OBJECTIVE To formulate Guidelines for the standardized implementation of pharmacist-managed clinics （ 2026 edition ） in response to the challenges faced by such clinics in China， including uneven development， large discrepancies in service specifications， insufficient patient awareness， and limited medical insurance coverage. METHODS Led by the Pharmaceutical Affairs Professional Committee of the Chinese Hospital Association， the Evidence-based Pharmacy Professional Committee of the Chinese Pharmaceutical Association， and the Hospital Pharmacy Professional Committee of the Cross-strait Medical and Health Exchange Association， a total of 19 domestic hospital pharmacy experts were organized. Through a systematic review of national policies and literature research， current practical experience was summarized. Consensus on the contents of the guidelines was reached after in-depth discussions. RESULTS &CONCLUSIONS The guidelines covered five sections： definition and connotation of pharmacist-managed clinics， establishment requirements， implementation and management， post competency， and practical research. Firstly， the definition and connotation included three operational forms of pharmacist-managed clinics （independent mode， physician-pharmacist joint mode， and online pharmacist-managed clinic mode） and classified service modes （specialty-specific， drug-specific， and disease-specific pharmacist-managed clinics）. The establishment requirements were further refined， covering system construction （pharmaceutical service management system， quality control and assessment mechanism）， personnel qualifications （professional credentials， continuing education and professional training， etc）， service recipients， as well as service venues and facilities. Subsequently， the implementation and management of pharmacist-managed clinics were proposed， involving service procedures， intervention measures， documentation and records， patient education and follow-up， humanistic care， as well as risk management and quality control. Finally， post competency encompassed the competency requirements for pharmacists providing services in pharmacist-managed clinics， as well as the suggestions on teaching methods； practical research encouraged the conduct of high-quality pharmaceutical practice in the setting of pharmacist-managed clinics. The guidelines provide valuable guidance for the standardized implementation of pharmacist-managed clinics in China in terms of establishment， management， teaching， and research， fill the guideline gap in this field， and can promote the high-quality development of pharmacist-managed clinics.

To understand the background of Escherichia coli(E.coli)carried by artificially bred sika deer and the biological characteristics of the isolated strains,such as drug resistance and pathogenicity,in April 2024,we collected 184 fresh deer fecal samples from four deer farms in Luxiang Township,Shuangyang District,Changchun City,Jilin Province,for isolation and cultivation of E.coli.The isolates were tested for drug resistance and biochemical identification with a BD PhoenixTM-100 Automated Microbiology System.The virulence genes were detected with PCR,and the strains were molecularly typed with ERIC-PCR.A total of 165 E.coli strains were isolated from 184 samples of deer feces,with an isolation rate of 89.67%.Twenty strains had a drug resistance phenotype,and the drug resistance rate was 12.12%;these strains included 15 strains of multi-drug resistant bacteria and 11 strains of ESBL-producing bacteria.Virulence gene detection indicated that the sika deer isolates carried multiple diarrhea-associated virulence genes,such as EAST-1(12.12%),eae(1.21%),stx1(7.88%),stx2(7.27%),and STa(1.82%).ERIC-PCR demonstrated that the isolates showed high polymorphism.The ESBL-producing E.coli carried by sika deer are likely to spread drug resistance in the community and livestock population.Some isolates carried multiple diarrhea-associated virulence genes,thus posing a human transmission risk.Therefore,monitoring of drug resistance and virulence genes must be strengthened,and antibiotics must be used reasonably during the breeding process to avoid excessive use and misuse.

