Immune-stimulating antibody drug conjugate (ISAC) can not only effectively solve the defects of stimulator of interferon genes (STING) agonists by coupling antibodies with STING agonists through the targeting of antibodies, but also play a synergistic role with antibodies to further improve the efficacy of STING agonists. This review first provides a concise overview of the current research landscape of ISACs and STING agonists, systematically elaborates on evolving trends in STING agonist development, and subsequently summarizes the mechanistic advances in STING ISAC research. Special emphasis is placed on representative STING ISAC candidates in preclinical/clinical development. Finally, the future directions of STING ISACs are critically discussed with perspectives and recommendations, aiming to provide theoretical insights and practical guidance for future investigations.

OBJECTIVE To clarify the current development status of clinical pharmacist training bases and the pharmacist workforce in China， and to provide evidence for standardizing base construction and promoting the high-quality development of hospital pharmacy. METHODS Questionnaires were distributed to all clinical pharmacist training bases for urgently-needed health professionals and clinical pharmacist training bases under the Chinese Hospital Association that had been approved by the end of 2023 to collect data including base profiles and pharmacist staffing conditions. Expert teams carried out field investigations to verify the collected data. Descriptive statistical analyses were conducted on the quantity， type and regional distribution of training bases， and the influencing factors of pharmacist staffing in the bases were analyzed. RESULTS Field surveys were completed covering 297 training bases across 31 provincial-level administrative regions. Among the base hospitals， 87.88% were Grade A tertiary general hospitals， and 65.32% were located in provincial capitals. The eastern region had the largest number of bases （136， accounting for 45.79%）， followed by the western region （79， 26.60%）. Great disparities existed among provinces in terms of base quantity and hospital scale. The median proportion of pharmaceutical technical personnel in base hospitals was 4.05%， and the median number of clinical pharmacists per 100 hospital beds was 0.53. Both indicators reached the highest in the eastern region （0.57， 4.43%） and the lowest in the northeastern region （0.45， 3.01%）. A total of 3 627 full-time clinical pharmacists were employed in all surveyed bases， among whom 83.68% held clinical pharmacist training certificates， 35.43% possessed senior professional titles， and 78.19% had postgraduate or higher educational background. The total annual training capacity of the surveyed bases was 4 291 trainees， with obvious differences in annual training capacity across regions and provinces. Training specialties covered 19 specialized disciplines plus one general discipline， and no province could deliver training for all 20 specialties simultaneously. Multivariate Logistic regression analysis showed that geographic region exerte d a significant impact on the proportion of pharmaceutical technical personnel （≥4%） （ P ＜0.05）， while the approval time of training bases and hospital scale had significant effects on the number of clinical pharmacists per 100 beds （≥0.6） （ P ＜0.05）. CONCLUSIONS China’s clinical pharmacist training system has basically matured and taken initial shape. The distribution of clinical pharmacist training resources is generally consistent with regional population and economic development levels. However， the allocation of pharmaceutical staff and clinical pharmacists has not yet met national standards and clinical service demands.

OBJECTIVE To clarify the current development status of clinical pharmacist training bases and the pharmacist workforce in China， and to provide evidence for standardizing base construction and promoting the high-quality development of hospital pharmacy. METHODS Questionnaires were distributed to all clinical pharmacist training bases for urgently-needed health professionals and clinical pharmacist training bases under the Chinese Hospital Association that had been approved by the end of 2023 to collect data including base profiles and pharmacist staffing conditions. Expert teams carried out field investigations to verify the collected data. Descriptive statistical analyses were conducted on the quantity， type and regional distribution of training bases， and the influencing factors of pharmacist staffing in the bases were analyzed. RESULTS Field surveys were completed covering 297 training bases across 31 provincial-level administrative regions. Among the base hospitals， 87.88% were Grade A tertiary general hospitals， and 65.32% were located in provincial capitals. The eastern region had the largest number of bases （136， accounting for 45.79%）， followed by the western region （79， 26.60%）. Great disparities existed among provinces in terms of base quantity and hospital scale. The median proportion of pharmaceutical technical personnel in base hospitals was 4.05%， and the median number of clinical pharmacists per 100 hospital beds was 0.53. Both indicators reached the highest in the eastern region （0.57， 4.43%） and the lowest in the northeastern region （0.45， 3.01%）. A total of 3 627 full-time clinical pharmacists were employed in all surveyed bases， among whom 83.68% held clinical pharmacist training certificates， 35.43% possessed senior professional titles， and 78.19% had postgraduate or higher educational background. The total annual training capacity of the surveyed bases was 4 291 trainees， with obvious differences in annual training capacity across regions and provinces. Training specialties covered 19 specialized disciplines plus one general discipline， and no province could deliver training for all 20 specialties simultaneously. Multivariate Logistic regression analysis showed that geographic region exerte d a significant impact on the proportion of pharmaceutical technical personnel （≥4%） （ P ＜0.05）， while the approval time of training bases and hospital scale had significant effects on the number of clinical pharmacists per 100 beds （≥0.6） （ P ＜0.05）. CONCLUSIONS China’s clinical pharmacist training system has basically matured and taken initial shape. The distribution of clinical pharmacist training resources is generally consistent with regional population and economic development levels. However， the allocation of pharmaceutical staff and clinical pharmacists has not yet met national standards and clinical service demands.

