OBJECTIVE To explore the characteristics and influential factors of pharmaceutical clinic service demands， providing evidence for optimizing pharmaceutical service models and facilitating pharmaceutical service models of pharmacist role transformation. METHODS A cross-sectional survey design was adopted， and 410 outpatient participants were selected from Fudan University Shanghai Cancer Center through convenience sampling for questionnaire administration from February to May 2025. Kano model was applied to analyze the demand attributes of 25 pharmaceutical services， while questionnaires were used to assess patients’ awareness and demand status. Subgroup analyses were conducted based on key demographic variables such as gender， age， educational attainment， and economic burdens， to SACA- systematically examine the differences in Kano attribute classification among patients in each subgroup. RESULTS The awareness rate of pharmaceutical outpatient services among patients was only 14.63%， yet those who were aware demonstrated a significantly higher demand rate for such services compared to those who were unaware （P＜0.001）. The demand for pharmaceutical clinic services exhibited a hierarchical characteristic： twelve items were identified as attractive attributes （e. g.， providing suggestions for more affordable treatment options， offering online consultation services， etc.）， five items as expected attributes （e.g.， having a good attitude and being able to patiently answer your questions， etc.）， three items as must-have attributes （e.g.， providing guidance on medication dosage and usage， providing guidance on medication precautions， etc.）， five items as indifferent attributes （e.g.， providing treatment plan recommendations based on the patient’s condition）. There were zero items classified as reverse attribute. Subgroup analysis revealed that female patients showed greater concern for “neat and clean attire of medical staff” than male patients （P＜0.001）； patients under 60 years of age demonstrated stronger demand for “providing treatment plan recommendations based on patients’ conditions” compared to patients aged 60 or above （P＝0.016）； those with below high school education placed greater emphasis on “providing guidance on medication precautions” compared to those with a high school education or above （P＝0.011）； patients with lower economic burdens exhibited stronger preferences for “neat and clean attire of medical staff ” （P＝0.002）. CONCLUSIONS The public awareness rate of pharmaceutical clinic services is considerably low； however， those who are aware of such services demonstrate significantly higher demand. The medication safety-related services and convenience-oriented demands should be prioritized in the development of pharmaceutical clinics. Moreover， the study also revealed that factors such as gender， age， educational level， and economic burdens exert significant influences on patients’ service demands.

Objective: To explore the association between CDKAL1 rs35261542, FAIM2 rs 3205718, and VGLL4 rs 2574704 polymorphisms with childhood obesity and related metabolic phenotypes to provide evidence for personalized prevention and management strategies. Methods: Based on the 2023 Long term Nutritional Health Effects of Early Childhood Nutrition Package Intervention project, the study enrolled 1 078 children aged 5-7 years from four counties in Henan (Songxian and Ruyang countries) and Guizhou (Guiding and Fuquan countries) provinces. Using BMI Z scores, 87 overweight and obese(OVOB) children were selected and matched by sex, age, and BMI Z score with 117 normal weight controls. Participants were further stratified into four metabolic phenotype groups: metabolically healthy normal weight (MHNW, n =51), metabolically unhealthy normal weight (MUNW, n =66), metabolically healthy obesity (MHO, n =31) and metabolically unhealthy obesity (MUO, n =56) based on four conventional cardiometabolic risk factor (CR) criteria. Data were collected through questionnaires, anthropometric measurements, serum biochemical tests, and KASP genotyping. The distribution of three genetic polymorphisms ( CDKAL1 rs35261542, FAIM2 rs3205718, VGLL4 rs 2574704) across metabolic subgroups was analyzed. Multivariate Logistic regression models assessed associations between these polymorphisms and obesity/metabolic phenotypes. Results: Multivariate Logistic regression analysis showed that Homozygous mutant AA genotype of CDKAL1 rs 35261542 was positively associated with OVOB( OR =3.63), MHO ( OR =11.04), MUO ( OR = 4.88 ) ( P <0.05). Homozygous TT genotype of FAIM2 rs 3205718 increased OVOB risk ( OR =4.44, P <0.05) but showed no association with metabolic phenotypes ( P >0.05). Homozygous mutant TT of VGLL4 rs 2574704 reduced the risks of MHO and MUO ( OR = 0.30, 0.24， P <0.05). Cumulative genetic effects analysis demonstrated carriers of 1 or 2 risk genotypes of rs 35261542 and rs 3205718 had progressively higher OVOB risk ( OR =2.53, 20.79), and the combination of rs 35261542 and rs 2574704 increased risks for both MHO ( OR =8.50) and MUO ( OR =5.00) ( P <0.05). Conclusions The AA genotype of rs 35261542 ( CDKAL1 ) positively correlates with childhood obesity and metabolic abnormalities. The TT genotype of rs 3205718 ( FAIM 2) increases obesity risk but not metabolic phenotypes. The TT genotype of rs 2574704 ( VGLL 4) shows protective effects against metabolic dysfunction. Risk genotypes exhibit dosedependent cumulative effects on obesity and metabolic outcomes.

