Objective To explore the effect of home-based pharmaceutical care for patients with stable chronic obstruc-tive pulmonary diseases(COPD)based on a digital remote management applet.Methods A total of 237 patients with stable COPD from a hospital pharmaceutical outpatient service from March 2022 to March 2023 were divided into a control group,a home visit group,and a remote management group according to the random number table method.Patients in the home visit and re-mote management groups received home-based pharmaceutical interventions such as health science popularization,medication con-sultation,medication guidance,effect evaluation of pharmacotherapy,prescription simplification,and reorganization.Such interven-tions were not provided in the control group.Regular follow-up was performed for 12 months.Results After a pharmaceutical intervention,the operating scores of the inhalation device and medication compliance scores of the home visit and remote manage-ment groups were significantly better than the control group(P＜0.05).The improvement in medication compliance was greater in the remote management group than in the home visit group(54.3％ vs.44.6％).In the three groups between enrollment and 12 months follow-up,CAT scores decreased by 0.78,6.16,and 7.30 points in the control group,home visit group,and remote manage-ment group,respectively.The mean scores of SGRQ symptom decreased by 1.19,4.24,and 6.10 points,the mean activity scores decreased by 1.65,3.56,4.80 points,the impact mean score decreased by 1.08,4.19,5.16 points,and the mean score of the total score decreased by 1.29,4.00,4.80 points in the control group,home visit group,and remote management group,respectively.The remote management group showed dia better decline in CAT score and SGRQ score than the home visit group,and there were sig-nificant differences between the two groups compared with the control group after intervention(P＜0.05).Conclusions Digital remote management of home-based pharmaceutical care mode can effectively improve medication compliance,operation accuracy of inhalation devices,clinical symptoms,and the patient quality of life.This is an effective and efficient pharmaceutical care mode for the long-term home medication management of stable COPD patients.

With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24％,the annual rate of acute exacerbation-related hospitalizations declined by about 72％,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37％to 64.41％,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.

Objective To summarize the clinical experience of the first case of sulbactam-durlobactam treatment for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation in China.Methods A retrospective analysis was conducted on a case of a patient with severe chronic obstructive pulmonary disease who received sulbactam-durlobactam treatment after lung transplantation.Results A 68-year-old male patient with a history of drug-resistant Acinetobacter baumannii infection before surgery,experienced worsening infection and impaired renal function after lung transplantation,with sputum culture showing extensively drug-resistant Acinetobacter baumannii.After receiving combination treatment with sulbactam-durlobactam and meropenem,the infection was controlled,and the function of the transplanted lung was restored.Conclusions Sulbactam-durlobactam has potential therapeutic value for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation and provides a new strategy for clinical practice.

Objective To explore the effect of home-based pharmaceutical care for patients with stable chronic obstruc-tive pulmonary diseases(COPD)based on a digital remote management applet.Methods A total of 237 patients with stable COPD from a hospital pharmaceutical outpatient service from March 2022 to March 2023 were divided into a control group,a home visit group,and a remote management group according to the random number table method.Patients in the home visit and re-mote management groups received home-based pharmaceutical interventions such as health science popularization,medication con-sultation,medication guidance,effect evaluation of pharmacotherapy,prescription simplification,and reorganization.Such interven-tions were not provided in the control group.Regular follow-up was performed for 12 months.Results After a pharmaceutical intervention,the operating scores of the inhalation device and medication compliance scores of the home visit and remote manage-ment groups were significantly better than the control group(P＜0.05).The improvement in medication compliance was greater in the remote management group than in the home visit group(54.3％ vs.44.6％).In the three groups between enrollment and 12 months follow-up,CAT scores decreased by 0.78,6.16,and 7.30 points in the control group,home visit group,and remote manage-ment group,respectively.The mean scores of SGRQ symptom decreased by 1.19,4.24,and 6.10 points,the mean activity scores decreased by 1.65,3.56,4.80 points,the impact mean score decreased by 1.08,4.19,5.16 points,and the mean score of the total score decreased by 1.29,4.00,4.80 points in the control group,home visit group,and remote management group,respectively.The remote management group showed dia better decline in CAT score and SGRQ score than the home visit group,and there were sig-nificant differences between the two groups compared with the control group after intervention(P＜0.05).Conclusions Digital remote management of home-based pharmaceutical care mode can effectively improve medication compliance,operation accuracy of inhalation devices,clinical symptoms,and the patient quality of life.This is an effective and efficient pharmaceutical care mode for the long-term home medication management of stable COPD patients.

