Objective To investigate the pharmacokinetic(PK)profile of ripretinib in patients with advanced gastrointestinal stromal tumors(GISTs)in real-world settings.Methods The PK data of eight advanced GIST patients treated with ripretinib and the steady-state trough concentration(Cmin)blood samples of 54 advanced GIST patients treated with ripretinib were collected from November 2023 to March 2025 at the First Affiliated Hospital of Sun Yat-sen University.A validated liquid chromatography-tandem mass spectrometry method was used to quantify ripretinib and DP-5439 concentrations.The PK profiles of ripretinib were characterized.Cmin was compared across various dosages.The correlations among PK parameters of ripretinib and DP-5439,and clinical features impacting PK were explored.Results All patients reached Cmin approximately 24 hours post-dose for ripretinib and DP-5439.The median time to maximum con-centration(Tmax)for both ripretinib and DP-5439 was 3.16 hours.The steady-state Cmin,maximum plasma concentration(Cmax),and area under the plasma concentration-time curve from 0 to 24 hours(AUC0-24 h)of ripretinib,DP-5439,and their combined total were found to be highly correlated(all r>0.85,all P<0.05).In patients receiving 150 mg once-daily(n=44),the median Cmin(range)was 381.66(40.90-1 045.48)ng/mL for ripretinib,589.08(25.28-1 168.11)ng/mL for DP-5439,and 998.00(66.18～2 381.48)ng/mL for total,with coeffi-cients of variation(CVs)of 59.4%,57.2%,and 53.6%.In the 300 mg group(n=11),the median Cmin(range)was 1 024.51(251.36-2 030.51)ng/mL for ripretinib,1 122.34(111.54-2 682.57)ng/mL for DP-5439,and 1 924.58(404.37-4 766.08)ng/mL for total,with CVs of 59.5%,57.3%,and 54.8%.Univariate analysis showed that no significant correlation was found between age or BMI and the dose-corrected Cmin of ripretinib and DP-5439(all P>0.05),and the median dose-corrected Cmin of ripretinib and DP-5439 was slightly lower in male patients than in female patients(P<0.05).In the multiple linear regression analysis,male patients were observed to have a lower median dose-cor-rected Cmin of DP-5439 than female patients(P=0.024),but no statistical difference was found in that of ripretinib(P>0.05).Conclusions In advanced GIST patients receiving ripretinib,ripretinib and DP-5439 reached Cmin 24 hours post-dose,just before the next administra-tion.The ripretinib,DP-5439,and total Cmin showed significant correlations with their AUC0-24 h,which indicated that Cmin could serve as an indicator of ripretinib exposure.The PK features of ripretinib in advanced GIST patients exhibit significant inter-individual variability.

Objective To explore the pharmaceutical care clinical pharmacists provide for anti-infective therapy in patients undergoing continuous renal replacement therapy(CRRT)after lung transplantation.Methods The clinical pharmacist utilized a limited sampling strategy and participated in the entire anti-infective treatment process for an adult lung transplant recipient based on pharmacokinetic monitoring results.The CRRT duration was flexibly adjusted,the dosing regimen was optimized,and adverse drug reactions were monitored.Result The clinical pharmacist assisted the physician in optimizing the polymyxin B anti-infective therapy post-transplantation,leading to successful infection control and patient discharge.Conclusion Clinical pharmacists can conduct real-time drug concentration monitoring in lung transplant patients based on pharmacokinetic characteristics,develop individualized dosing regimens,and improve medication safety and efficacy during anti-infective therapy.

Objective To investigate the pharmacokinetic(PK)profile of ripretinib in patients with advanced gastrointestinal stromal tumors(GISTs)in real-world settings.Methods The PK data of eight advanced GIST patients treated with ripretinib and the steady-state trough concentration(Cmin)blood samples of 54 advanced GIST patients treated with ripretinib were collected from November 2023 to March 2025 at the First Affiliated Hospital of Sun Yat-sen University.A validated liquid chromatography-tandem mass spectrometry method was used to quantify ripretinib and DP-5439 concentrations.The PK profiles of ripretinib were characterized.Cmin was compared across various dosages.The correlations among PK parameters of ripretinib and DP-5439,and clinical features impacting PK were explored.Results All patients reached Cmin approximately 24 hours post-dose for ripretinib and DP-5439.The median time to maximum con-centration(Tmax)for both ripretinib and DP-5439 was 3.16 hours.The steady-state Cmin,maximum plasma concentration(Cmax),and area under the plasma concentration-time curve from 0 to 24 hours(AUC0-24 h)of ripretinib,DP-5439,and their combined total were found to be highly correlated(all r>0.85,all P<0.05).In patients receiving 150 mg once-daily(n=44),the median Cmin(range)was 381.66(40.90-1 045.48)ng/mL for ripretinib,589.08(25.28-1 168.11)ng/mL for DP-5439,and 998.00(66.18～2 381.48)ng/mL for total,with coeffi-cients of variation(CVs)of 59.4%,57.2%,and 53.6%.In the 300 mg group(n=11),the median Cmin(range)was 1 024.51(251.36-2 030.51)ng/mL for ripretinib,1 122.34(111.54-2 682.57)ng/mL for DP-5439,and 1 924.58(404.37-4 766.08)ng/mL for total,with CVs of 59.5%,57.3%,and 54.8%.Univariate analysis showed that no significant correlation was found between age or BMI and the dose-corrected Cmin of ripretinib and DP-5439(all P>0.05),and the median dose-corrected Cmin of ripretinib and DP-5439 was slightly lower in male patients than in female patients(P<0.05).In the multiple linear regression analysis,male patients were observed to have a lower median dose-cor-rected Cmin of DP-5439 than female patients(P=0.024),but no statistical difference was found in that of ripretinib(P>0.05).Conclusions In advanced GIST patients receiving ripretinib,ripretinib and DP-5439 reached Cmin 24 hours post-dose,just before the next administra-tion.The ripretinib,DP-5439,and total Cmin showed significant correlations with their AUC0-24 h,which indicated that Cmin could serve as an indicator of ripretinib exposure.The PK features of ripretinib in advanced GIST patients exhibit significant inter-individual variability.

