OBJECTIVE To construct a whole-process management system for the smart pharmacy based on the integration of drug batch numbers and traceability codes， aiming to solve the problems of low upload rates and traceability difficulties of drug traceability codes in the central pharmacy， and to enhance its level of refined management and medication safety. METHODS Following the FOCUS-PDCA framework（find，organize，clarify，understand，select-plan，do，check，act）， a drug batch number and traceability code management system was established by optimizing batch number management processes， introducing “pre-scan registration” technology， and establishing a dynamic “code pool” mechanism. Based on medical insurance upload data and operational performance indicators in our hospital from June to August 2025， the differences in management efficacy before and after the implementation of the system were compared and analyzed. RESULTS The drug batch number and traceability code management system was successfully established， achieving “one-object， one-code” whole-process association with batch numbers for inpatient drugs， especially split drugs. After the application of this system， the upload rate of inpatient drug traceability codes reached 100%， significantly higher than the average upload rate of inpatient drugs in other tertiary hospitals in our city （with the highest rate being only 23.22%， P ＜0.001）. The inventory stocktaking error rate dropped from 0.9% to 0.3% （a decrease of 66.7%）； the number of daily dispensing errors decreased from 1.43 to 0.37； the dispensing time （14.75 min） for temporary medical orders recovered to the routine level （14.42 min） prior to the system implementation. CONCLUSIONS By adopting the “pre-scan registration-code pool management-closed-loop traceability” model， this system enables traceability for individual drug products in their smallest packaging units， improves the upload rate of traceability codes， significantly reduces the medication dispensing error rate， and does not increase the time cost for temporary medical order dispensing， thereby balancing efficiency with closed-loop traceability.

OBJECTIVE To establish an integrated central pharmacy management model combining the inpatient pharmacy and the pharmacy intravenous admixture service （PIVAS）， and to evaluate its effectiveness and economic value in terms of operational cost composition， dispensing output， and dispensing efficiency.METHODS Through spatial integration， flexible staff scheduling， the application of intelligent equipment， and a dual prescription review system， the inpatient pharmacy and PIVAS were integrated， and an integrated management model was implemented. Operational data from the Fourth Affiliated Hospital of Soochow University （hereinafter referred to as “our hospital”） in 2023 were selected for analysis， with national median data and data from another hospital in the same region that still implemented a separate management model for the inpatient pharmacy and PIVAS serving as controls. The activity-based costing method was used to calculate operating costs. Dispensing output， dispensing efficiency， and unit activity cost were compared among the three. Cost-benefit analysis was further conducted by calculating the net benefit （NB） and the incremental cost-effectiveness ratio （ICER） for economic evaluation.RESULTS Under the integrated central management model， the total operational cost of our hospital’s central pharmacy was 3.968 3 million yuan， representing an 11.80% reduction compared with the external hospital’s pharmacy （4.499 0 million yuan）， with consumable costs and labor costs decreasing by 38.73% and 10.99%， respectively. The total prescription dispensing volume （3.613 4 million orders） was 43.58% higher than that of the external hospital’s pharmacy （2.516 7 million orders）. The daily dispensing volume per capita reached 471.41 medication orders， 3.5 times that of the external hospital’s pharmacy （135.20 medication orders）. The unit activity cost was 1.10 yuan， showing a 38.55% decrease relative to the external hospital’s pharmacy （1.79 yuan）. The NB was 755 200 yuan， and the ICER was －2.36. In terms of PIVAS operations， the daily dispensing volume per capita for general infusions （including antibacterial drugs） in our hospital was 50.83 sets， higher than the national PIVAS median （49.11 sets） and the external hospital pharmacy （36.14 sets）； the daily dispensing volume per capita for hazardous drugs was 0.86 sets， higher than the national median （0.70 sets） and the external hospital pharmacy （0.16 sets）.CONCLUSIONS The integrated central pharmacy management model established by our hospital achieved reduced operational costs and enhanced staff efficiency despite growing service volumes. Integrating the functions of both the inpatient pharmacy and the PIVAS， this model outperformed national medians and peer hospitals in dispensing output， dispensing efficiency， unit activity cost control， and economic evaluation， and surpassed the national median specifically in PIVAS dispensing efficiency.

