1.Rapid Identification of Different Parts of Nardostachys jatamansi Based on HS-SPME-GC-MS and Ultra-fast Gas Phase Electronic Nose
Tao WANG ; Xiaoqin ZHAO ; Yang WEN ; Momeimei QU ; Min LI ; Jing WEI ; Xiaoming BAO ; Ying LI ; Yuan LIU ; Xiao LUO ; Wenbing LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):182-191
ObjectiveTo establish a model that can quickly identify the aroma components in different parts of Nardostachys jatamansi, so as to provide a quality control basis for the market circulation and clinical use of N. jatamansi. MethodsHeadspace solid-phase microextraction-gas chromatography-mass spectrometry(HS-SPME-GC-MS) combined with Smart aroma database and National Institute of Standards and Technology(NIST) database were used to characterize the aroma components in different parts of N. jatamansi, and the aroma components were quantified according to relative response factor(RRF) and three internal standards, and the markers of aroma differences in different parts of N. jatamansi were identified by orthogonal partial least squares-discriminant analysis(OPLS-DA) and cluster thermal analysis based on variable importance in the projection(VIP) value >1 and P<0.01. The odor data of different parts of N. jatamansi were collected by Heracles Ⅱ Neo ultra-fast gas phase electronic nose, and the correlation between compound types of aroma components collected by the ultra-fast gas phase electronic nose and the detection results of HS-SPME-GC-MS was investigated by drawing odor fingerprints and odor response radargrams. Chromatographic peak information with distinguishing ability≥0.700 and peak area≥200 was selected as sensor data, and the rapid identification model of different parts of N. jatamansi was established by principal component analysis(PCA), discriminant factor alysis(DFA), soft independent modeling of class analogies(SIMCA) and statistical quality control analysis(SQCA). ResultsThe HS-SPME-GC-MS results showed that there were 28 common components in the underground and aboveground parts of N. jatamansi, of which 22 could be quantified and 12 significantly different components were screened out. Among these 12 components, the contents of five components(ethyl isovalerate, 2-pentylfuran, benzyl alcohol, nonanal and glacial acetic acid,) in the aboveground part of N. jatamansi were significantly higher than those in the underground part(P<0.01), the contents of β-ionone, patchouli alcohol, α-caryophyllene, linalyl butyrate, valencene, 1,8-cineole and p-cymene in the underground part of N. jatamansi were significantly higher than those in the aboveground part(P<0.01). Heracles Ⅱ Neo electronic nose results showed that the PCA discrimination index of the underground and aboveground parts of N. jatamansi was 82, and the contribution rates of the principal component factors were 99.94% and 99.89% when 2 and 3 principal components were extracted, respectively. The contribution rate of the discriminant factor 1 of the DFA model constructed on the basis of PCA was 100%, the validation score of the SIMCA model for discrimination of the two parts was 99, and SQCA could clearly distinguish different parts of N. jatamansi. ConclusionHS-SPME-GC-MS can clarify the differential markers of underground and aboveground parts of N. jatamansi. The four analytical models provided by Heracles Ⅱ Neo electronic nose(PCA, DFA, SIMCA and SQCA) can realize the rapid identification of different parts of N. jatamansi. Combining the two results, it is speculated that terpenes and carboxylic acids may be the main factors contributing to the difference in aroma between the underground and aboveground parts of N. jatamansi.