With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24％,the annual rate of acute exacerbation-related hospitalizations declined by about 72％,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37％to 64.41％,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.

Objective To summarize the clinical experience of the first case of sulbactam-durlobactam treatment for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation in China.Methods A retrospective analysis was conducted on a case of a patient with severe chronic obstructive pulmonary disease who received sulbactam-durlobactam treatment after lung transplantation.Results A 68-year-old male patient with a history of drug-resistant Acinetobacter baumannii infection before surgery,experienced worsening infection and impaired renal function after lung transplantation,with sputum culture showing extensively drug-resistant Acinetobacter baumannii.After receiving combination treatment with sulbactam-durlobactam and meropenem,the infection was controlled,and the function of the transplanted lung was restored.Conclusions Sulbactam-durlobactam has potential therapeutic value for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation and provides a new strategy for clinical practice.

Objective:To explore the clinical characteristics of lung injury related to tyrosine kinase inhibitors (TKIs).Methods:The electronic medical records of patients with lung injury who received TKIs treatment in the First Affiliated Hospital of Guangzhou Medical University from August 2014 to May 2019 were collected by searching the Hospital Information System and retrospectively analyzed. The data extracted from the medical records included the patient′s gender, age, primary disease, clinical manifestation, TKIs medication, time from TKIs medication to occurrence of lung injury, laboratory test and imaging examination results, treatment and outcome, etc.Results:A total of 20 patients were enrolled in the study, including 10 males and 10 females. Their ages were from 32 to 75 years, with a median age of 60 years. The primary diseases were lung adenocarcinoma in 16 cases, chronic myeloid leukemia in 3 cases, and small intestinal stromal cell tumor in 1 case; 6 patients had smoking history; the clinical manifestations were cough in 19 patients, shortness of breath after activity in 17 patients, expectoration in 12 patients, chest pain and fever in 5 patients each, fatigue in 1 patient, and hypoxemia in 13 patients. Among the 20 patients, 17 were treated with epidermal growth factor receptor TKI and 3 with imatinib. The time of occurrence of lung injury was 2 days to 2 years after medication, with a median time of 1 month. Laboratory tests showed that the level of C-reactive protein increased in 15 patients, the level of Krebs von den Lungren-6 increased in 11 patients, procalcitonin increased in 11 patients, erythrocyte sedimentation rate increased in 10 patients, and lactate dehydrogenase increased in 6 patients; partial pressure of oxygen decreased in 13 patients, oxygen saturation decreased in 11 patients, partial pressure of carbon dioxide decreased in 7 patients, and partial pressure of carbon dioxide increased in 5 patients. All 20 patients underwent chest CT examination, showing patchy ground glass shadow in 18 patients, pleural effusion in 8 patients, nodules in 6 patients, interlobular septal thickening in 3 patients, grid fuzzy shadow in 2 patients, and pneumothorax in 1 patient. After the occurrence of lung injury, all patients stopped TKIs, 18 received glucocorticoid and symptomatic treatments, 4 were cured, 9 were improved, 4 had poor efficacy, and 1 died; 2 patients were improved only after anti-infection and symptomatic treatments.Conclusions:The clinical manifestations of lung injury related to TKIs are nonspecific, and the time from medication to occurrence of adverse reactions varies. After drug withdrawal and receiving glucocorticoid and symptomatic treatments, the prognosis in most patients is good. However, the occurrence of adverse consequences should be paid attention to.

