“Chinese Pharmacopoeia” is the legal basis for drug development, production, operation, use and management in China, and the Chinese Pharmacopoeia 2025 Edition is going to be issued and implemented. This article introduces the revision and amendment situations, analyzes the characteristics of the new edition of the Pharmacopoeia and the future development direction of national standards for better understanding and implementation of the latest edition of pharmacopoeia.

Based on the implementation of GMP, comprehensive improvement of quality control measures, and consideration of the 3Rs principle for experimental animals, Several years ago, WHO, the European Pharmacopoeia and the FDA gradually abolished the testing for abnormal toxicity of biological products, and the Chinese Pharmacopoeia 2025 Edition(Volume Ⅲ)also revised the testing for abnormal toxicity of biological products. In order to help users of the Chinese Pharmacopoeia(Volume Ⅲ) better understand and implement this pharmacopoeia, this article provides a detailed review of the changes in regulatory concepts for abnormal toxicity test in various countries and the process of gradually phasing out abnormal toxicity test, as well as the actual situation of China’s pharmaceutical industry. It also interprets the ideas and considerations for revising the Chinese Pharmacopoeia 2025 Edition(Volume Ⅲ) on abnormal toxicity test for biological products.

With the transformation in modern medical models and the increasingly diversified needs of patients， building a harmonious and mutually trusting doctor-patient community relationship has become the key to improving the quality of medical services， enhancing patients’ sense of access to medical care， and promoting medical effects. Medical social worker is an indispensable member of the medical team， whose interdisciplinary background knowledge and professional skills provide unique advantages for building a harmonious doctor-patient community relationship. However， the current subjects of research on the doctor-patient community are still limited to the medical staff and patients， and there is a lack of relevant research that uses interdisciplinary thinking and tools to explore the path of building a doctor-patient community. Therefore， under the guidance of the spiral research idea of action research method， by sorting out the action paths of medical social workers in carrying out pediatric neurosurgery specialist services in the past five years， three analytical tools from management， namely the strategic decision-making process model， the organization- stakeholder fit model， and the value proposition canvas， were used to solve the problems and dilemmas in the different stages of building a doctor-patient community. On these foundations， practical knowledge was produced， providing valuable experience and methods for medical social workers to build a doctor-patient community.

The professional development of medical social workers currently faces several dilemmas， such as insufficient professionalism， unbroken professional barriers， and an incomplete policy system. To address these dilemmas， medical social workers should clarify the dimensions of their professional capabilities and strive to improve their professional capabilities， building a professional capability framework focusing on problem-solving. Meanwhile， with the popularization of AI technology， the cross-field integration and development of “AI + medical social workers” have brought new opportunities for the professional capability construction of medical social workers. For example， big data can enhance the optimization of electronic health record services； virtual reality （VR） and augmented reality can facilitate the electronic standardization of social worker training for clients； and machine learning can promote the transformation of the social work service model towards “risk prediction and advance intervention，” assisting in improving direct service capabilities. ChatGPT and VR remote consultation systems can be used for supervision services， big data cloud classrooms and robot teaching assistants can broaden learning channels， and natural language processing technology can assist in professional document writing， aiding in enhancing indirect service capabilities. However， applying AI technology to the professional capacity construction of medical social workers may also lead to the alienation of the professional service relationship of medical social workers from needs assessment and relationship building to service intervention， further causing ethical risks brought by demand bias， relationship alienation， and weakened subjectivity. Therefore， it is necessary to rationally view AI’s “double-edged sword” effect. While enjoying the field transformation brought about by high and new technology， it is also imperative to address the subsequent challenges from the perspectives of social work professional assessment and review， educational supervision， and ethical awareness enhancement.

OBJECTIVES: To investigate the effect of Qianggu Kangshu Formula (QGKSF) for alleviating osteoclast differentiation in rheumatoid arthritis and the underlying mechanism. METHODS: RAW264.7 cells cultured under hypoxic conditions were treated with RANKL to induce osteoclast differentiation and incubated with normal rat serum or sera from rats medicated with methotrexate (MTX) or QGKSF at low and high doses. Cell viability, TRAP-positive multinucleated cells and F-actin ring formation in the treated cells were assessed with CCK-8 assay, TRAP staining and Phalloidin staining, respectively. Autophagy and autophagosomes in the cells were observed with MDC staining and transmission electron microscopy. ELISA was used to measure IL-6 and TNF-α levels in the culture supernatant, and the expressions of HIF-1α, BNIP3, Bcl-2, Beclin1, LC3-I, LC3-II, P62 and TRAP mRNAs and proteins were analyzed using RT-qPCR and Western blotting. RESULTS: In hypoxia- and RANKL-induced RAW264.7 cells treated with normal rat serum, significant increments of TRAP-positive cells and F-actin ring formation were observed with an enhanced autophagic fluorescence intensity and increased autophagosomes. Treatment of the induced cells with rat sera medicated with MTX and low- and high-dose QGKSF obviously reduced the TRAP-positive cells, F-actin rings and autophagosomes as well as the autophagic fluorescence intensity. RANKL treatment significantly increased IL-6 and TNF-α levels in RAW264.7 cells, which were obviously decreased by treatment with MTX- and QGKSF-medicated sera. RANKL also significantly increased the mRNA and protein expression levels of HIF-1α, BNIP3, Bcl-2, Beclin1, LC3 and TRAP and lowered P62 expressions, and these changes were effectively reversed by treatment with MTX- and QGKSF-medicated sera. CONCLUSIONS QGKSF attenuates RANKL-induced osteoclast differentiation in hypoxic RAW264.7 cells by inhibiting the HIF-1α/BNIP3 autophagy signaling pathway, suggesting its potential for treatment of bone destruction in rheumatoid arthritis.
Animals ; Drugs, Chinese Herbal/pharmacology* ; Osteoclasts/drug effects* ; Autophagy/drug effects* ; Mice ; Signal Transduction/drug effects* ; Rats ; Cell Differentiation/drug effects* ; Arthritis, Rheumatoid/pathology* ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; RAW 264.7 Cells ; Membrane Proteins/metabolism* ; Mitochondrial Proteins