2.Practice and evaluation of pharmacists’participation in long-term MTM models for stroke patients based on family doctor system
Lu SHI ; Chun LIU ; Lian TANG ; Jingjing LI ; Sudong XUE ; Yanxia YU ; Wenwen LI ; Keren YU ; Jianhui XUE ; Wen MA ; Hongzhi XUE
China Pharmacy 2025;36(9):1129-1134
OBJECTIVE To investigate the clinical efficacy of integrating pharmacists into family health teams (FHTs) for long-term medication therapeutical management (MTM) in stroke patients, and empirically evaluate the service model. METHODS A pharmacist team, jointly established by clinical and community pharmacists from the Affiliated Suzhou Hospital of Nanjing Medical University (hereinafter referred to as “our hospital”), developed a pharmacist-supported MTM model integrated into FHTs. Using a prospective randomized controlled design, 170 stroke patients discharged from our hospital (July 2022-December 2023) and enrolled in FHTs at Suzhou Runda Community Hospital were randomly divided into trial group (88 cases) and control group (82 cases) according to random number table. The control group received routine FHTs care (without pharmacist involvement in the team collaboration), while the trial group xhz8405@126.com received 12-month MTM services supported by pharmacists via an information platform. These services specifically included innovative interventions such as personalized medication regimen optimization based on the MTM framework, dynamic medication adherence management, medication safety monitoring, a home medication assessment system, and distinctive service offerings. Outcomes of the 2 grousp were compared before and after intervention, involving medication adherence (adherence rate, adherence score), compliance rates for stroke recurrence risk factors [blood pressure, low-density lipoprotein cholesterol (LDL-C)], and incidence of adverse drug reactions (ADR). RESULTS After 12 months, the trial group exhibited significantly higher medication adherence rates, improved adherence scores, higher compliance rates for blood pressure and LDL-C targets compared to the control group (P<0.05). The incidence of ADR in the trial group (4.55%) was significantly lower than that in the control group (8.11%), though the difference was not statistically significant (P> 0.05). CONCLUSIONS Pharmacist involvement in FHTs to deliver MTM services significantly enhances medication adherence and optimizes risk factor for stroke recurrence, offering practical evidence for advancing pharmaceutical care in chronic disease management under the family doctor system.
3.Expert consensus on artificial intelligence-assisted pharmaceutical care
Commission PHARMACY ; Association GERIATRIC ; Society SUB-ASSOCIATION
China Pharmacy 2025;36(13):1553-1562
OBJECTIVE To provide guidance for the scientific and standardized application of artificial intelligence (AI) technology in supporting pharmaceutical care services, and to promote the high-quality development of pharmaceutical care. METHODS Using keywords such as “artificial intelligence” and “pharmaceutical care”, a comprehensive search was conducted across domestic and international databases and relevant policy documents. Drawing upon practical experience in AI-assisted pharmaceutical care services in China, a consensus framework and preliminary recommendations were drafted. Consensus was defined as agreement by 70% or more of expert panel members. RESULTS & CONCLUSIONS Through two rounds of the Delphi method and multiple rounds of discussions, 23 strong recommendations (approval rate >90%) were formulated. These address the definition, scope, objectives, multiple application scenarios (including pharmaceutical outpatient, medication reconciliation, medication education, adverse drug event prediction and monitoring, home-based pharmaceutical care services, and drug supply), ethical considerations and accountability, challenges encountered, and quality control recommendations for AI-assisted pharmaceutical care. Intended for use by professional technical staff engaged in pharmaceutical care, managers, and AI technology developers within healthcare institutions, these recommendations provide guidance for the practice of pharmaceutical care in the era of AI.
4.Investigation on the current status and optimization strategies for the standardized on-the-job training for community clinical pharmacists in Shanghai
Yangjiayi XIANG ; Jing SHENG ; Liping WANG ; Lie LUO ; Yuan YUAN ; Xiaodan ZHANG ; Yan LI ; Bin WANG ; Guanghui LI
China Pharmacy 2025;36(13):1568-1573
OBJECTIVE To systematically investigate the current status and effectiveness of the standardized on-the-job training program for community clinical pharmacists in Shanghai, and to provide a scientific basis for optimizing the training scheme. METHODS A questionnaire survey was conducted to collect the data from trainees and mentor pharmacists who participated in the program between 2016 and 2024. The survey examined their basic information, evaluations of the training scheme, satisfaction with training outcomes, and suggestions for improvement. Statistical analyses were also conducted. RESULTS A total of 420 valid responses were collected, including 340 from trainees and 80 from mentor pharmacists. Before training, only 30.29% of trainees were engaged in clinical pharmacy-related work, whereas this proportion increased to 73.24% after training. Most mentor pharmacists had extensive experience in clinical pharmacy (76.25% with ≥5 years of experience) and mentoring (78.75% with ≥3 teaching sessions). Totally 65.59% of trainees and 55.00% of mentor pharmacists believed that blended training yielded the best learning outcomes. Over 80.00% of both trainees and mentor pharmacists considered the overall training duration, theoretical study time, and practical training time to be reasonable. More than 95.00% of trainees and mentor pharmacists agreed that the homework and assessment schemes were appropriate. Trainees rated the relevance of training content to their actual work highly (with an average relevance score >4.5), though they perceived the chronic disease medication therapy management module as significantly more challenging than the prescription review and evaluation module and the home-based pharmaceutical care module. The average satisfaction score of trainees and mentor pharmacists with the training effectiveness of each project was above 4 points, indicating a high overall satisfaction. Inadequate provision of teaching resources was unanimously recognized by trainees and mentor pharmacists as the key area requiring improvement. CONCLUSIONS The standardized on-the-job training program for community clinical pharmacists in Shanghai has contributed to improving pharmaceutical services in community healthcare settings. However, ongoing improvements must concentrate on content design, resource development, and faculty cultivation.
