance of pharmaceutical care for pediatric child with disseminated cryptococcosis.Methods Medical records were established for a disseminated cryptococcosis pediatric child.Upon analyzing drug use,pharmaceutical care was provided for drug use.Results The child geting better,was discharged from hospital.Conclusion Tothrough participating in the clinical practice,clinical pharmacists can assist the clinicians to make effective and reasonable dosage regime as well as providing pharmaceutical service for patients.