Objective To explore the preferences and needs of colorectal cancer patients for"Internet+TCM nursing services",aiming to provide a basis for the improvement of service quality and the formulation of relevant policies,so as to better meet the needs of patients.Methods A total of 189 patients with colorectal cancer who were admitted to a tertiary A Chinese Medicine hospital in Qingdao from September 2023 to July 2024 were selected as the research subjects.A general data questionnaire and Questionnaire on"Internet+Traditional Chinese Medicine Nursing Service"Preference of Colorectal Cancer Patients were used with 6 attributes,including average out-of-pocket cost,nurse qualification,service waiting time,service mode,comprehensiveness of service content,and platform service evaluation,each attribute with 2 to 3 levels.The preference,payment intention of"Internet+TCM nursing services"were analyzed by constructing a mixed Logit model,and the influencing factors of choice preference of different colorectal cancer patients was explored through subgroup analysis.Results Totally 189 questionnaires were sent out,and 156 valid questionnaires were collected,with an effective recovery rate of 82.54％.Among the respondents,112 patients(71.79％)actively accepted"Internet+TCM nursing services",and the attributes of"Internet+TCM nursing services"such as payment fee,service evaluation,service content and nurse qualification had an impact on nursing service preference of colorectal cancer patients(P＜0.05).Based on willingness to pay,the ranking of attributes was service evaluation,service content and nurse qualification.Factors such as education level and the presence of ostomy also affected the preference of"Internet+TCM nursing services"in patients with colorectal cancer(P＜0.05).Conclusion Patients with colorectal cancer prefer"Internet+TCM nursing services",which has an average service cost of 50 yuan per time,excellent platform service evaluation,comprehensive service content,specialized TCM nurses.The preferences and specific characteristics of patients with colorectal cancer can be considered to optimize the allocation of nursing resources and provide services in line with their preferences.

Objective To explore the preferences and needs of colorectal cancer patients for"Internet+TCM nursing services",aiming to provide a basis for the improvement of service quality and the formulation of relevant policies,so as to better meet the needs of patients.Methods A total of 189 patients with colorectal cancer who were admitted to a tertiary A Chinese Medicine hospital in Qingdao from September 2023 to July 2024 were selected as the research subjects.A general data questionnaire and Questionnaire on"Internet+Traditional Chinese Medicine Nursing Service"Preference of Colorectal Cancer Patients were used with 6 attributes,including average out-of-pocket cost,nurse qualification,service waiting time,service mode,comprehensiveness of service content,and platform service evaluation,each attribute with 2 to 3 levels.The preference,payment intention of"Internet+TCM nursing services"were analyzed by constructing a mixed Logit model,and the influencing factors of choice preference of different colorectal cancer patients was explored through subgroup analysis.Results Totally 189 questionnaires were sent out,and 156 valid questionnaires were collected,with an effective recovery rate of 82.54％.Among the respondents,112 patients(71.79％)actively accepted"Internet+TCM nursing services",and the attributes of"Internet+TCM nursing services"such as payment fee,service evaluation,service content and nurse qualification had an impact on nursing service preference of colorectal cancer patients(P＜0.05).Based on willingness to pay,the ranking of attributes was service evaluation,service content and nurse qualification.Factors such as education level and the presence of ostomy also affected the preference of"Internet+TCM nursing services"in patients with colorectal cancer(P＜0.05).Conclusion Patients with colorectal cancer prefer"Internet+TCM nursing services",which has an average service cost of 50 yuan per time,excellent platform service evaluation,comprehensive service content,specialized TCM nurses.The preferences and specific characteristics of patients with colorectal cancer can be considered to optimize the allocation of nursing resources and provide services in line with their preferences.

OBJECTIVE To investigate and analyze the current situation and problems of the advanced personnel en-gaging in the hospital-acquired infection control during their training period and explore the existing countermeas-ures and future development.METHODS The literatures regarding to the advanced study in China were retrieved from databases,the subjects of the literatures covered infection control-related advanced study practice,discipline construction,position competence,talent cultivation,scientific research innovation,professional title evaluation,laws,regulations and development plans.From Aug.2024 to Nov.2024,a questionnaire survey and face-to-face interviews were conducted among 36 advanced study personnel from 9 provinces of China who engaged in hos-pital-acquired infection control in the First Medical Center of Chinese PLA General Hospital.Eventually,36 ques-tionnaires were retrieved,all of which were valid with a questionnaire recovery rate of 100.00％.RESULTS Among the 36 advanced study personnel of hospital-acquired infection control,58.33％were medium-grade professional ti-tle;preventive medicine(41.67％),clinical medicine(25.00％)and nursing(16.67％)ranked the top 3 majors.The personnel engaged in the infection control for more than 6 years,and the duration of the advanced study was generally 3 or 6 months.In reality,the personnel faced the choices in terms of the purposes of further education,learning approaches and learning contents.The advanced study personnel also encountered the problems of challenges from promotion,improvement of position competency,integration with clinical training,supervision and practice,as well as physiological,psychological and family pressure.CONCLUSION Aiming at the problems that the advanced study personnel are generally concerned about,such as how to scientifically and effectively carry out hospital-acquired infection control advanced study and preset and solve the problems that may encounter,it is necessary to formulate targeted training programmes so as to provide bases and enlightenment for establishment of a long-term mechanism for advanced study of infection control in China.

