ObjectiveTo establish a geographical origin identification model for Foeniculi Fructus from Haiyuan， providing a new technical reference for the protection of Haiyuan's geo-authentic medicinal materials and its designation as a national geographical indication agricultural product. MethodsSamples of Foeniculi Fructus were collected from eight producing areas， including Minqin （Gansu）， Bozhou （Anhui）， Qingdao （Shandong）， Dezhou （Shandong）， Urumqi （Xinjiang）， Nujiang （Yunnan）， Gutuo （Inner Mongolia）， and Haiyuan （Ningxia）. Gas chromatography-ion mobility spectrometry （GC-IMS） was used to detect the volatile organic compounds （VOCs） in samples from these geographic origins. VOCs were qualitatively analyzed through dual matching with the National Institute of Standards and Technology （NIST） mass spectral database and the IMS drift time database. Using the Reporter module and Gallery Plot visualization tools within the LAV analytical platform， VOC fingerprint profiles characterizing geographic origins were constructed. A non-targeted analytical strategy was adopted， and 97 VOCs detected via GC-IMS were subjected to principal component analysis （PCA） and partial least squares discriminant analysis （PLS-DA） based on their differential distribution patterns to construct an origin identification model for Foeniculi Fructus from Haiyuan region. Key discriminative markers were screened using variable importance in projection （VIP） values greater than 1. ResultsA total of 97 VOCs were identified， including alcohols， aldehydes， ketones， esters， organic acids， terpenoids， ethers， alkenes， and benzenes. The PLS-DA model， based on VOCs data obtained by GC-IMS， effectively distinguished Foeniculi Fructus in Haiyuan region from those of other origins. During cross-validation， the model achieved a prediction parameter （Q²） of 0.976 and a goodness-of-fit parameter （R²） of 0.936， with no overfitting observed in permutation testing. Twelve key flavor markers with VIP > 1 were identified as characteristic indicators of Haiyuan origin. ConclusionA stable and highly predictive origin identification model for Foeniculi Fructus from Haiyuan was successfully established using GC-IMS technology， PLS-DA， and VIP-based marker screening. This model provides a novel technical strategy for accurately distinguishing Foeniculi Fructus in Haiyuan region from other regional varieties and offers new technical support for its protection as a geo-authentic medicinal material and a nationally designated geographical indication agricultural product in China.

ObjectiveTo establish a geographical origin identification model for Foeniculi Fructus from Haiyuan， providing a new technical reference for the protection of Haiyuan's geo-authentic medicinal materials and its designation as a national geographical indication agricultural product. MethodsSamples of Foeniculi Fructus were collected from eight producing areas， including Minqin （Gansu）， Bozhou （Anhui）， Qingdao （Shandong）， Dezhou （Shandong）， Urumqi （Xinjiang）， Nujiang （Yunnan）， Gutuo （Inner Mongolia）， and Haiyuan （Ningxia）. Gas chromatography-ion mobility spectrometry （GC-IMS） was used to detect the volatile organic compounds （VOCs） in samples from these geographic origins. VOCs were qualitatively analyzed through dual matching with the National Institute of Standards and Technology （NIST） mass spectral database and the IMS drift time database. Using the Reporter module and Gallery Plot visualization tools within the LAV analytical platform， VOC fingerprint profiles characterizing geographic origins were constructed. A non-targeted analytical strategy was adopted， and 97 VOCs detected via GC-IMS were subjected to principal component analysis （PCA） and partial least squares discriminant analysis （PLS-DA） based on their differential distribution patterns to construct an origin identification model for Foeniculi Fructus from Haiyuan region. Key discriminative markers were screened using variable importance in projection （VIP） values greater than 1. ResultsA total of 97 VOCs were identified， including alcohols， aldehydes， ketones， esters， organic acids， terpenoids， ethers， alkenes， and benzenes. The PLS-DA model， based on VOCs data obtained by GC-IMS， effectively distinguished Foeniculi Fructus in Haiyuan region from those of other origins. During cross-validation， the model achieved a prediction parameter （Q²） of 0.976 and a goodness-of-fit parameter （R²） of 0.936， with no overfitting observed in permutation testing. Twelve key flavor markers with VIP > 1 were identified as characteristic indicators of Haiyuan origin. ConclusionA stable and highly predictive origin identification model for Foeniculi Fructus from Haiyuan was successfully established using GC-IMS technology， PLS-DA， and VIP-based marker screening. This model provides a novel technical strategy for accurately distinguishing Foeniculi Fructus in Haiyuan region from other regional varieties and offers new technical support for its protection as a geo-authentic medicinal material and a nationally designated geographical indication agricultural product in China.

