1.Society of Critical Care Medicine 2024 Guidelines on Adult ICU Design: An Interpretation
Hui ZHANG ; Jianhua SUN ; Wanchen ZHAO ; Lingli XIE ; Cong MA ; Yifan FANG ; Jing CAI ; Na GUO
Medical Journal of Peking Union Medical College Hospital 2026;17(2):421-428
This article provides a systematic interpretation and review of the
2.Analysis of the Burden of Acute Lymphoid Leukemia in China and Globally from 1990 to 2021
Derong LIN ; Jingya FANG ; Yue LI ; Xiaohua XIE ; Xiaolin YE ; Xiaowen ZHANG ; Jiexuan LI ; Aiguo XUE
Medical Journal of Peking Union Medical College Hospital 2026;17(2):463-475
To analyze the disease burden of acute lymphoid leukemia(ALL) and its changing trends in China and globally from 1990 to 2021, aiming to provide a theoretical basis for disease prevention, treatment, and policy formulation. Data on the incidence, prevalence, mortality, and disability adjusted life years(DALYs) of ALL in China and globally from 1990 to 2021 were extracted from the Global Burden of Disease(GBD) 2021 database. The Joinpoint regression model was used to calculate the average annual percentage change(AAPC) to assess the trends in disease burden. Decomposition analysis was employed to identify and quantify the contributions of different factors to the changes in ALL disease burden. The population attributable fraction(PAF) was used to compare the risk factors for ALL in China and globally in 1990 and 2021. Stratified by the sociodemographic index(SDI), the locally estimated scatterplot smoothing(LOESS) method was used to assess the association between age-standardized incidence rate(ASIR), age-standardized mortality rate(ASMR), and SDI. The incidence-mortality ratio(IMR) was calculated to evaluate the diagnostic level and current treatment status of ALL. From 1990 to 2021, ASIR of ALL in the Chinese population increased from 3.385/100 000 to 3.637/100 000(AAPC: 0.005), the age-standardized prevalence rate(ASPR) increased from 6.596/100 000 to 22.022/100 000(AAPC: 0.478), the ASMR decreased from 3.051/100 000 to 1.357/100 000(AAPC: -0.056), and the age-standardized DALYs rate(ASDR) decreased from 195.792/100 000 to 74.063/100 000(AAPC: -3.996). Globally, the corresponding figures were: ASIR decreased from 1.789/100 000 to 1.371/100 000(AAPC: -0.014), ASPR increased from 4.122/100 000 to 5.425/100 000(AAPC: 0.039), ASMR decreased from 1.551/100 000 to 0.898/100 000(AAPC: -0.021), and ASDR decreased from 94.894/100 000 to 48.858/100 000(AAPC: -1.494). During this period, the aforementioned disease burden indicators were generally higher in males than in females, both in China and globally.In 2021, the peak incidence of ALL in China and globally was primarily concentrated in the 0-19 years age group, with the highest rate observed in those under 5 years of age. The burden of prevalence and DALYs was also mainly concentrated in this age group. Regarding mortality, the death burden in China was predominantly observed in the older adult age group, particularly among those aged ≥60 years. Globally, the mortality burden was highest in the under-5 age group, while remaining at a relatively high level in the older adult population. SDI correlation analysis based on data from 204 countries/regions globally from 1990 to 2021 showed that ASIR gradually increased with increasing SDI, whereas ASMR showed an initial increase followed by a decreasing trend. The ASIR and ASMR for the overall Chinese population and by sex were higher than expected. PAF results indicated that smoking and high body mass index were the main attributable risk factors for ALL mortality and DALYs burden, with their contribution consistently increasing. Decomposition analysis revealed that population growth and epidemiological changes were the primary drivers behind the changes in ALL incidence and mortality burden. Compared with 1990, the IMR for ALL in both China and globally increased in 2021. Over the past three decades, the ASMR and ASDR for ALL in China and globally have generally declined. During the same period, the ASIR and ASPR for ALL increased in China, while globally, the ASIR decreased and the ASPR increased. However, the disease burden of ALL remains high in males, children, and the older adult population. Differentiated prevention and control measures should be implemented in accordance with changes in SDI. The findings highlight the importance of strengthening prevention and early diagnosis, and suggest the need for targeted screening and treatment strategies for different age and sex groups. Concurrently, attention should be paid to the role of weight management and tobacco control in comprehensive prevention and control efforts to further reduce the disease burden of ALL.
