OBJECTIVE To compare the predictive accuracy and clinical applicability of four vancomycin individualized dosing tools （SmartDose， ClinCalc， Gulou， Pharmado） and provide a basis for rational clinical medication use. METHODS A retrospective cohort study was conducted， enrolling 479 adult patients who received vancomycin therapy and underwent steady-state trough concentration monitoring in Zhongshan Hospital， Fudan University （Xiamen Branch） from January 1， 2022， to June 30， 2024. The predictive accuracy of each tool was evaluated using indicators， such as mean error （ME）, mean absolute error （MAE）， mean percentage error （MPE）， mean absolute percentage error （MAPE）， the proportion of patients with an absolute percentage error （APE） of less than 30%， the 95% limits of agreement， and the overall relative percentage difference between predicted and measured values. Using indicators such as accessibility， patient management， and recommendation of multiple treatment options， the clinical panxso@163.com applicability of the tools for all patients was evaluated； using the discrepancy in accuracy between the predicted and actual measured blood drug concentrations as an indicator， the clinical applicability was assessed for patients in different renal function subgroups （hyperfunction， normal， mild impairment， moderate impairment， and severe impairment）. RESULTS In terms of accuracy， SmartDose demonstrated the best overall performance with an MAPE of 46.40% and a proportion of APE ＜30% （46.56%）. Bland-Altman analysis indicated that SmartDose had the smallest overall relative percentage difference （－7.25%）， although the 95% limits of agreement were broad for all tools， with differences between the upper and lower limits exceeding 200%. In terms of applicability， all four dosing tools were freely accessible and demonstrated good availability； SmartDose and Pharmado provided the most comprehensive solutions， offering features such as patient management， multiple regimen recommendations， and drug concentration-time curve plotting. Stratified analysis based on renal function revealed that Pharmado showed optimal prediction for hyperfiltration patients （mean difference： 0.11 mg/L）. SmartDose and ClinCalc showed relatively better performance in normal and mild renal impaiment （mean difference： 0.37， 0.51 mg/L and －1.13， －1.33 mg/L，respectively）. SmartDose performed best in moderate renal impairment （mean difference： －2.60 mg/L）. Pharmado and Gulou had smaller prediction biases in severe renal impairment （mean differences： 1.52 mg/L and －0.23 mg/L， respectively）. CONCLUSIONS The four individualized dosing tools demonstrated limited accuracy in the initial prediction of vancomycin concentrations. Among them， SmartDose demonstrates the highest overall prediction accuracy and possesses comprehensive clinical management features. It is recommended that Pharmado be preferred for patients with renal hyperfiltration； SmartDose or ClinCalc can be used for patients with normal or mildly impaired renal function； SmartDose is recommended for patients with moderately impaired renal function； Pharmado or Gulou may be considered for patients with severely impaired renal function.

Objective To evaluate the cost-effectiveness of posaconazole compared with voriconazole in the empiric or diagnostic-driven treatment of invasive mould diseases （IMD） in immunocompromised patients from the perspective of Chinese health system. Methods A decision tree model was constructed based on a phase Ⅲ clinical trial and other publicly available data to evaluate the incremental cost-effectiveness ratio （ICER） of posaconazole versus voriconazole. One-way sensitivity analysis, probability sensitivity analysis, and scenario analysis were conducted. Results The results of base-case analysis indicated that, at a willingness-to-pay （WTP） threshold of 3 times Chinese GDP per capita, posaconazole gained 0.0327 quality-adjusted life years （QALYs） with the cost savings of CNY 1 711.24, demonstrating a clear cost-effectiveness advantage. Sensitivity analysis revealed that the cost of voriconazole and posaconazole significantly influenced the ICER. Under different WTP thresholds, posaconazole consistently maintained its economic advantage over voriconazole. Scenario analysis showed that the incidence of mucormycosis did not impact the results, but a price reduction in voriconazole could change result. Conclusion In the empiric or diagnostic-driven treatment of IMD in immunocompromised patients, posaconazole was both an effective and economically viable choice when compared to voriconazole.

Off-label use means that the intended use of the drug is not included in the instructions approved by the National Medical Products Administration,including unapproved indication,dosage,the course of treatment,route of administration,or population.The formulation of Pharmaceutical Supply Services-Key Medications Management-Off-label Uses is based on relevant laws,regulations,normative documents,guidelines,literatures,and expert opinions,and follows the principles of scientificity,versatility,instructiveness,and operability.This standard regulates and standardizes the institutional and organizational construction,process management,and the whole process of quality management and evaluation improvement of off-label uses,which is the basis for medical institutions to carry out off-label uses management.This article introduced the formulation process of the off-label uses standard and analyzed the key contents of the standard,which would help medical institutions to better comply with and meet the requirements of this standard in the practice of off-label use management.

Drugs under special management include narcotic drugs,psychotropic drugs,toxic drugs for medical use,radiopharmaceuticals,and pharmaceutical precursor chemicals.Supervising and guiding the clinical use of drugs under special management is one of the important responsibilities of the Pharmaceutical Management and Drug Therapy Committee(Group)of medical institutions.The standard for drugs under special management is led by the Pharmaceutical Professional Committee of the China Hospital Association,which standardizes 16 key elements of organizational management,process management,and quality control management drugs under special management in medical institutions.It can guide the standardized implementation of Pharmaceuticals under special control work in various levels and types of medical institutions.This article elaborates on the methods and contents of formulating standards for Pharmaceuticals under special management,to provide reference and inspiration for medical institutions to carry out special drug drug management and daily related work.