Objective:To analyze the association between the pre-pregnancy oral microbiota of women and fetal overgrowth, and the possible mechanisms involved.Methods:A nested case-control study design based on a pre-pregnancy cohort was used to select 51 mothers who delivered macrosomia and/or large-for-gestational-age (LGA) infants from the population recruited at the Maternal and Child Health Care Hospital of Jiading District in Shanghai from October 2016 to December 2021 as the case group. A control group was formed by selecting 204 mothers who delivered infants with normal birth weight and appropriate for gestational age during the same period, in a 1:4 ratio. The LGA subgroup consisted of 48 mothers who delivered LGA infants from the total population, and a corresponding control group of 192 was randomly selected from the remaining mothers who delivered non-LGA infants in a 1∶4 ratio for the LGA subgroup analysis. The 16S rRNA gene sequencing technique was utilized to detect pre-pregnancy saliva samples to compare the characteristics of the oral microbiota, differential microorganisms, and differential functional pathways between groups. Nonparametric Wilcoxon rank-sum tests, two independent samples t-tests, or Chi-square (or Fisher's exact) tests were used for statistical analysis. Factor analysis was conducted on the pre-pregnancy diet data of women, and the primary dietary pattern of each study subject was identified based on the highest score of the dietary pattern factors. For microbiota count data, α and β diversity indices were calculated using R and QIIME2 software, and the corresponding microbiota functional count data were acquired through PICRUSt2. Results:(1) General data: There was no significant difference in the time interval from pre-pregnancy sampling to pregnancy and from sampling to delivery between the two groups. In the case group, there were three cases of macrosomia and 48 cases (94.1%) of LGA. The corresponding control group for the LGA subgroup consisted of 192 cases. There were no significant differences in dietary patterns between the case group and the control group. (2) α diversity analysis: The species richness index of the case group was lower than that of the control group [(367.27±84.57) vs. (408.71±93.08), multivariate analysis, P=0.009], while no significant differences were found between the two groups in the Shannon and Simpson indices; the species richness index of the LGA subgroup was also lower than that of the corresponding control group [(371.04±83.92) vs. (408.04±94.21), multivariate analysis, P=0.033], with no significant differences in the Shannon and Simpson indices. (3) β diversity analysis: There was a statistically significant difference in the unweighted UniFrac distance of the oral microbiota between the case group and the control group ( R2=0.006, F=1.479, P=0.048). No significant differences were found in the β diversity indices of the oral microbiota between the LGA subgroup and the corresponding control group. (4) Differential microbiota analysis: There were 14 differential microbiotas from phylum to genus between the case group and the control group. At the genus level, members of the G1 genus of the Streptococcaceae were enriched in the case group, while the Lautropia, Dialister, Leptotrichia, and Rothia were enriched in the control group. In the LGA subgroup and its corresponding control group, there were 14 differential microbiota from phylum to genus; at the genus level, Leptotrichia, Rothia, G6 genus of the Saccharibacteria, and Selenomonas were enriched in the control group (all LDA value>2, and all P<0.05). (5) Differential functional analysis: In the case group, metabolic pathways such as nicotinate degradation [log 2 fold change ( FC)=3.510, q=0.005], de novo synthesis of pyrimidine nucleotides (log 2FC=0.078, q=0.005), and L-tyrosine degradation pathway (log 2FC=0.710, q=0.034) were enriched in the oral microbiota of women. In the LGA subgroup, compared to the corresponding control group, metabolic pathways related to nicotinate degradation were enriched in the oral microbiota (log 2FC=3.660, q=0.012). Conclusions:There are differences in the structure of the pre-pregnancy oral microbiota of mothers with overgrown fetuses compared to those with normally grown fetuses, and mothers of normally grown fetuses show higher diversity in their pre-pregnancy oral microbiota. The enrichment of certain pathogenic bacteria and the reduction of symbiotic bacteria in the pre-pregnancy oral microbiota are associated with fetal overgrowth, and this association may be mediated by functional pathways such as nicotinate degradation.