Objective:To explore the experience of psychological resilience in coping with diabetes, to elucidate the factors that contribute to the development of psychological resilience in coping with diabetes.Methods:A descriptive phenomenological approach, guided by the Kumpfer resilience framework in this study was used. A total of 15 diabetic patients who were hospitalized in the Department of Endocrinology of the First Affiliated Hospital with Nanjing Medical University from September to November 2023 were selected for the study using purposive sampling method to conduct semi-structured interviews. Colaizzi's 7-step analysis was used to summarize and refine themes from the interview findings.Results:A total of four themes and 11 sub-themes were distilled, namely, environmental context (availability of social resources, diversity of social support), intrinsic resilience factors (accumulation of positive mindset, physiological resilience reserve, diabetic learning experience, altruism), person-environment interaction processes (acceptance coping, avoidance coping, cognitive reappraisal, role-modeling learning) and resilience processes (enhancement of self-efficacy) .Conclusions:Mobilizing social resources and building a supportive environment are the cornerstones of psychological resilience in diabetes, enhancing intrinsic resilience factors is the core strength of psychological resilience in diabetes, and focusing on the use of coping strategies is the mechanism by which psychological resilience plays a role in adapting to the environment for patients with diabetes.

Objective To explore the pharmaceutical care clinical pharmacists provide for anti-infective therapy in patients undergoing continuous renal replacement therapy(CRRT)after lung transplantation.Methods The clinical pharmacist utilized a limited sampling strategy and participated in the entire anti-infective treatment process for an adult lung transplant recipient based on pharmacokinetic monitoring results.The CRRT duration was flexibly adjusted,the dosing regimen was optimized,and adverse drug reactions were monitored.Result The clinical pharmacist assisted the physician in optimizing the polymyxin B anti-infective therapy post-transplantation,leading to successful infection control and patient discharge.Conclusion Clinical pharmacists can conduct real-time drug concentration monitoring in lung transplant patients based on pharmacokinetic characteristics,develop individualized dosing regimens,and improve medication safety and efficacy during anti-infective therapy.

Objective:To explore the experience of psychological resilience in coping with diabetes, to elucidate the factors that contribute to the development of psychological resilience in coping with diabetes.Methods:A descriptive phenomenological approach, guided by the Kumpfer resilience framework in this study was used. A total of 15 diabetic patients who were hospitalized in the Department of Endocrinology of the First Affiliated Hospital with Nanjing Medical University from September to November 2023 were selected for the study using purposive sampling method to conduct semi-structured interviews. Colaizzi's 7-step analysis was used to summarize and refine themes from the interview findings.Results:A total of four themes and 11 sub-themes were distilled, namely, environmental context (availability of social resources, diversity of social support), intrinsic resilience factors (accumulation of positive mindset, physiological resilience reserve, diabetic learning experience, altruism), person-environment interaction processes (acceptance coping, avoidance coping, cognitive reappraisal, role-modeling learning) and resilience processes (enhancement of self-efficacy) .Conclusions:Mobilizing social resources and building a supportive environment are the cornerstones of psychological resilience in diabetes, enhancing intrinsic resilience factors is the core strength of psychological resilience in diabetes, and focusing on the use of coping strategies is the mechanism by which psychological resilience plays a role in adapting to the environment for patients with diabetes.

Objective:To investigate the effect of combination of D-methionine and docetaxel on gastric cancer cells. Methods:First, seven gastric cancer cell lines were cultured with three different kinds of media (D-Met, L-Met and Met~ - ) for five days, and cell cycle was detected by flow cytometry. Second, gastric cancer cells were respectively cultured in L-Met, D-Met, and Met~ - media for 96 h, then docetaxel was added into 3 media. After 24 h, proliferation was measured by MTT method. Results:All gastric cancer cell lines were arrested in G_ 2 /M phase (P

Objectives: To study the effect of D-methionine on gastric cancer and its mechanism. Methods: We used a medium with D-methionine to culture six gastric cancer cell lines. The medium with L-methionine acted as control to culture cells. The proliferation of cells was detected by MTT. Apoptotic rates and cell cycle were detected by FMC. Results: Absorbance of all cell lines was significantly lower than control (P0.05). KATO-Ⅲ cells stayed more in G 0 /G 1 phase (P