5.Guideline for the workflow of clinical comprehensive evaluation of drugs
Zhengxiang LI ; Rong DUAN ; Luwen SHI ; Jinhui TIAN ; Xiaocong ZUO ; Yu ZHANG ; Lingli ZHANG ; Junhua ZHANG ; Hualin ZHENG ; Rongsheng ZHAO ; Wudong GUO ; Liyan MIAO ; Suodi ZHAI
China Pharmacy 2025;36(19):2353-2365
OBJECTIVE To standardize the main processes and related technical links of the clinical comprehensive evaluation of drugs, and provide guidance and reference for improving the quality of comprehensive evaluation evidence and its transformation and application value. METHODS The construction of Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs was based on the standard guideline formulation method of the World Health Organization (WHO), strictly followed the latest definition of guidelines by the Institute of Medicine of the National Academy of Sciences of the United States, and conformed to the six major areas of the Guideline Research and Evaluation Tool Ⅱ. Delphi method was adopted to construct the research questions; research evidence was established by applying the research methods of evidence-based medicine. The evidence quality classification system of the Chinese Evidence-Based Medicine Center was adopted for evidence classification and evaluation. The recommendation strength was determined by the recommendation strength classification standard formulated by the Oxford University Evidence-Based Medicine Center, and the recommendation opinions were formed through the expert consensus method. RESULTS & CONCLUSIONS The Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs covers 4 major categories of research questions, including topic selection, evaluation implementation, evidence evaluation, and application and transformation of results. The formulation of this guideline has standardized the technical links of the entire process of clinical comprehensive evaluation of drugs, which can effectively guide the high-quality and high-efficient development of this work, enhance the standardized output and transformation application value of evaluation evidence, and provide high-quality evidence support for the scientific decision-making of health and the rationalization of clinical medication.
6.Current status and development suggestions of PIVAS automated equipment allocation in China
Ruimin DENG ; Yuqi FU ; Wei YANG ; Lulu SUN
China Pharmacy 2024;35(17):2068-2071
OBJECTIVE To investigate the current allocation status of automated equipment in pharmacy intravenous admixture services (PIVAS) of medical institutions in China, and to provide reference for understanding the current status and future direction of PIVAS automation construction. METHODS In the form of a questionnaire survey, a questionnaire was distributed to medical institutions in 30 provinces across the country through the “Wenjuanxing” platform to investigate the four aspects of PIVAS, such as the allocation of automated equipment, intelligent intravenous medication dispensing robots, design and development of workflow software and information integration methods for automated equipment, and conduct statistical analysis. RESULTS A total of 761 PIVAS participated in the survey, 373 PIVAS were equipped with automated equipment. Among 373 PIVAS with automated equipment, automatic finished infusion sorting machines and automatic labeling machines were the main equipment, and 93.56% of PIVAS were not equipped with intelligent intravenous medication dispensing robots; 511 PIVAS used workflow software designed and developed by third-party software companies. In the project of information integration for automated equipment, there was not much difference in the proportion of cases where there was no automated equipment, automated equipment directly interfaced with hospital information systems, and automated equipment interfaced with PIVAS software platform. CONCLUSIONS The automated equipment allocation rate of PIVAS in China is relatively low, and there is still a lot of room for development. We should improve the relevant guidelines for automated equipment as soon as possible, promote standardized and reasonable equipment research and development, and enable PIVAS to more efficiently complete intravenous drug dispensing, in order to provide more dengrm3@mail.sysu.edu.cn comprehensive pharmaceutical services.