The methodological framework for interventional clinical research of Chinese medicine （CM） under the research mode of syndrome dominating disease provides a set of technical principles and methods to design， evaluate， and implement of this kind. It consists of three main parts including general principles， research points and key design elements， with a total of 25 items. This methodological framework proposes implementing requirements and recommendations in a variety of aspects， including basic norms to be followed in relevant studies， perspectives for selecting research topics， as well as the technological details on study population （P）， intervention （I） and comparison（C）， outcome measurement （O）， time frame （T） of treatment and follow-up， sample orientation （prospective versus retrospective）， study design （S） format and type. To provide practical guidance for future studies， this article clearly explains each items of the methodological framework through some supportive cases.

Objective To systematically evaluate the efficacy and safety of hydromorphone or morphine for cancer pain using intrathecal drug infusion system(IDDS).Methods Chinese and English literature databases,including CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,and Ovid,were searched from inception to Aug.31,2023 to collect randomized controlled trials(RCTs)about intrathecal infusion of morphine or hydromorphone in treatment of cancer pain.Two reviewers independently screened literature and extracted data according to the inclusion and exclusion criteria,and evaluated the quality of RCTs using a Cochrane bias risk assessment tool.Then,meta-analysis was performed using RevMan 5.4.1 software.Results A total of 6 RCTs,involving 544 patients,were enrolled.Among them,there were 282 cases in the hydromorphone group and 262 cases in the morphine group.The meta-analysis results showed that there were no significant differences in pain score or number of breakthrough pain episodes between the 2 groups after treatment(all P＞0.05).Compared with the morphine group,the incidence rates of nausea and vomiting,constipation,and somnolence were significantly decreased in the hydromorphone group(P≤0.05),and the quality of life was significantly higher(P＜0.05).Conclusion The efficacy of hydromorphone administered by IDDS for cancer pain is comparable to morphine;hydromorphone has advantages in reducing adverse reactions and improving quality of life of patients.

OBJECTIVE To in vestigate the existing problems about store construction and market operation and management of DTP （direct-to-patient）pharmacies in Guizhou province ，and to provide countermeasures and suggestions for the improvement and development of professional operation of DTP pharmacies in Guizhou province. METHODS According to the literature review ， the questionnaire was designed. Then the field survey of 11 DTP pharmacies and questionnaire survey for the person in charge （or store managers ） in Guizhou province were conducted from April to May 2021. The questionnaire mainly included the basic information，online sales channel construction ，pharmaceutical logistics distribution ，pharmaceutical care ，vocational training ， construction of pharmacy management system and application of drug management information system etc. ，in order to analyze the inadequacies of market operation and management of DTP pharmacies in Guizhou province and put forward suggestions. RESULTS Totally 11 questionnaires were delivered and 9 valid questionnaires were retrieved ，the effective response rate of questionnaires was 81.82％ . The sample pharmacies were all from Guiyang ，most of them （77.78％）were established by local pharmaceutical enterprises in Guizhou province ，and only 22.22％ of the sample pharmacies had opened online drug purchase channels. In terms of pharmaceutical care ，55.56％ of the sample pharmacies provided basic testing and life style interventions respectively ，44.44％ of the sample pharmacies provided adverse drug reaction monitoring ，and 33.33％ of the sample pharmacies implemented health education presentations and chronic disease rehabilitation program respectively. In term of personnel training ，only 11.11％ of the sample pharmacies implemented weekly business training ，and 66.67％ of the sample pharmacies received innovative and academic pharmacy information training. The construction of DTP pharmacy management systems in Guizhou province was completed basically ， but in terms of application of drug management information system ， 22.22％ of the sample pharmacies conducted drug application analysis and monitoring. CONCLUSIONS The development of DTP pharmacies in Guizhou province is still in initial stage currently. The convenience and accessibility of medicines for patients and the construction of online sales channel need to be improved ；the internet channel construction is slow ；an effective selection and evaluation mechanisms for pharmaceutical logistics enterprises need to be created ；pharmaceutical care ability and pharmacy service personnel training system need to be strengthened ；informatization management and industrial recognition of DTP pharmacies in Guizhou province need to be promoted. Therefore ，the enterprises ， government， universities and associations should work together and strengthen the professionalization ， informatization， institutionalization and standardization of DTP pharmacies in Guizhou province ，in order to provide patients with a convenient drug sales channels and high-quality personalized pharmaceutical care platforms eventually.

OBJECT IVE To deeply unders tand the utilization of monoclonal antibody drugs in different levels of medical institutions in China ，so as to provide an empirical basis for further promoting tiered healthcare delivery system. METHODS The basic informations of listed monoclonal antibody drugs in China as of May 2021 were collected through the official websites of government agencies such as National Medical Products Administration and National Healthcare Security Administration ，so as to understand the overall development status of monoclonal antibody drugs in China. The clinical utilization data of monoclonal antibody drugs in all categories of antitumor drugs and immune modulators were collected through “chemical drug terminal of Chinese public medical institutions ”database of Metnet ；the clinical application of monoclonal antibody drugs in medical institutions at different levels was analyzed. RESULTS As of May 2021，there were 53 monoclonal antibody drugs had been approved for listing in China ，including 31 imported monoclonal antibody drugs and 22 domestic monoclonal antibody drugs. From 2015 to 2019，the amount and quantity of monoclonal antibody drugs used in urban medical institutions were the highest among the three levels of medical institutions （both accounted for more than 95％ for five consecutive years ），but the growth rate of drug use in county-level medical institutions was the fastest. In 2019，the cumulative proportion of DDDs and drug amount of the top 10 monoclonal antibody drugs ranked in DDDs were the highest among county-level medical institutions ，being 97.09％ and 94.16％ respectively. From the change trend of DDDc of monoclonal antibody drugs from 2015 to 2019，DDDc of cetuximab decreased the most （70.32％），followed by trastuzumab （67.29％） and bevacizumab（62.89％）. From 2015 to 2019，the number of monoclonal antibody drugs with B/A value of no less than 1 ranked the top 10 of the annual cost were 6，6，6，7 and 5， respectively. CONCLUSIONS In China ，the overall approval and listing speed of monoclonal antibody drugs has accelerated，their quantity has increased rapidly ，and the accessibility is also improved. Among them ，the quantity of monoclonal antibody drugs has increased the fastest in county-level medical institutions ，and they are mainly medical insurance drugs ，and the effect of tiered healthcare delivery system has gradually appeared.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree with a novel ABO subtype. METHODS: The proband and his family members were subjected to serological analysis, and their genotypes were determined by fluorescence PCR and direct sequencing of the coding regions of the ABO gene. Exons 6 to 7 of the ABO gene were also subjected to clone sequencing for haplotype analysis. RESULTS: The proband was determined as an AxB subtype. By fluorescence PCR, he was typed as A/B. Clone sequencing has revealed a insertional mutation c.797_798 insT in exon 7 of the ABO gene, which yielded a novel allele. Pedigree analysis confirmed that the novel ABO*A1.02 allele carried by the proband and his sister was inherited from their father. The c.797_798insT mutation has been submitted to GenBank with an accession number of MK125137. CONCLUSION The c.797_798insT mutation of exon 7 of the ABO gene probably has led to weakened expression of A antigen.