Objective:To explore the clinical characteristics of lung injury related to tyrosine kinase inhibitors (TKIs).Methods:The electronic medical records of patients with lung injury who received TKIs treatment in the First Affiliated Hospital of Guangzhou Medical University from August 2014 to May 2019 were collected by searching the Hospital Information System and retrospectively analyzed. The data extracted from the medical records included the patient′s gender, age, primary disease, clinical manifestation, TKIs medication, time from TKIs medication to occurrence of lung injury, laboratory test and imaging examination results, treatment and outcome, etc.Results:A total of 20 patients were enrolled in the study, including 10 males and 10 females. Their ages were from 32 to 75 years, with a median age of 60 years. The primary diseases were lung adenocarcinoma in 16 cases, chronic myeloid leukemia in 3 cases, and small intestinal stromal cell tumor in 1 case; 6 patients had smoking history; the clinical manifestations were cough in 19 patients, shortness of breath after activity in 17 patients, expectoration in 12 patients, chest pain and fever in 5 patients each, fatigue in 1 patient, and hypoxemia in 13 patients. Among the 20 patients, 17 were treated with epidermal growth factor receptor TKI and 3 with imatinib. The time of occurrence of lung injury was 2 days to 2 years after medication, with a median time of 1 month. Laboratory tests showed that the level of C-reactive protein increased in 15 patients, the level of Krebs von den Lungren-6 increased in 11 patients, procalcitonin increased in 11 patients, erythrocyte sedimentation rate increased in 10 patients, and lactate dehydrogenase increased in 6 patients; partial pressure of oxygen decreased in 13 patients, oxygen saturation decreased in 11 patients, partial pressure of carbon dioxide decreased in 7 patients, and partial pressure of carbon dioxide increased in 5 patients. All 20 patients underwent chest CT examination, showing patchy ground glass shadow in 18 patients, pleural effusion in 8 patients, nodules in 6 patients, interlobular septal thickening in 3 patients, grid fuzzy shadow in 2 patients, and pneumothorax in 1 patient. After the occurrence of lung injury, all patients stopped TKIs, 18 received glucocorticoid and symptomatic treatments, 4 were cured, 9 were improved, 4 had poor efficacy, and 1 died; 2 patients were improved only after anti-infection and symptomatic treatments.Conclusions:The clinical manifestations of lung injury related to TKIs are nonspecific, and the time from medication to occurrence of adverse reactions varies. After drug withdrawal and receiving glucocorticoid and symptomatic treatments, the prognosis in most patients is good. However, the occurrence of adverse consequences should be paid attention to.

OBJECTIVE:To investigate the effect of STAT5 pathway inhibitor pimozide on the expressions of nitric oxide (NO)and nitric oxide synthetase(iNOS)in the model of mouse macrophage RAW264.7 inflammation induced by lipopolysaccha-ride (LPS). METHODS:RAW264.7 cells in logarithmic growth phase were divided into blank control group,drug control group (10μmol/L pimozide),model group(1μg/ml LPS)and the pimozide groups of low,middle and high doses(2.5,5 and 10μmol/L), where the corresponding cells were given pimozide 30 min before the administration of LPS,and then were cultured for 24 h. Griess method was used to determine the content of NO in the supernate of cell culture solutions of all groups,real-time quantita-tive polymerase chain reaction(RT-PCR)to determine iNOS mRNA expression,and Western blot method to determine the protein expression of iNOS and phosphorylated STAT5(p-STAT5). RESULTS:The content of NO,iNOS mRNA and protein expressions and the content of p-STAT5/STAT5 in the cells in the model group were higher than those in the blank control group,with statisti-cally difference (P<0.01). Compared to the model group,the pimozide groups of middle and high doses had lower content of NO,iNOS mRNA and protein expressions and the content of p-STAT5/STAT5 in the cells,with statistically difference(P<0.01 or P<0.05). CONCLUSIONS:STAT5 pathway inhibitor pimozide can inhibit the release of NO by inhibiting iNOS mRNA and pro-tein expressions in cells.

OBJECTIVE:To provide reference for further formulation of the rational use of vancomycin. METHODS:Retro-spective analysis was conducted on the related information of discharged patients who intravenously used vancomycin from Jun. 2013 to Dec. 2014. RESULTS:178 patients were enrolled,with average age of 59.6 and 73.60% male,who were mainly with lung infectious(74.72%). Support examinations were sufficient before using of vancomycin. 66.29% patients were empirically giv-en vancomycin with pathogenic detection rate of 85.39%. 71.91% patients were conducted therapeutic drug monitoring with only 47.54% of first blood samples achieved the target range. CONCLUSIONS:Vancomycin application is generally rational in our hos-pital. However,issues like duration of empirical therapy,rational therapeutic monitoring,and individualized start dosing still need to be noticed.