The management of clinical application of antimicrobial drugs is an important part of the pharmaceutical management and pharmacy services in medical institutions.Based on national policies and regulations,this standard focuses on the whole life cycle of antimicrobial drugs in medical institutions.It is developed based on the principles of scientific validity,universality,guidance and operability,formed by sorting out problems,collecting opinions,expert argumentation and deliberation.It is the first group standard to standardize the clinical application management of antimicrobial drugs.This paper introduces and analyzes the team composition,problem sorting and compilation process,and various elements of the standard in the process of formulating the standard,and provide a reference for the majority of peers who use it.

Antineoplastic drugs refer to the drugs that act at the cellular and molecular levels to inhibit tumor growth or eliminate tumors through pathways such as cell killing,immune regulation,and endocrine regulation.Antineoplastic drugs generally including chemotherapeutic drugs,molecular targeted therapeutic drugs,immunotherapeutic drugs,and endocrine therapeutic drugs.The management and rational application of antineoplastic drugs in medical institutions are related to the safety of patient treatment.The standard for management of antineoplastic drugs use in clinical is compiled by the Pharmaceutical Affairs Committee of China Hospital Association,which specification requirements 18 key elements in the organizational management and system,medication management,drug monitoring and evaluation of antineoplastic drug management in healthcare institutions.This standard is applicable to all levels and types of healthcare institutions carrying out oncology diagnosis and treatment.This paper describes the methodology and basic content of the standard,hoping to providing a reference for medical institutions to carry out relevant work.

Objective To explore the fluctuation characteristics of long-term doctor's order workload in pharmacy intravenous admixture services (PIVAS) and build a daily workload fluctuation prediction model and provide reference for the adjustment of PIVAS work mode. Methods Daily workload data of long-term doctor’s orders from PIVAS in the East Campus of Zhongshan Hospital affiliated to Fudan University from July 2020 to June 2021 were selected , and the time series analysis method was used to analyze the workload fluctuation characteristics and a prediction model was established. The accuracy of the model was verified by fitting parameters and prediction results. Results The fluctuation of PIVAS long-term doctor's daily workload data had the characteristics of periodicity, short-term slow rise and irregular variation. The Winters multiplier model was used to fit the series with R² = 0.777, the significance value of Ljung-Box statistic value (P value) was 0.060, and the mean absolute error percentage between the fitted and actual values was 4.45%, indicating that the model fitting accuracy was high. The average relative deviation between the predicted and actual results was 3.81%, indicating that the model prediction was effective. Conclusion The model constructed in this study could be used for the analysis and prediction of long-term doctor's orders workload of PIVAS. However, because the workload of doctor's orders has fluctuations such as periodicity and irregular changes, it is necessary to adjust the working model according to the fluctuation characteristics of the workload and the prediction results to ensure the efficient operation of PIVAS.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To investigate the current situation and needs of pharmaceutical training for general practice faculty.Methods:A self-designed questionnaire survey was conducted in April 2019. The participants were general practice faculty attending the national training course in Zhongshan Hospital and selected by convenience sampling method.Results:A total of 219 general practice teachers participated in the survey, 51.14% (112/219) of the participants thought that the current pharmaceutical knowledge did not meet the needs of pharmaceutical services in daily work, and 67.58% (148/219) attended pharmacy related training every year, and the frequency was mainly 1—2 times per year (56.62%, 124/219). The main reasons for attending the training were working needs (68.24%, 101/148) and willingness (55.41%, 82/148); 63.51% (94/148) of the participants thought that the training was moderate or less effective, mainly because of the weak strength of trainers (40.54%, 60/148), insufficient attention paid by trainers (37.16%, 55/148) and lack of depth (37.16%, 55/148). The survey showed that 76.26% (167/219) of general practice teachers had pharmaceutical training needs; and gender, working years and working experience in secondary and/or tertiary hospitals were influencing factors for pharmaceutical training needs. And female faculty, those working less than 10 years and with working experience in secondary hospitals had higher demand for pharmaceutical training. The expected pharmaceutical training focused primarily on the selection and optimization of medication schemes (72.60%, 159/219), interaction/incompatibility between medicines (62.10%, 136/219) and pharmaceutical care in medical treatment (57.08%, 125/219). The expected training methods were mainly interactive case analysis and discussion (69.41%, 152/219) through the internet or APP (such as WeChat) (54.34%, 119/219); the expected training frequency was no more than once in two months (36.07%, 79/219), better in working time (48.86%, 107/219) and each session was 30—45 minutes (38.36%, 84/219).Conclusion:General practice faculty has a high demand for pharmaceutical training. Targeted, individualized and systematic pharmaceutical training courses should be developed according to the pharmaceutical training needs of participants.

Humans ; Warfarin/therapeutic use* ; Cytochrome P-450 CYP2C9/genetics* ; Anticoagulants/therapeutic use* ; Genotype ; Heart Valves ; China ; Apolipoproteins E/genetics* ; Dose-Response Relationship, Drug ; Receptors, Calcitriol/genetics*