7.Investigation and analysis of pharmaceutical management in compact medical consortium of Guangdong province
Xiaodan ZHU ; Xiao CHEN ; Weiling CAO ; Yuan ZENG ; Zuojing LU ; Xuejun LI ; Wenying CHEN
China Pharmacy 2024;35(4):390-394
OBJECTIVE To investigate the current situation of pharmaceutical management in compact medical consortium of Guangdong province, and to provide decision-making basis for promoting the high-quality construction and sustainable development of the provincial medical consortium. METHODS A self-designed questionnaire was used to select 50 compact medical consortiums in Guangdong province. The survey was answered by the heads of the pharmacy department of the general hospitals. The survey covered the basic scale of the consortium, the appointment of chief pharmacists, the implementation of pharmaceutical management and pharmaceutical care homogenization within the consortium, the difficulties in promoting the homogenization, and the expected provincial support. Descriptive statistical analysis was performed on the survey results. RESULTS A total of 50 questionnaires were collected, and the effective recovery rate was 100%. There were 16 chief pharmacists (32.00%) in charge of the pharmacy department of the general hospital in the medical consortium. Thirty-seven medical consortiums (74.00%) had established a drug supply support system within the consortium, 35 medical consortiums (70.00%) had carried out pharmaceutical management and coordination work within the medical consortium, 23 medical consortiums (46.00%) had established a clinical medication guidance system, 25 medical consortiums chenwenying2016@163.com (50.00%) had established a bidirectional communication mechanism, and only 8 medical consortiums (16.00%) had developed new models of pharmaceutical care. At present, the difficulties in promoting the homogenization of pharmaceutical management and pharmaceutical care within the medical consortium were mainly found in three aspects: the wide gap in management level of each member unit, the lack and uneven level of pharmaceutical personnel, and insufficient policy support and implementation. Most medical consortiums hoped that relevant departments could promote the homogenization of pharmaceutical work by holding special training courses or special supervision. CONCLUSIONS At present, the compact medical consortium in Guangdong province has achieved initial results in the implementation of the chief pharmacist system, the homogenization of pharmaceutical management and pharmaceutical care. However, it is still necessary to improve the coverage of chief pharmacist appointments in the medical consortium, implement the homogenization of pharmaceutical management, and accelerate the homogenization process of pharmaceutical care.
8.Cross-sectional study on working mode and human resource setting of PIVAS in national medical institutions
Ke LI ; Hongyan GU ; Dechun JIANG ; Lulu SUN ; Yingbo ZHAO
China Pharmacy 2024;35(18):2199-2202
OBJECTIVE To know about the working mode and human resource status of pharmacy intravenous admixture services (PIVAS) in national medical institutions. METHODS Through questionnaire survey, the national PIVAS was invited to fill out questionnaire and statistical analysis was performed on the effective sample data related to PIVAS working mode and human resources in the questionnaire. RESULTS In this study, 761 PIVAS from 722 medical institutions of 29 provinces were involved in the questionnaire survey, with 471 valid questionnaires for working mode and 441 valid questionnaires for human resources survey. In terms of working mode, among 471 PIVAS, 292 PIVAS (62.0%) were in pharmacist-alone mode, and 176 PIVAS (37.4%) were in pharmacist-nurse cooperative mode; there was no significant difference in the types of medical orders received by PIVAS between these two working modes except for the other medical orders (P>0.05). In terms of human resource setting, among 441 PIVAS, the average number of total staff of single PIVAS was 24(16,33), including 11(6,19) pharmacists, 7(2,13) nursing staff, and 3(1,5) workers; there was a statistically significant difference in the number of personnel among three groups (P< 0.01). The per capita income of PIVAS respondents in 2019 was [7.9(4.8,10.7)]×104 yuan, and in 2021 it was [8.8(5.8,11.7)]× 104 yuan, with an increase of 9.0% compared to 2019. The difference between the two groups was statistically significant (P< 0.01). CONCLUSIONS Medical institutions’ PIVAS in China had not fully implemented the pharmacist-alone work model, and some medical institutions had chosen a pharmacist-nurse cooperative mode. It is suggested that relevant departments formulate corresponding qualification requirements and training standards for nursing personnel as soon as possible based on sufficient research on PIVAS’s demand for nursing professionals.