3.Interpretation on the ACcurate COnsensus Reporting Document (ACCORD): Reporting Guidelines for Consensus Methods in Biomedical Research
Haodong LI ; Junxian ZHAO ; Yishan QIN ; Ye WANG ; Huayu ZHANG ; Qi ZHOU ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(2):534-545
The importance of consensus research in medical decision-making has become increasinglyprominent. However, this field has long lacked unified terminology definitions and reporting standards, leading to significant heterogeneity in study design, implementation, and result presentation that affects the credibility and reproducibility of outcomes. The ACCurate COnsensus Reporting Document (ACCORD) in the field of biomedical research provides a structured writing framework for various consensus methods such as the Delphi method and nominal group technique, aiming to enhance the completeness and transparency of study reports. Combined with specific cases, this article interprets the core items of ACCORD, offering references for the design, implementation, and reporting of high-quality consensus research in China.
4.Rapid Qualitative Analysis Methods and Their Application in Implementation Science
Xuehan WEI ; Xiaoying CHEN ; Runze WANG ; Yingqian ZHANG ; Xuehan LIU ; Jin SUN ; Guoyan YANG ; Wei XIAO ; Chunli LU
Medical Journal of Peking Union Medical College Hospital 2026;17(2):546-556
Implementation science (IS) aims to systematically analyze and address the real-world gaps from evidence to practice and the influencing factors of the context. It is necessary to carry out qualitative research to gather relevant implementation outcomes. Nevertheless, traditional qualitative analysis has issues such as consuming a great deal of time and energy, and it is unable to promptly provide the crucial data required for implementation science research. The Rapid Qualitative Analysis (RQA) method, through semi-structured interviews and the adoption of techniques such as immediate data condensation and matrix analysis, can effectively shorten the cycle of qualitative data collection and data processing. RQA can promptly identify social determinants of health such as structural barriers, facilitators, and the behavioral characteristics of target groups. It provides a real-time basis for public health decision-making, the interpretation of complex social phenomena, and the process and effectiveness evaluation of research projects. Although RQA is difficult to conduct in-depth theoretical analysis based on grounded theory, its efficiency and flexibility make it the preferred tool for large-scale and time-sensitive research. Thus, it has been widely applied in implementation science research. This paper sorts out the core concepts and commonly used technical methods of RQA, as well as the differences between RQA and traditional qualitative analysis. It also explores the applications of RQA in intervention optimization, process evaluation, and implementation outcome evaluation. By integrating specific cases, this paper clarifies its application value in the field of implementation science. In the future, it is advisable to explore the integration of RQA with technologies such as artificial intelligence and big data, in order to bridge the gap between the transformation of scientific research achievements into practice. Under circumstances of limited resources or tight time constraints, RQA can be used to efficiently conduct implementation science research, providing convenient and scientific methodological and technical support for accelerating evidence-based practice.
5.Peyton's Four-Step Teaching Method for Intestinal Ultrasound Training: Efficacy and Practical Implications
Zihan NIU ; Xiaoyan ZHANG ; Zhaojue WANG ; Qingli ZHU ; Mengsu XIAO ; Li MA ; Yudi HE ; Wenbo LI
Medical Journal of Peking Union Medical College Hospital 2026;17(2):591-596
To evaluate the application value of the Peyton four-step teaching method in the standardized training of intestinal ultrasound and compare it with traditional teaching methods, so as to provide an optimized approach for clinical ultrasound training. Participants from the Department of Ultrasound at Peking Union Medical College Hospital between September 2024 and March 2025 were randomly assigned to either the traditional group or Peyton group. The traditional group followed the conventional "lecture- demonstration-practice" model, while the Peyton group implemented the standardized "demonstration-deconstruction-comprehension-execution" four-step approach. All training focused on standard intestinal ultrasound scanning techniques. After the training, the operational skills were independently evaluated by the instructors. To verify the reproducibility of the teaching method, the participants in traditional teaching group received additional Peyton method training after the initial assessment and underwent a second evaluation. A total of 18 participants were included in this study, with 9 in the traditional teaching group and 9 in the Peyton teaching group. Participants in the Peyton group demonstrated significantly higher scores than those in the traditional group at every anatomical site assessed (all The Peyton four-step method is significantly more effective than traditional teaching in improving residents' intestinal ultrasound skills, demonstrating its suitability as the preferred approach for standardized training programs.