To create flexible and high-quality pediatric continuing education opportunities, the Children's Hospital of Zhejiang University School of Medicine has developed an online teaching system based on the medical consortium information system, mobile application, and website, which includes "5G+" digital classroom for case teaching, hierarchical diagnosis and treatment tracking, mobile courses, and live interactive lectures about difficult medical cases as support extensions of offline training. From 2020 to 2023, over 9 000 people participated in online activities. The results of questionnaire survey, theoretical examination, and semi-structured interview showed that the members of the medical consortium were satisfied with the training content and effect of the online medical continuing education model; medical personnel's theoretical levels were improved after training; the interviewees believed that online training was flexible and convenient with regard to time, location, and space, with positive impact for improving clinical ability and personal development. However, the online form cannot yet replace the traditional refresher training completely. In the future, we will establish a unified evaluation and assessment mechanism, form a standardized management system, and introduce advanced technologies, so as to encourage enthusiastic and effective participation, and promote the rational and efficient use of medical education resources.

Objective:To discuss the clinical characteristics,diagnosis,and treatment of Shwachman-Diamond syndrome(SDS),and to enhance the clinicians'awareness of the disease.Methods:The clinical materials of one patient diagnosed with SDS,primarily presented with neutropenia and elevated transaminase levels,confirmed by genetic testing were retrospectively analyzed.The clinical manifestations,genetic features,diagnosis,and treatment methods of SDS were analyzed complemented with the relevant literatures.Results:This patient was a male child,aged 27 months.His initial clinical presentations were neutropenia and elevated transaminase levels.The patient had previously experienced diarrhea when the patient was 3 months old,which improved after treated with oral pancreatic enzyme dispersion.Over the past six months,the patient had recurrent respiratory infections.Upon admission,the examination results showed there was dental enamel hypoplasia,and the imaging results showed the abnormal bone density in the long bones of the limbs.The genetic sequencing results showed a homozygous mutation in the Shwachman-Bodian-Diamond syndrome(SBDS)gene(c.258+2T>C).During hospitalization,the patient received the hepatoprotective care and granulocyte augmentation supportive treatment,leading to an improvement in his condition,and the patient was discharged.During a one-year follow-up,the patient's condition was stable.Conclusion:The typical presentation of the SDS patient includes diarrhea,liver function abnormalities,hematologic abnormalities,and skeletal anomalies,particularly neutropenia;there may also be developmental delays and involvement of the heart,liver,central nervous system,skeleton,and immune system.The genetic testing of suspected children is crucial,and it can aid in the early diagnosis and treatment of SDS patients.

Objective To gain an in-depth understanding of the authentic experiences of impaired dignity among patients in the recovery phase of severe bums,thereby informing the development of targeted dignity intervention plans by clinical medical staff.Methods By purposive sampling,the study included 16 patients in the recovery phase of severe burns,admitted to the Burn and Plastic Surgery Rehabilitation Department of a tertiary hospital in Guangzhou between December 2023 and January 2024.Face-to-face,semi-structured in-depth interviews were conducted,and the themes were analyzed,summarized,and distilled by the Colaizzi 7-step analysis method.Results 3 themes were identified,including impairment of physical dignity(physical disfigurement,change in appearance,and limitations in autonomous activities),psychological dignity conflicts(negative emotional disturbances and positive adjustment for adaptation)and the aspiration for social dignity(desire for family understanding,social support,and the hope to return to a normal life).Conclusion Clinical nurses should value the dignity experience of patients in the recovery phase of severe burns and establish patient-dignity-centered intervention plans to facilitate their dignified and high-quality recovery to a normal life.

Administrative multi-disciplinary team (MDT) is an efficient management approach that involves multiple administrative departments working together to solve cross functional systemic problems. Grid management improves management efficiency by constructing a three-level management network, efficiently transmitting information and coordinating resources. Starting from 2021, Children′s Hospital, Zhejiang University School of Medicine has adopted a combination of administrative MDT and grid management, with the average length of stay as the starting point to carry out medical efficiency management. Through the three stages of pre-, during-, and post-treatment, the hospital has reconstructed processes from technological innovation, information construction, team collaboration, and other aspects to shorten ineffective length of stay. After 3 years of practice, the average length of stay has been reduced from 6.41 d to 5.54 d, achieving an improvement in service efficiency while ensuring medical quality and safety.