OBJECTIVE To observe the characteristics of outer membrane vesicles(OMVs)of 1 strain of hypervir-ulent Klebsiella pneumoniae(hvKp)11492.METHODS The hvKp11492,one of major clones of hvKp that were i-solated from patients with bloodstream infection in the First Medical Center of Chinese PLA General Hospital,was chosen as the research subject.The strain was identified by means of matrix-assisted laser desorption/ioniza-tion time of flight mass spectrometry and whole genome sequencing.The hvKp1 1492-OMVs were separated and purified by high speed centrifugation in combination with polymer precipitation,the morphology and particle size of the hvKp11492-OMVs were identified by transmission electron microscopy(TEM)and nanoparticle tracking a-nalysis(NTA),the proteomic characteristics were analyzed through bicinchoninic acid assay(BCA)and liquid chromatography-mass spectrometry(LC-MS)series technique,and the virulence genes were detected by PCR.RESULTS The hvKp11492-OMVs were displayed differently in size,round or oval,and complete double-layer membrane vesicles on TEM.The result of NTA showed that the average particle size of the hvKp1 1492-OMVs was 270 nm.The protein content of hvKp11492-OMVs was(2.448±0.975)μg/μl.The result of subcellular lo-calization indicated that the protein included plasmosin,intracellular membrane protein,periplasmic protein,ex-tracellular membrane protein and nuclear region protein,which were found,by the annotation of GO database,to participate in the biological processes such as oxidation-reduction,interpretation,and metabolism.The hvKp11492-OMVs contained various proteins such as GDP-L-fucose synthetase,iron ion transporter protein and ferritin that were associated with pathogenicity.In addition,the hvKp1 1492-OMVs carried with iutA,iroN,iucA and rmpA virulence genes.CONCLUSIONS The morphologic characteristics,size and proteomic characteris-tics of the hvKp11492-OMVs are identified in the study.It is concluded that the hvKp11492-OMVs carry with va-rious proteins and genes that are association with the virulence and pathogenicity.

OBJECTIVE To explore the distribution of pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections and observe the expressions of maternal expression gene 3(MEG3)/microribonucleic acid-223(miR-223)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)axis in peripheral blood.METHODS Totally 48 lung cancer patients who underwent thoracoscopic lobec-tomy and had postoperative pulmonary infections in the First Affiliated Hospital of Guangzhou University of Chi-nese Medicine from Jun.2021 to Jun.2024 were assigned as the infection group,meanwhile,31 lung cancer pa-tients who underwent thoracoscopic lobectomy but did not have postoperative infections were chosen as the no in-fection group.The sputum specimens were collected from the infection group,the distribution of isolated patho-gens was analyzed.The clinical data and the expression MEG3,miR-223 and NLRP3 were observed and compared between the two groups.The values of MEG3,miR-223 and NLRP3 in prediction of the postoperative infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS Totally 63 strains of pathogens were i-solated from the 48 thoracoscopic lobectomy patients with postoperative pulmonary infections,33(52.38％)of which were gram-negative bacteria,25(39.68％)were gram-positive bacteria,and 5(7.94％)were fungi.There were significant differences in age,diabetes mellitus,chronic obstructive pulmonary disease(COPD),operation duration,and expression levels of MEG3,miR-223 and NLRP3 between the infection group and the no infection group(P＜0.05).ROC curve analysis showed that the areas under the curves of MEG3,miR-223 and NLRP3 and the joint detection of the three indexes were 0.861,0.760,0.912 and 0.968,respectively,in prediction of the post-operative pulmonary infections,and the predictive efficiency of the joint detection was highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the thoracoscopic lo-bectomy patients with postoperative pulmonary infections,the occurrence and progression of the infections may be closely associated with the activation of MEG3/miR-223/NLRP3 axis.The joint detection of the three indexes can effectively predict the postoperative pulmonary infections in the thoracoscopic lobectomy patients.