6.Expert consensus on the implementation and management of drug selection for centralized volume-based procurement in medical institutions of Guangxi
Tingting LI ; Ganping ZHOU ; Yanqing CHEN ; Dongni WU ; Weiyan TANG ; Hongliang ZHANG
China Pharmacy 2026;37(7):829-834
OBJECTIVE To formulate the Expert Consensus on the Implementation and Management of Drug Selection for Centralized Volume-Based Procurement in Medical Institutions of Guangxi (hereinafter referred to as the “ Consensus ”), and to provide decision-making support and practical guidance for the drug selection and management of centralized volume-based procurement (hereinafter referred to as “centralized procurement”) drugs in medical institutions at all levels in Guangxi. METHODS A systematic review was conducted on the materials from previous batches of centralized procurement implemented in Guangxi. A comprehensive search was carried out for drug-related works and books, along with a systematic collation of guidelines on drug selection, expert consensus on centralized procurement, and policy documents. Through three rounds of specialized seminars, combined with existing evidence-based data and the practical drug selection experiences of medical institutions at various levels, this Consensus was formulated after thorough discussion and successive rounds of revision. RESULTS & CONCLUSIONS The Consensus systematically outlines the three key stages in the implementation of centralized procurement in medical institutions: procurement volume reporting, confirmation of agreed procurement volume, and procurement and usage implementation. It proposes drug selection strategies for centralized procurement bas ed on multiple dimensions, including specifications, dosage forms, packaging materials, fill volume, and manufacturing enterprises. In response to practical challenges encountered in the selection process, corresponding countermeasures are proposed, such as establishing a regularized information reserve mechanism, strengthening information technology support, and implementing categorized selection approaches. The Consensus advocates for medical institutions to construct an integrated “policy, data, and quality” decision-making system to promote full-cycle management of centralized procurement. This Consensus will provide scientific and practical guidance for medical institutions at all levels in Guangxi in the drug selection of centralized procurement, facilitating the smooth implementation and sustainable development of centralized procurement policies at the institutional level.
7.Development and application of hospital drug traceability code management model based on full-cycle perspective
Mei ZHANG ; Chunhua GONG ; Guanghui CHEN ; Jiawei LIN ; Haiwei ZHANG ; Kaifeng QIU
China Pharmacy 2026;37(7):854-858
OBJECTIVE To explore and establish a full-cycle management model for drug traceability codes that aligns with national policy requirements and the practical needs of healthcare institutions, thereby enhancing the refinement of drug management and the level of medication safety. METHODS A tripartite strategy integrating “hardware deployment, system transformation, and process re-engineering” was adopted. This involved the introduction of intelligent identification devices (personal digital assistant, high-definition industrial reader), the modification of the hospital information system interface, and the re-engineering of workflows (drug warehousing, dispensing and distribution, drug withdrawal, uploading to the insurance platform) to achieve comprehensive, informatized collection and association of drug traceability codes throughout all stages. RESULTS A full-cycle management model for drug traceability codes was successfully established, realizing the goals of making drugs “traceable to their source, trackable in their distribution, and accountable in their responsibility”. The patient waiting time for medication dispensing before and after the implementation was [3.08(1.67,5.58)] min and [3.28(1.77,5.98)] min, respectively. Among them, the patient waiting time under the pre-preparation mode was [3.60(2.13,6.35)] min and [3.50(2.03,6.30)] min, respectively; the patient waiting time under the real-time mode was [2.05(0.83,4.03)] min and [2.78(1.18,5.38)] min, respectively; the number of dispensing errors was 3, 0, respectively; the staffing of relevant positions had not been increased. CONCLUSIONS The drug traceability code management model constructed from a full-cycle perspective effectively meets national policy requirements. It provides data support for refined hospital management and offers solid technical and procedural safeguards for ensuring patient medication safety and strengthening medical insurance fund supervision, demonstrating practical value.