OBJECTIVE To investigate the current status of quality management in clinical pharmacist training bases in China， and to provide references for the standardized development and improvement of these bases. METHODS A combined approach of questionnaire survey and on-site investigation was adopted， targeting the healthcare highly sought-after talent （clinical pharmacist） training bases in 31 provinces of China as well as the clinical pharmacist training bases affiliated with the Chinese Hospital Association. A training quality management evaluation index system consisting of 25 tertiary indicators was established. Investigations were conducted from two dimensions： structural quality of training and quality management of training processes. Data were statistically analyzed using descriptive statistical methods. RESULTS On-site investigations were completed for 297 clinical pharmacist training bases across the 31 provinces， among which 284 were affiliated with the Chinese Hospital Association and 271 were healthcare highly sought-after talent （clinical pharmacist） training bases. In terms of structural quality， the core indicator compliance rate for hospital-level training systems exceeded 80%， the rate of special fund utilization for designated purposes reached 80.13%， and the overall compliance rate for software and hardware facilities surpassed 88%. A total of 1 348 preceptors were employed across the training bases， among whom those with senior professional titles and full-time specialist clinical pharmacists as lead preceptors accounted for 62.91% and 94.36%， respectively. Regarding process quality， the compliance rate for “establishment of clinical practice teaching groups in accordance with regulations during clinical department rotations” was 85.19%， and 79.80% and 76.09% of the bases were found to implement strict confidentiality in theoretical examinations and meet the required scale of assessment cases， respectively. However， formal documents of corresponding training management regulations were formulated in only 57.91% of the bases， and the completeness and standardization rate of training manual completion was merely 47.47%. In addition， considerable disparities in quality management levels were observed among provinces， with issues in training process quality being particularly prominent. CONCLUSIONS The management system， hardware facilities， and preceptor staffing of clinical pharmacist training bases in China are relatively well-established， yet notable variations in quality management exist among training bases across different provinces.

Objective:To evaluate the effects of different exercise therapies on postoperative joint function in patients after total knee arthroplasty (TKA), so as to provide evidence-based evidence for clinical medical staff to choose the best exercise therapy.Methods:China National Knowledge Infrastructure, Wanfang, VIP, Chinese Biomedical Literature Service System, PubMed, Web of Science, Embase, and Cochrane Library were searched for randomized controlled trials of different exercise therapies in patients after TKA from inception to April 1, 2024. Stata 17.0 software was used for network Meta-analysis.Results:A total of 38 articles were included, with 2 921 patients after TKA, exercise therapies involved passive exercise, suspension exercise, Otago exercise, cycling exercise, resistance training, proprioceptive training, virtual reality training, muscle strength training, balance training and motor imagery training. The results of network Meta-analysis showed that in terms of improvement in Hospital for Special Surgery Knee Score (HSS), the top 3 ranking results of surface under the cumulative ranking curve (SUCRA) were cycling (96.0%)>resistance training (84.2%)>proprioceptive training (64.2%). In terms of improvement in Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), the top 3 SUCRA ranking results were resistance training (99.5%)>motor visualization training (72.3%)>balance training (61.6%). In terms of improvement in pain score, the top 3 SUCRA ranking results were resistance training (70.9%)>motor imagination training (68.1%)>virtual reality training (64.3%). In terms of improvement in Berg Balance Scale, the top 3 SUCRA ranking results were balance training (89.8%)>virtual reality training (83.5%)>proprioceptive training (55.9%). In terms of improvement of knee flexion range of motion, the top 3 SUCRA ranking results were suspension exercise (82.2%)>proprioceptive training (68.4%)>Otago exercise (63.9%).Conclusions:Cycling exercise is the best exercise therapy to improve HSS, resistance training is the best exercise therapy to reduce WOMAC and relieve pain, balance training is the best exercise therapy to improve balance function, suspension exercise is the best exercise therapy to increase knee flexion range of motion, the above 4 exercise therapy have advantages in improving knee function of patients after TKA.

