Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Objective To establish the argatroban drug use evaluation(DUE)criteria and provide reference for the rational use of argatroban in clinical practice.Methods Based on the domestic and foreign drug instructions of argatroban,referring to relevant guidelines and literature,the DUE standard rules were established by expert consultation.Using the established standard rules,the medical records of argatroban in the Fuzhou First Hospital Affiliated with Fujian Medical University from August 2020 to August 2022 were evaluated for the rationality of medication.Results A total of 368 medical records were included,the rational rate of drug use was 48.64％,and the irrational drug use was mainly without indications(46.19％)and inappropriate combination of drugs(4.35％).Conclusion The rational rate of argatroban clinical use in the hospital is not high,and the problems mainly include off-indication drug use and unreasonable combination drug use.Through the establishment and clinical application of DUE standard rules,the clinical use of argatroban can be further standardized and the ability of rational drug use can be improved.

OBJECTIVE To understand the status of clinical practice guidelines and consensus on central precocious puberty, evaluate and analyze its quality, and to provide reference for the revision and improvement of clinical decision-making and consensus on central precocious puberty. METHODS PubMed, OVID, CNKI, Wanfang database, International Guideline Alliance, Guidelines International Network(GIN), National Institute for Health and Care Excellence(NICE), Scottish Intercollegiate Guidelines Network(SIGN), American Society of Clinical Oncology(ASCO), American Urological Association(AUA) and other Chinese and English databases and related websites were searched with computer. The retrieval time was from the establishment of the database to May 2021. Two researchers rigorously screened the literature according to inclusion and exclusion criteria, and included clinical practice guidelines. The Appraisal of Guidelines for Research & Evaluation II(AGREE II) was used to evaluate and analyze the quality, and the recommendations for drug therapy were compared and summarized. RESULTS Five guidelines were included in this study. The quality evaluation results of AGREE II showed that the average standardization scores of the six fields were 86.6% for scope and purpose, 43.9% for participants, 22.3% for rigor, 75.5% for clarity, 40.0% for application, and 40.8% for independence. Four guidelines were recommended for grade B and one was recommended for grade C. CONCLUSION The overall methodological quality of clinical practice guidelines for central precocious puberty is moderately to low. High-quality evidence-based clinical practice guidelines for central precocious puberty should be developed strictly in accordance with the formulation standards of evidence-based guidelines and the requirements of each domain of AGREE II.

OBJECTIVE To study the basic strategies suitable for the development of current drug therapy clinics in China and to provide reference for the development of drug therapy clinics in tertiary hospitals. METHODS SWOT analysis was applied to analyze the strengths, weaknesses, opportunities and threats faced by drug therapy clinic in Department of Pharmacy, Union Hospital, Fujian Medical University in the context of health insurance payment reform for chronic airway disease management. RESULTS The pharmacotherapy clinic in the hospital where the author was located had the following strengths in carrying out the management of chronic airway diseases: the management of chronic airway diseases has been carried out for many years; increasing demand for pharmacy services from physicians; having a separate consultation room and being open all day on weekdays to meet patients' needs. However, there were also the following weaknesses: patients' recognition and awareness of pharmacists are not high, and there is an acceptance process for fees; some physicians are not aware of the existence and service scope of the pharmacy clinic; there is a gap between the pharmacist's clinical knowledge base and clinical practice. The opportunities provided by the external environment include: national policies driving the development of pharmacy clinics; support from local medical security bureaus; increasing demand for pharmacy services from patients; and improving patient satisfaction with medical services. However, it also faced the following threats: new things, systems and systems are not well developed; prescriptive authority restrictions; high manpower costs. CONCLUSION Pharmacists in medication clinics should make full use of the advantages and opportunities, overcome the disadvantages and threats, and improve the quality of services in medication clinics in general.

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.