8.Study on the mechanism of Huatan qushi huoxue formula in improving metabolic dysfunction-associated steatohepatitis by inhibiting macrophage pyroptosis
Yajie GUAN ; Qizhen ZHANG ; Junjiao XU ; Yijia SONG ; Dongfang SHANG ; Wenxia ZHAO ; Minghao LIU
China Pharmacy 2026;37(7):864-869
OBJECTIVE To focus on the classic NOD-like receptor protein 3 (NLRP3)/Caspase-1/gasdermin D (GSDMD) pyroptosis pathway and explore the mechanism by which Huatan qushi huoxue formula (HQHF) inhibits macrophage pyroptosis to ameliorate metabolic dysfunction-associated steatohepatitis (MASH). METHODS RAW264.7 cells were divided into 5 groups: Control group (10% blank serum), Model group [10% blank serum+5 μg/mL lipopolysaccharide (LPS)], HQHF-L group (2.5% drug-containing serum+7.5% blank serum+5 μg/mL LPS), HQHF-M group (5% drug-containing serum+5% blank serum+5 μg/mL LPS), and HQHF-H group (10% drug-containing serum+5 μg/mL LPS). After 24 h of routine culture post-administration, cells and supernatants were collected for assays. Cell morphology was observed via scanning electron microscopy and phase-contrast microscopy; localization and expression of gasdermin D-N (GSDMD-N) were observed by immunofluorescence. Interleukin-1β (IL-1β) and IL-18 contents in supernatants were detected by ELISA; mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD were measured using real-time PCR and Western blot. RESULTS Compared with the Control group, the Model group showed typical pyroptotic morphology (cell membrane bulging and pore formation), increased aggregation and fluorescence intensity of GSDMD-N on the cell membrane ( P <0.05), significantly increased the contents of IL-1β and IL-18 in cell supernatants ( P <0.05), and significantly up-regulated mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD in cells ( P <0.05). Compared with the Model group, the HQHF-L, HQHF-M and HQHF-H groups showed improved pyroptotic morphology, reduced membrane localization and significantly weakened fluorescence intensity of GSDMD-N ( P <0.05), significantly decreased the contents of IL-1β and IL-18 in cell supernatants ( P <0.05), and significantly down-regulated mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD in cells ( P <0.05). CONCLUSIONS HQHF inhibits LPS-induced macrophage pyroptosis, and its mechanism of improving MASH may be associated with the suppression of the activation of the classical NLRP3/Caspase-1/GSDMD pyroptosis pathway.