9.Research and analysis of the blending types and workload of PIVAS in China
Hongmei LYU ; Jing ZHAO ; Yuqi FU ; Jianzhong ZHANG
China Pharmacy 2024;35(18):2203-2206
OBJECTIVE To assess the blending types and workload of pharmacy intravenous admixture services (PIVAS) in China. METHODS By questionnaire survey, the working status of PIVAS in different levels of hospitals nationwide was investigated, involving the types of blending infusion, daily blending volume of hazardous drugs infusion, parenteral nutrition solution, general and antibacterial drug infusion, intravenous bolus drugs, skin test solution and intravenous agents, as well as the daily packing volume. RESULTS A sample of 750 PIVAS in 30 provinces (autonomous regions, municipalities) across China were surveyed by questionnaire, involving 621 tertiary hospitals and 90 secondary hospitals. The main types of liquid preparation were intravenous infusion, followed by parenteral nutrition solution, and chemotherapy pump (including chemotherapy infusion), accounting for 99.73%, 79.47% and 43.33%, respectively. The daily blending volume of hazardous drugs infusion, parenteral nutrition solution, general and antibacterial drug infusion, intravenous bolus drugs, skin test solution and intravenous agents in PIVAS of tertiary hospitals were 23.00 (9.00, 56.50) sets, 31.00 (13.97, 74.00) bags, 813.00 (375.00, 2 061.75) bags, 426.00 (210.00, 987.00) bags, 30.00 (6.00, 155.00) ampoules, 30.00 (7.13, 136.84) ampoules, 3 200.00 (1 684.50, 5 554.50) ampoules respectively, while the daily packing volume was 218.50 (52.26, 559.00) bags; above indexes of PIVAS in secondary hospital were 4.00(2.00,12.00)sets, 8.90(3.00,23.00)bags, 270.50(108.00, 2 061.75)bags, 157.00(71.00,987.00)bags, 5.85 (3.75,141.00) ampoules, 0 ampoule, 1 349.00(548.10,2 408.00)ampoules, 107.50(33.25,207.00)bags. CONCLUSIONS The scope of blending types of PIVAS has been significantly expanded, and tertiary hospitals are significantly higher than secondary hospitals in the blending and packing volumes of all types of intravenous fluids and drugs dispensed, showing obvious advantages in dealing with complex medications and high-risk treatments.
10.Investigation and analysis of the medical prescription approval in PIVAS in China
Jing ZHAO ; Lulu SUN ; Hongmei LYU ; Jianzhong ZHANG
China Pharmacy 2024;35(19):2340-2344
OBJECTIVE To know about the current status of medical order auditing in pharmacy intravenous admixture service (PIVAS) of medical institutions nationwide, further improve the management of medical orders in PIVAS, and reduce and eliminate the occurrence of intravenous medication administration errors. METHODS Through the questionnaire survey method, to address the problems and current situation of PIVAS medical order auditing in medical institutions nationwide, experts from each province (autonomous region, municipality directly under the central government) in the research group were responsible for organizing the PIVAS directors of relevant medical institutions in their provinces to fill in the questionnaires on medical order audit and inappropriate medical order interventions, and conduct a statistical analysis of the results. RESULTS A total of valid 751 responses were received to the PIVAS questionnaire on the review of medical prescriptions. Our PIVAS medical order audit is mainly carried out by a combination of manual and computer. The median number of medical orders were audited by PIVAS per day were 700.00-771.00; the median number of new medical orders were audited by PIVAS per day were 209.68-215.00; medical order auditing rates were 85.50%-92.44% averagely; the inappropriate doctor’s orders accounted for 1.82%-1.89% averagely; the intervention rates of inappropriate medical orders ranged 74.90%-79.41%, the success rates of intervention were 79.62%-87.28% averagely; the medication refund rates were 2.92%-3.08%. CONCLUSIONS Most of the PIVAS in China’s healthcare institutions use medical order review software to assist in the review of medical orders, and there are cases of individual PIVAS in which medical orders are not reviewed comprehensively and inappropriate orders are not intervened in, and the standards and processes of medical prescription review need to be improved. It is recommended to emphasize the pharmacist’s responsibility system, standardize the use of prescription review software; gradually expand the scope of medical order review, and adopt a multi-departmental collaborative approach so as to increase the success rate of intervention for inappropriate prescriptions and reduce the rate of PIVAS withdrawals.

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