Objective:To investigate the distribution of CGG repeat numbers in the FMR1 gene among reproductive-age women in China, providing data reference for carrier screening and genetic counseling of Fragile X syndrome. Methods:This cross-sectional study recruited 16 610 reproductive-age women from 12 medical institutions between July 2022 and October 2023. Peripheral venous blood samples (3 mL) were collected, and genomic DNA was extracted. The number of CGG repeats in the FMR1 gene was determined using the triplet-primed polymerase chain reaction (TP-PCR) combined with capillary electrophoresis technology. Statistical analyses were performed to assess the prevalence and distribution of CGG repeat expansions. Results:Among 16 610 women of childbearing age, 5 684 (34.220%) women had the same number of CGG repeats in the two alleles of FMR1 gene, and 10 926 (65.780%) women had different numbers of repeats in the two alleles. Among the 33 220 FMR1 alleles in 16 610 women of reproductive age, the most common CGG repeat numbers were 29 [48.645% (16 160/33 220)] and 30 [26.276% (8 729/33 220)], while the most frequent CGG genotype was CGG 29/29 [24.726% (4 107/16 610)]. The CGG repeat numbers of FMR1 gene were normal in 16 498 women (99.326%). Among the 112 women (0.674%) with CGG repeat abnormities, 96 (0.578%) women were classified as intermediate carriers, 15 (0.090%) as premutation carriers, and 1 (0.006%) as a full mutation carrier, whose CGG genotype was (36, >200). Conclusion:In the general reproductive-age female population in China, the normal CGG repeat numbers of the FMR1 gene account for 99.326%, while the intermediate carrier rate is 0.578%, and the combined carrier rate of the premutation and full mutation types is 0.096%.

Objective To systematically evaluate malnutrition risk factors in diabetic foot patients through systematic review and inform evidence-based nutritional interventions.Methods A top-down search of the literature on risk factors for malnutrition in patients with diabetic foot was conducted according to the"6S"pyramid model,using a computerized decision-making system,clinical guideline websites,professional association websites and databases,with a timeframe of up to March 2025 for the search.Totally 2 researchers independently performed literature screening,quality assessment,and data extraction.Meta-analysis was conducted using Stata 18 software.Results Totally 23 studies with a total sample size of 5 068 cases were included.There were 10 influencing factors being extracted,including age(OR=2.709),BMI(MD=0.709),duration of diabetes mellitus(OR=2.589),glyco-sylated hemoglobin(OR=2.190),albumin(MD=0.578),hemoglobin(OR=2.948),infection(OR=1.816),C-reactive protein(OR=2.228),Wagner classification of diabetic foot(OR=4.620)and degree of self-care(OR=0.220).The incidence of malnutrition in DFU patients who were assessed by the MNA-SF tool,the MNA tool and GLIM tool were 52.2％,70.2％and 41.4％.Conclusion The incidence of malnutrition in DFU patients is relatively high.Healthcare providers should continuously monitor the nutritional status of diabetic foot patients and implement personalized intervention plans to prevent malnutrition.