OBJECTIVE To observe the characteristics of outer membrane vesicles(OMVs)of 1 strain of hypervir-ulent Klebsiella pneumoniae(hvKp)11492.METHODS The hvKp11492,one of major clones of hvKp that were i-solated from patients with bloodstream infection in the First Medical Center of Chinese PLA General Hospital,was chosen as the research subject.The strain was identified by means of matrix-assisted laser desorption/ioniza-tion time of flight mass spectrometry and whole genome sequencing.The hvKp1 1492-OMVs were separated and purified by high speed centrifugation in combination with polymer precipitation,the morphology and particle size of the hvKp11492-OMVs were identified by transmission electron microscopy(TEM)and nanoparticle tracking a-nalysis(NTA),the proteomic characteristics were analyzed through bicinchoninic acid assay(BCA)and liquid chromatography-mass spectrometry(LC-MS)series technique,and the virulence genes were detected by PCR.RESULTS The hvKp11492-OMVs were displayed differently in size,round or oval,and complete double-layer membrane vesicles on TEM.The result of NTA showed that the average particle size of the hvKp1 1492-OMVs was 270 nm.The protein content of hvKp11492-OMVs was(2.448±0.975)μg/μl.The result of subcellular lo-calization indicated that the protein included plasmosin,intracellular membrane protein,periplasmic protein,ex-tracellular membrane protein and nuclear region protein,which were found,by the annotation of GO database,to participate in the biological processes such as oxidation-reduction,interpretation,and metabolism.The hvKp11492-OMVs contained various proteins such as GDP-L-fucose synthetase,iron ion transporter protein and ferritin that were associated with pathogenicity.In addition,the hvKp1 1492-OMVs carried with iutA,iroN,iucA and rmpA virulence genes.CONCLUSIONS The morphologic characteristics,size and proteomic characteris-tics of the hvKp11492-OMVs are identified in the study.It is concluded that the hvKp11492-OMVs carry with va-rious proteins and genes that are association with the virulence and pathogenicity.

OBJECTIVE To explore the distribution of pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections and observe the expressions of maternal expression gene 3(MEG3)/microribonucleic acid-223(miR-223)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)axis in peripheral blood.METHODS Totally 48 lung cancer patients who underwent thoracoscopic lobec-tomy and had postoperative pulmonary infections in the First Affiliated Hospital of Guangzhou University of Chi-nese Medicine from Jun.2021 to Jun.2024 were assigned as the infection group,meanwhile,31 lung cancer pa-tients who underwent thoracoscopic lobectomy but did not have postoperative infections were chosen as the no in-fection group.The sputum specimens were collected from the infection group,the distribution of isolated patho-gens was analyzed.The clinical data and the expression MEG3,miR-223 and NLRP3 were observed and compared between the two groups.The values of MEG3,miR-223 and NLRP3 in prediction of the postoperative infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS Totally 63 strains of pathogens were i-solated from the 48 thoracoscopic lobectomy patients with postoperative pulmonary infections,33(52.38％)of which were gram-negative bacteria,25(39.68％)were gram-positive bacteria,and 5(7.94％)were fungi.There were significant differences in age,diabetes mellitus,chronic obstructive pulmonary disease(COPD),operation duration,and expression levels of MEG3,miR-223 and NLRP3 between the infection group and the no infection group(P＜0.05).ROC curve analysis showed that the areas under the curves of MEG3,miR-223 and NLRP3 and the joint detection of the three indexes were 0.861,0.760,0.912 and 0.968,respectively,in prediction of the post-operative pulmonary infections,and the predictive efficiency of the joint detection was highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the thoracoscopic lo-bectomy patients with postoperative pulmonary infections,the occurrence and progression of the infections may be closely associated with the activation of MEG3/miR-223/NLRP3 axis.The joint detection of the three indexes can effectively predict the postoperative pulmonary infections in the thoracoscopic lobectomy patients.