OBJECTIVE：To provide reference for improving the rationality of discharged prescriptions. METHODS：According to the prescriptions that were often judged as forbidden or not recommended （such as irrational dosage and course of treatment ， off-label drug use ，drug interaction ，medication suitability ，dosage form ） in the pre-audit system of discharged prescriptions （hereinafter referred to as the “audit system ”）of Union Hospital Affiliated to Fujian Medical University （hereinafter referred to as the“our hospital ”），combined with actual case analysis ，the clinical pharmacists looked for evidence-based evidence and evaluate it，communicated with the clinician for feedback ，maintained the content of misjudgment in the intercepted prescription in real time，set up the relevant rules of audit in the audit system ，evaluated the effect and put forward suggestions to improve the scientificity and accuracy of the audit results of the discharged prescription. RESULTS & CONCLUSIONS ：For prescriptions that were judged to be forbidden or not recommended by the system ，such as the limited daily dose of Morphine hydrochloride tablet in patients with cancer pain ，the daily maximum dose of calcium sulfate D 3 after thyoidetomy ，hyper-indication use of megestrol acetate after chemotherapy for rectal cancer ，off-label usage of vitamin B 6 after postpartum delivery ，the combined use of clopidogrel bisulfate and oxcarbazepine after intracranial infection ，clinical contraindication of enteral nutrition powder after intestinal obstruction ，unsuitable dose of Dabigatran ester capsule after atrial fibrillation surgery and so on ，the clinical pharmacist looked for evidence-based evidence ，evaluated and communicated with the clinician . The relevant rules were updated to the audit system in real time. On the whole ，the audit system improves the work efficiency and the scientificity and accuracy of the audit results，but it is necessary to improve the professional knowledge level of the pharmacists ，the ability to find and use evidence-based evidence ，the accuracy of the audit system and the acceptance and recognition of the audit results by doctors ，so as to enhance the rationality of the discharged prescription ，reduce medication security risks.

Objective To investigate the performance of MicroScan WalkAway 96 Plus (MSW) system in detection of carbapenem-resistant Enterobacteriaceae (CRE).Methods A total of 81 stock CRE strains were used in this study. Bacterial identification and antimicrobial susceptibility test were performed by MSW system. Beta-lactamases genes blaKPC,blaIMP,blaVIM, blaOXA-48 and blaNDM were amplified by PCR and subjected to sequencing analysis. Disk diffusion method and PCR were used as gold standard to evaluate the performance and reliability of MSW system in identifying carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.Results Overall, 69.1 % (56/81) of the Enterobacteriaceae strains were identified as CRE by the MSW system. The results of PCR showed that 48 strains were carbapenemase-producing Enterobacteriaceae. When carbapenemase-producing Enterobacteriaceae strains were identified by the instrument using an advanced expert system, the sensitivity was 93.8 % and specificity was 42.4 %. The positive predictive value was 70.3 %, the negative predictive value was 82.4 % and the predictive accuracy value was 72.8 %.Conclusions The MicroScan WalkAway 96 Plus system has shown good performance in detection of CRE.

OBJECTIVE:To study the excitation mechanisms to clinical pharmacists at present in the hope of promoting clinical pharmacy.METHODS:Maslow's hierarchy of needs was introduced to study the psychological state of clinical phar-macists.RESULTS:The results showed that the needs of clinical pharmacists at 5 levels failed to be satisfied at present,which was one of the negative factors resulting in slow development of clinical pharmacy.CONCLUSION:Hierarchy of needs should be applied and effective measures should be taken to encourage clinical pharmacists and give free rein to their activity.

OBJECTIVE:To discuss measures taken to improve the auditing quality of the electronic prescriptions.METHODS:The problematic prescriptions in our hospital audited from June,2002to June,2004were analyzed statistically.RESULTS:Of the total audited621092prescriptions,8542were problematic prescriptions,which made up1.4%.Of the total problematic prescriptions,6749involved obvious misinput,which accounted for79%;1281involved overmaximal doses of narcotic drugs and psychotropic substances,which accounted for15%;427involved misinput of penicillins,which accounted for5%;85involved irrational prescriptions,which accounted for1%.CONCLUSION:The auditing quality of the electronic prescriptions can be improved through measures like improving the electronic prescription auditing system,enhancing pharmacist auditors'general quality,etc.