Objective:To explore the death characteristics and disease burden of lung cancer in Chinese population from 2004 to 2021.Methods:A cross sectional study was conducted. The demographic data and lung cancer mortality surveillance data from 605 surveillance areas in the Chinese mortality surveillance dataset from 2004 to 2021 were used to calculate the crude death rate (CDR), potential years of life lost, average potential years of life lost, work years of potential life lost, and average work years of potential life lost for lung cancer in the population. Joinpoint model was used, and the trend of lung cancer mortality rates in different characteristic populations in the surveillance area was analyzed using average annual percentage change (AAPC) and annual percentage change (APC).Results:The CDR of lung cancer in the surveillance population of China from 2004 to 2021 was 42.94/100 000, with males having a higher CDR than females (58.94/100 000 vs. 26.92/100 000); the overall population, male and female lung cancer CDR showed an upward trend (AAPC were 2.70%, 3.20% and 1.85%, respectively), with a decreasing trend in the total population in 2004 and 2005 (APC = -1.04%), an increasing trend from 2006 to 2014 (APC = 4.46%), and an increasing trend from 2015 to 2021 (APC = 1.41%); the overall increase rate of lung cancer CDR in rural registered residence population (AAPC = 3.70%) was higher than that in urban registered residence population (AAPC = 1.30%). From 2004 to 2021, the age specific lung cancer CDR of the population in surveillance areas of China increased with age, reaching a peak of 437.77/100 000 in the population aged 85 years and above. From 2004 to 2021, the potential life loss caused by lung cancer in surveillance areas of China was 8 532 790.08 person years, with an average potential life loss of 6.55 years. Among them, females had a higher potential life loss than males (8.70 years vs. 4.30 years); the average potential work loss caused by lung cancer in males was 7.02 years, while in females it was 6.76 years. Conclusions:From 2004 to 2021, the overall mortality rate of lung cancer in China shows an upward trend, and the burden of lung cancer disease is relatively heavy. Male and elderly populations need to be given special attention.

Objective To understand the trends in availability and usage for four non-statin lipid-lowering drugs between 2020 and 2023 in China,and to explore the impact of centralized drug procurement and national drug price negotiation policy on the accessibility and utilization trends of these medications.Methods Data processing was performed on four non-statin lipid-lowering drugs(ezetimibe,hybutimibeh,evolocumab,alirocumab)from over 1 000 hospitals within the China Pharmaceutical Association network units from 2020 to 2023 was performed on.SPSS 27.0 was employed for descriptive statistical analysis and x2 tests regarding drug availability,sales revenue,defined daily dose system(DDDs),and cost per DDD(DDDc).Results The availability and DDDs of four cholesterol absorption inhibitors or PCSK9-mAbs increased year by year during the study period,with the most significant increase observed in the first year after centralized drug procurement or national drug price negotiation policy.After the national drug price negotiation policy,alirocumab had the highest availability among the three negotiated drugs.The sales volume of ezetimibe,which was included in the centralized drug procurement program,increased before the negotiation but decreased significantly afterwards,with its share of sales declining year by year.During the study period,the sales volumes and market shares of the three negotiated drugs all increased annually,with evolocumab showing notably higher sales values and percentages than both hybutimibe and alirocumab after the negotiation.The DDDc for all four drugs continued to decrease during the survey period,with the first-year post-centralized drug procurement or national drug price negotiation policy witnessing the largest drop.Conclusion Both of the centralized drug procurement and the national drug price negotiation policy can significantly increase the accessibility to non-statin lipid-lowering drugs and promote their clinical application,however,there is a mismatch between the growth in usage and accessibility for certain varieties.

Objective:To investigate the distribution of CGG repeat numbers in the FMR1 gene among reproductive-age women in China, providing data reference for carrier screening and genetic counseling of Fragile X syndrome. Methods:This cross-sectional study recruited 16 610 reproductive-age women from 12 medical institutions between July 2022 and October 2023. Peripheral venous blood samples (3 mL) were collected, and genomic DNA was extracted. The number of CGG repeats in the FMR1 gene was determined using the triplet-primed polymerase chain reaction (TP-PCR) combined with capillary electrophoresis technology. Statistical analyses were performed to assess the prevalence and distribution of CGG repeat expansions. Results:Among 16 610 women of childbearing age, 5 684 (34.220%) women had the same number of CGG repeats in the two alleles of FMR1 gene, and 10 926 (65.780%) women had different numbers of repeats in the two alleles. Among the 33 220 FMR1 alleles in 16 610 women of reproductive age, the most common CGG repeat numbers were 29 [48.645% (16 160/33 220)] and 30 [26.276% (8 729/33 220)], while the most frequent CGG genotype was CGG 29/29 [24.726% (4 107/16 610)]. The CGG repeat numbers of FMR1 gene were normal in 16 498 women (99.326%). Among the 112 women (0.674%) with CGG repeat abnormities, 96 (0.578%) women were classified as intermediate carriers, 15 (0.090%) as premutation carriers, and 1 (0.006%) as a full mutation carrier, whose CGG genotype was (36, >200). Conclusion:In the general reproductive-age female population in China, the normal CGG repeat numbers of the FMR1 gene account for 99.326%, while the intermediate carrier rate is 0.578%, and the combined carrier rate of the premutation and full mutation types is 0.096%.