Objective To investigate the clinical characteristics of women with abnormal uterine bleeding(AUB)in sub-plateau regions and analyze the factors affecting their treatment methods.Methods AUB patients who were hospitalized from Jan 1,2018 to Dec 31,2022,in a sub-plateau region(Yongping County People's Hospital of Yunnan Province)with an average altitude of 1 620 meters were selected.The general clinical characteristics of the patients were summarized,and patients were classified into two categories(with or without uterine structural lesion)and nine subtypes(PALM-COEIN)according to the FIGO recommended etiological classification guidelines.Then the patients were divided into groups based on the presence or absence of uterine structural lesions,ethnic group(Han and minority),conservative drug treatment and surgical treatment groups,blood transfusion and non-blood transfusion groups.Binary Logistic regression analysis was used to identify factors affecting treatment methods.Results A total of 481 AUB patients enrolled,and the delayed consultation rate was as high as 80.46%,and the proportion of overweight and obese patients was 49.90%,which was higher than the average level among Chinese women.The main cause was AUB-O(AUB-ovulatory dysfunction),accounting for 78.59%of cases,the proportion of patients with delayed medical treatment was higher than those without delayed medical treatment(82.17%vs.74.47%).Patients who received blood transfusion were significantly younger,had lower hemoglobin(HGB)levels,fewer pregnancies,and lower BMI compared to those in the non-blood transfusion group(P<0.05).Univariate analysis showed that the surgical treatment group had older age,longer onset time,higher HGB levels,more pregnancies and deliveries,higher BMI,a higher proportion of Han ethnicity patients,lower rates of non-blood transfusion,higher rates of hypertension,and more uterine structural lesions compared to the conservative drug treatment group.Multivariate regression analysis revealed that blood transfusion treatment reduced the probability of surgical treatment.Age and uterine structural lesions were risk factors for requiring surgical treatment,for each additional year of age,the risk of undergoing surgical treatment increased by 10%.The risk of requiring surgical treatment for patients with uterine structural lesions was 2.987 times higher than for those without.Conclusion AUB patients in this sub-plateau regions have a high rate of delayed consultation and a high proportion of overweight and obesity,with AUB-O being the primary cause.Older age and the presence of uterine structural lesions were risk factors for requiring surgical treatment.

Aim To explore the mechanism of action of Guizhi Jia Gegen decoction(GGD)in treating pneu-monia-enteritis induced by H1N1 influenza virus infec-tion in a mouse model,using network pharmacology and molecular docking techniques,followed by in vivo verification.Methods A pneumonia-enteritis mouse model was established,and the intervention effects of GGD on the model mice were evaluated using indica-tors such as body weight,rectal temperature,lung in-dex,colon length,H1N1 M gene expression,relative mRNA expression levels of inflammatory cytokines,and pathological sections of the lung and intestine.The targets of the blood-absorbed components of GGD were identified using the Swiss Target Prediction platform,and the disease targets were retrieved from the Gene-Cards platform.The intersecting targets were analyzed through PPI network analysis using the STRING data-base to identify core targets.GO analysis and KEGG pathway enrichment analysis were performed using the Metascape database.RT-qPCR was employed to vali-date the core targets and pathways.Molecular docking was conducted using AutoDock Tools software to verify the interactions between blood-absorbed components and key targets.Results GGD demonstrated signifi-cant therapeutic effects on the pneumonia-enteritis mouse model.The results of network pharmacology in-dicated that the therapeutic effects of GGD were strong-ly associated with targets such as TNF,ALB,PTGS2,MMP9,EGFR,ESR1,SRC,HSP90AA1,PPARG and MMP2.RT-qPCR results indicated that GGD could intervene in pneumonia-enteritis by regulating the targets TNF,ALB,EGFR and the related targets of the NF-κB pathway.Molecular docking results re-vealed that blood-absorbed components such as puerar-in and liquiritin could stably bind to TNF,ALB and EGFR.Conclusion Components such as puerarin and liquiritin in GGD may exert therapeutic effects on pneumonia-enteritis induced by H1N1 influenza virus infection by acting on targets such as TNF,ALB and EGFR.