9.Study on the improving mechanism of Yifei xuanfei jiangzhuo formula on vascular dementia model rats based on the GRB2/ERK/CRLS1 pathway
Guifeng ZHUO ; Wei CHEN ; Xiaomin ZHU ; Yulan FU ; Jinzhi ZHANG ; Lin WU
China Pharmacy 2026;37(7):877-882
OBJECTIVE To explore the improvine mechanism of Yifei xuanfei jiangzhuo formula (YFXF) on vascular dementia (VAD) model rats based on the growth factor receptor-bound protein 2 (GRB2)/extracellular signal-regulated kinase (ERK)/cardiolipin synthase 1 (CRLS1) pathway. METHODS VAD rat model was established by permanent bilateral common carotid artery ligation. Forty-eight successfully modeled rats were randomly divided into the model group (normal saline), donepezil hydrochloride group (positive control group, 0.2 g/kg), and YFXF low- and high-dose groups (12.18 and 24.36 g/kg, calculated based on the total amount of crude drug), respectively. In addition, a sham operation group (normal saline) was set up. There were 12 rats in each group. Daily intragastric administration of drug or normal saline was performed for 30 consecutive days. After the last administration, the spatial cognitive ability of the rats was evaluated, the pathological morphology of the hippocampus was observed, the contents of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) in serum were detected, the expression levels of GRB2/ERK/CRLS1 pathway-related proteins and the mRNA levels of GRB2, CRLS1, NADH dehydrogenase subunit 1(ND1), Tafazzin (TAZ), phospholipid scramblase 3(PLSCR3) and the ATP content in hippocampal tissue were measured. RESULTS Compared with the sham operation group, the escape latency of rats in the model group was significantly prolonged ( P <0.05), and the number of crossing platform was significantly reduced ( P <0.05), while the number of pyramidal cells and Nissl bodies in the hippocampus decreased sharply; the content of TNF-α in serum was significantly increased ( P <0.05), and the content of IL-4 was significantly decreased ( P <0.05); the expression levels of GRB2 and CRLS1 proteins, the phosphorylation level of ERK protein, the relative expression levels of GRB2, CRLS1,ND1, TAZ, and PLSCR3 mRNA, and the content of ATP in hippocampal tissue were significantly decreased ( P <0.05). Compared with the model group, the above pathological changes in the hippocampal tissue of each administration group were alleviated, and the quantitative indicators were significantly restored ( P <0.05). CONCLUSIONS YFXF may improve hippocampal neuron injury in VAD rats by activating the GRB2/ERK/CRLS1 pathway, maintaining cardiolipin homeostasis, and improving mitochondrial energy metabolism.
10.Quality control of Sagina japonica by HPLC fingerprint combined with quantitative analysis of multi-components by single-marker
Junhong LIU ; Xue LI ; Meiqin ZHANG ; Han HU ; Chunmei BAI ; Chunhua LIU ; Yongjun LI
China Pharmacy 2026;37(7):883-888
OBJECTIVE To establish the high-performance liquid chromatography (HPLC) fingerprint of Sagina japonica , and to establish a quantitative analysis of multi-components by single-marker (QAMS) method for simultaneous determination of six componen ts in S. japonica , aiming to provide references for the quality control of this medicinal herb. METHODS HPLC method was used to establish the fingerprints of 12 batches (No. S1-S12) of S . japonica according to Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine . The similarity evaluation and identification of common peaks were conducted, followed by cluster analysis (CA) and principal component analysis (PCA) for 12 batches of samples. Using vicenin-2 as internal reference, the contents of p-hydroxy cinnamic acid, apigenin-6-C-arabinoside-8-C-glucoside, isoorientin, vitexin and 20-hydroxyecdysone were determined by QAMS method. The results were then compared with those obtained by the external standard method. RESULTS The similarities of HPLC fingerprints for 12 batches of S . japonica ranged from 0.828-0.998. A total of 17 common peaks were calibrated, and 6 common peaks were identified. Specifically, peak 5 was identified as vicenin-2, peak 7 as p-hydroxycinnamic acid, peak 10 as apigenin-6-C-arabinoside-8-C-glucoside, peak 11 as isoorientin, peak 13 as vitexin, and peak 15 as 20-hydroxyecdysone. The results of CA showed that S1-S5, S7 and S9-S11 were clustered into one category, S6 was clustered into one category, and S8 and S12 were clustered into one category. The results of PCA revealed that the accumulative contribution rate of the four main components was 89.430%. The content ranges measured by QAMS method for p-hydroxy cinnamic acid, apigenin-6-C-arabinoside-8-C-glucoside, isoorientin, vitexin and 20-hydroxyecdysone were 0.017 4-0.269 4, 0.568 8-4.240 3, 0.503 2-5.040 3, 0.024 0-0.132 0 and 2.551 3-4.881 1 mg/g, respectively. There was no significant difference in the contents of components measured between QAMS method and the external standard method ( P >0.05). CONCLUSIONS The established HPLC fingerprint and QAMS method can be used for quality evaluation and quality control of S . japonica.

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