Objective To investigate the incidence and severity of enamel demineralization during clear aligner treatment and provide reference for clinical medical nursing work.Methods A total of 151 patients(3 507 teeth)undergoing clear aligner treatment in our hospital from 2015 to 2022 were collected.The enamel demineralization before and after treatment was compared,and the enamel demi-neralization index(EDI)was calculated to evaluate the severity of demineralization.The incidence and severity of enamel demineraliza-tion were analyzed statistically,and the differences among different genders,ages and dental positions were compared.Results Enam-el demineralization occurred in 84 patients during treatment,with an incidence rate of 55.63%.Gender and treatment time had no effect on the incidence,and the incidence of adolescent patients was higher than that of adult patients.Among the investigated 3 507 teeth,601 teeth had enamel demineralization,and the incidence rate was 17.14%.The incidence of maxillary anterior teeth and mandibular posterior teeth was higher;the incidence of right teeth was significantly higher than that of left teeth,and the incidence of teeth with ad-hesive attachments was also significantly increased.88%of the enamel demineralization lesions were 1－2 degrees,and the degree of enamel demineralization was similar in male and female patients.But the degree in adolescents was significantly higher than that in adult patients.The average EDI value of maxillary anterior teeth was significantly higher than that of mandible,but that of maxillary posterior teeth was significantly lower than that of mandible.The average EDI value of right teeth was significantly higher than that of left.Conclusion The incidence of enamel demineralization is high in the process of clear aligner treatment,and teenagers are suscep-tible to it.The demineralization of teeth is significantly different among different tooth positions,and adhesive attachments will increase the risk of enamel demineralization.Therefore,medical staff should take active and effective measures in the prevention and treatment of enamel demineralization.

OBJECTIVE: To explore the expression, localization and regulatory effect on mitochondrial calcium signaling of Rictor in embryonic stem cell-derived cardiomyocytes (ESC-CMs). METHODS: Classical embryonic stem cell cardiomyogenesis model was used for differentiation of mouse embryonic stem cells into cardiomyocytes. The location of Rictor in ESC-CMs was investigated by immunofluorescence and Western blot. The expression of Rictor in mouse embryonic stem cells was interfered with lentiviral technology, then the superposition of mitochondria and endoplasmic reticulum (ER) in ESC-CMs was detected with immunofluorescence method; the cellular ultrastructure of ESC-CMs was observed by transmission electron microscope; the mitochondrial calcium transients of ESC-CMs was detected by living cell workstation;immunoprecipitation was used to detect the interaction between 1,5,5-trisphosphate receptor (IP3 receptor, IP3R), glucose-regulated protein 75 (Grp75) and voltage-dependent anion channel 1 (VDAC1) in mitochondrial outer membrane; the expression of mitochondrial fusion protein (mitonusin-2, Mfn2) was detected by Western blot. RESULTS: Rictor was mainly localized in the endoplasmic reticulum and mitochondrial-endoplasmic reticulum membrane (MAM) in ESC-CMs. Immunofluorescence results showed that Rictor was highly overlapped with ER and mitochondria in ESC-CMs. After mitochondrial and ER were labeled with Mito-Tracker Red and ER-Tracker Green, it was demonstrated that the mitochondria of the myocardial cells in the Rictor group were scattered, and the superimposition rate of mitochondria and ER was lower than that of the negative control group (<0.01). The MAM structures were decreased in ESC-CMs after knockdown of Rictor. The results of the living cell workstation showed that the amplitude of mitochondrial calcium transients by ATP stimulation in ESC-CMs was decreased after knockdown of Rictor (<0.01). The results of co-immunoprecipitation showed that the interaction between IP3R, Grp75 and VDAC1 in the MAM structure of the cardiomyocytes in the Rictor group was significantly attenuated (<0.01); the results of Western blot showed that the expression of Mfn2 protein was significantly decreased (<0.01). CONCLUSIONS Using lentiviral technology to interfere Rictor expression in mouse embryonic stem cells, the release of calcium from the endoplasmic reticulum to mitochondria in ESC-CMs decreases, which may be affected by reducing the interaction of IP3R, Grp75, VDAC1 and decreasing the expression of Mfn2, leading to the damage of MAM structure.
Animals ; Calcium Signaling ; genetics ; Gene Expression Regulation ; genetics ; Gene Knockdown Techniques ; Mice ; Mitochondria ; physiology ; Mouse Embryonic Stem Cells ; Myocytes, Cardiac ; physiology ; Protein Transport ; Rapamycin-Insensitive Companion of mTOR Protein ; genetics ; metabolism