Objective·To explore the efficacy of the XP-Endo Shaper(XPS)and Reciproc(RC)engine-driven nickel-titanium file systems in removing root canal fillings,and to provide evidence for clinical application.Methods·The maxillary first permanent molars were obtained from patients who visited the Department of General Dentistry,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,between March and September 2022,which required tooth extraction due to periodontal disease.A total of 30 mesiobuccal or distobuccal root canals with moderate curvature were selected and randomly divided into the RC file group(control group,n=15)and the XPS file group(experimental group,n=15).All root canals were first negotiated and shaped using M3-PRO nickel-titanium files,followed by root canal obturation with bioceramic paste using the single-cone technique.Then,RC files(R25)were used in the control group,while XPS files were used in the experimental group to remove the root canal obturation.Cone Beam Computed Tomography(CBCT)scans were performed before and after the removal procedures.The time required for obturation removal,the percentage of residual obturation volume,the amount of apical debris extrusion,and the degree of instrument deformation were recorded.Independent-sample t-tests and chi-square test were used to compare the differences between the two groups.Results·The XPS group required slightly more time(118.87±18.58)s than the RC group(107.93±14.79)s,but the difference between two groups was not statistically significant.The XPS group had a lower percentage of residual obturation volume(7.51±8.06)%compared to the RC group(15.02±14.63)%,but the difference was not statistically significant.The XPS group had significantly less apical debris extrusion(6.15±1.42)mg than the RC group(8.29±2.01)mg,with a statistically significant difference(P=0.002).Both groups exhibited varying degrees of instrument deformation,but yet no instrument separation occurred in either group.Conclusion·The RC engine-driven nickel-titanium files were slightly more time-efficient in removing root canal fillings,whereas the XPS files achieved a higher canal cleanliness and produced less apical debris extrusion.As there was no significant difference in removal time,and considering the superior cleaning performance and reduced risk of postoperative complications,the XPS file system appears more suitable for removing root canal fillings in moderately curved root canals.

As the first defense of respiratory system,airway epi-thelial cells(AECs)play an important role in separating the re-spiratory internal and external environment.They are essential for the natural immune function.Small airway lesions are an im-portant early pathology of chronic obstructive pulmonary disease(COPD),when AECs are exposed to harmful particles or gases for a long time,the epithelial barrier is damaged,and the signa-ling pathways which involved in differentiation,repair,and in-flammatory are disordered,resulting in epithelial cell cycle stag-nation and accelerated aging.A number of studies have sugges-ted that AECs of COPD patients express high levels of aging markers,suggesting that senescence of AECs is closely related to COPD.This review discusses the potential mechanisms of AECs senescence in COPD,the impact of AECs senescence on the de-velopment and severity of the disease,and highlights potential targets for modulating cellular senescence in airway epithelium as a therapeutic approach in COPD.

[Objective] To analyze the prevalence of human T-lymphocyte leukemia virus (HTLV) among blood donors in Guangzhou from 2016 to 2021, and provide a basis for blood collection and supply management in this region. [Methods] A total of 2 116 951 voluntary blood donors were screened for anti-HTLV by enzyme-linked immunosorbent assay (ELISA) from March 2016 to December 2021 in Guangzhou, and the reactive cases were further confirmed by Western blotting (WB). Qualitative data were analyzed by χ2 with spss19 software. The trend of the total positive rate of HTLV confirmation test by WB from 2016 to 2021 was analyzed with the Joinpoint software, and the annual percent change (APC) was used to determine whether the trend changes were statistically significant. [Results] From March 2016 to December 2021, the total positive rate for anti-HTLV by ELISA among voluntary blood donors in Guangzhou was 0.019 7% (416/ 2116 951), and the WB confirmed positive rate was 0.001 1% (23/2 116 951). The total positive rate of HTLV among individual voluntary blood donors in the six main districts (0.002 12%, 19/895 301) was higher than that among group voluntary blood donors (0.000 32%, 3/951 947) (P<0.05). There was no significant difference in the total positive rate of HTLV confirmation between the six main districts (0.001 19%) and the three non-main districts (0.000 37%) (P>0.05). The trend of the total positive rate of HTLV infection in the six main districts and the Guangzhou area(including the six main districts and three non-main districts) showed no significant increase or decrease. [Conclusion] The prevalence of HTLV among blood donors in Guangzhou remains at a low level.