ABO Blood-Group System/genetics* ; Alleles ; China ; Genotype ; Humans ; Male ; Mutation ; N-Acetylgalactosaminyltransferases/genetics* ; Pedigree

OBJECTIVE: To delineate the serological and molecular profiles of a patient with A(w)37B subtype. METHODS: The ABO bloodtypes of the proband, his wife and daughter were determined with a standard serological method. Their ABO genotypes were determined by sequence-specific primer polymerase chain reaction (PCR-SSP). All exons of the ABO gene were directly sequenced. Exons 6 and 7 of the ABO gene were further analyzed by cloning and sequencing. RESULTS: The red blood cells of the proband showed a weak B phenotype. His serum sample contained weak reactive anti-A antibody, which was defined as A(w)B blood group based on the serological characteristics. The A and B alleles were detected by blood group genotyping. Gene cloning and sequencing have identified a characteristic c.940A>G variant (ABO*AW.37) in exon 7 of the ABO gene, which resulted in substitution of Lysine by Glutamate at position 314. The proband's daughter has inherited the ABO*AW.37 allele. CONCLUSION The c.940A>G variant in exon 7 of the ABO gene probably underlay the decreased activity of GTA transferase and resulted in the Aw37 phenotype.
ABO Blood-Group System/genetics* ; Alleles ; Genotype ; Humans ; Pedigree ; Phenotype

OBJECTIVE：To provide evidence for promoting the scientific resea rch ability and talent team construction of hospital pharmacists. METHODS ：From Dec. 2019 to Apr. 2020，“Survey Form for Scientific Research Ability of Hospital Pharmacists”were issued to pharmacists in 62 medical institutions from 20 provinces across the country. The questionnaire was mainly based on five aspects ，i.e. general information of surveyed pharmacists ，the number of internal/external funds and patents approved in recent five years （2015-2019），the number of papers published in domestic/abroad/SCI journals ，the familiarity with scientific research projects ，the difficulties in carrying out scientific research. The collected data were summarized and analyzed with R 4.0.3 software. RESULTS ：A total of 300 questionnaires were sent out ，and 288 valid questionnaires were collected with effective recovery rate of 96％. Among surveyed pharmacists ，94 were male and 194 were female. The majority of them were 31-39 years old （52.78％）；56.25％，28.12％ and 15.63％ of them had bachelor ’s degree ，master’s degree and doctor ’s degree respectively，and 156（54.17％）had intermediate title. Totally 74.66％ of hospital pharmacists thought it was very necessary or necessary to carry out research projects （involving all doctors ，26 masters and 4 bachelors）. There were significant differences among pharmacists with different educational background in respects of the number of applications for internal and external funds and patents ，as well as the number of papers published in domestic/foreign/SCI journals ，and most of them were doctors （P＜ 0.05）. In recent five years ，most of hospital pharmacists had published 1-3 papers in domestic journals ，accounting for 44.80％， while 27.08％ had published papers in SCI journals. Totally 51.39％ of hospital pharmacists were not familiar or not very familiar with scientific research projects funding （most of them had bachelor ’s degree ）；52.43％ expressed that experimental conditions were the biggest difficulty in conducting scientific research. CONCLUSIONS：This survey shows that hospital pharmacists have a relatively positive attitude towards scientific researchprojects. Most of papers are published in domestic journals. 8804919。E-mail：songjc1234@126.com However， there are still many shortcomings in scientific research status. Scientific research capabilities need to be improved. Experimental conditions also limit the scientific research projects to a certain extent. Hospitals need to strengthen funding for pharmacist research projects ，strengthen academic exchanges ， so that pharmacists can understand scientific research projects more comprehensively and systematically.