Tenofovir disoproxil fumarate （TDF） is a first-line treatment for chronic hepatitis B. With increasing use worldwide， the adverse events of renal injury caused by this drug have also attracted industry attention. This article reports a 61- year-old patient with liver cancer complicated with hepatitis B virus （HBV） infection. The patient started using TDF in mid-March 2022 and developed kidney injury after 2 months of treatment， during which he received 2 courses of donafenib combined with sintilimab chemotherapy and irregular administration of diclofenac for pain relief. In this paper， Naranjo’s assessment scale was used to evaluate the drugs that may be associated with renal injury， including TDF and sintilimab， and the drugs that are suspected to be associated with renal injury are donafenib and diclofenac. The renal injury caused by TDF can be judged according to the changes in the patient’s condition， the incidence of drug-induced renal injury， clinical manifestations， occurrence time， occurrence mechanism， drug combination， and high-risk factors. The changes of serum creatinine in patients with liver cancer complicated with HBV infection after TDF should be dynamically monitored in the clinic， and the dose of antiviral drugs should be adjusted if necessary and other antiviral drugs with less impact on renal function can be selected， to provide individualized medication recommendations for tumor patients， reduce the incidence of TDF-related renal injury.

Abstract Biomarkers could improve the understanding of the causes of obesity and its association with chronic diseases for people. The purpose of the review is to summarize recent advances in transcriptomic, proteomic, and metabolomic phenotypic biomarkers of obesity in order to deepen the understanding of the etiology of obesity and its metabolic consequences. In the precise prevention and control of childhood obesity, different groups of biomarkers can improve the accuracy of the word "obesity" and help early detection of specific biomarkers with risk characteristics, so as to realize the transformation of childhood obesity from a one size fits all prevention and control strategy to a personalized prevention and control plan during the development of obesity.

This article reports the pharmacotherapy process of a clinical pharmacist participating in the treatment of acute liver injury caused by nintedanib in a patient with lung cancer complicated with interstitial pneumonia.Clinical pharmacist analyzed the rapid increase of liver enzymes in patients by excluding their past drug use history,stopping suspicious drugs and searching domestic and foreign literature,and determined that the association with nidanib was very likely according to RUCAM scale.The clinical pharmacies suggesteded stopping nintedanib and taking liver protection treatment actively.The clinician adopted the suggestion,and finally the patient's liver function improved after 20 days of treatment.Clinical pharmacists demonstrate their value by analyzing the causes and characteristics of liver injury in patients,assisting physicians in the timely identification and management of adverse reactions,and participating in clinical practice.This article can provide a reference for the diagnosis and treatment of similar cases of acute liver injury.

Objective To provide alternative delivery methods of novel oral antitumor drugs for patients with dysphagia.Methods The retrieval range was determined according to the"Guidelines for Clinical Application of Novel Antitumor Drugs(2022 edition)".By consulting the instructions and searching databases such as PubMed,Micromedex,UpToDate,etc.,the preparation,stability,storage,and related clinical information of temporary liquid drug formulations were obtained.Results Seventy novel oral anticancer drugs were included in the literature search.Thirty-three drugs had relevant literature or data supporting alternative administration methods,only eight had information on alternative administration in the instructions,and the level of evidence for other drugs varied.Conclusion The evidence levels were low for most temporary liquid formulations,and medical teams should fully consider the advantages and disadvantages of using these products outside the instructions and use them with caution.