OBJECTIVE To establish a scientific， systematic， multi-dimensional performance management system for pharmacy practice， so as to improve the efficiency and quality of pharmacy practice performance management in public hospitals. METHODS Based on the four dimensions of the balanced scorecard theory， finance， customer， internal process， learning and growth， reference indicators for pharmacy practice performance management were summarized. The Delphi method was used to screen indicators， and the analytic hierarchy process was applied to determine the weights of indicators. A pharmacy practice performance management system was then constructed. Based on this system， action plans were formulated and implemented. The effectiveness was evaluated from two aspects： customer reviews and changes in pharmacy practice outcomes. RESULTS A total of 28 reference indicators were summarized， and a performance management system for pharmacy practice was constructed， consisting of 4 primary indicators， 9 secondary indicators， and 20 tertiary indicators. Compared with action plans implementation before， the satisfaction of clinical departments was significantly improved， and 11 pharmacy practice performance management indicators were optimized after implementation. CONCLUSIONS A scientific and systematic performance management system for pharmacy practice has been successfully established， which can provide a reference for the innovation of hospital pharmacy practice management and the high quality development of pharmacy practice.

ObjectiveTobacco-related diseases remain one of the leading preventable public health challenges worldwide and are among the primary causes of premature death. In recent years, accumulating evidence has supported the classification of nicotine addiction as a chronic brain disease, profoundly affecting both brain structure and function. Despite the urgency, effective diagnostic methods for smoking addiction remain lacking, posing significant challenges for early intervention and treatment. To address this issue and gain deeper insights into the neural mechanisms underlying nicotine dependence, this study proposes a novel graph neural network framework, termed TI-GNN. This model leverages functional magnetic resonance imaging (fMRI) data to identify complex and subtle abnormalities in brain connectivity patterns associated with smoking addiction. MethodsThe study utilizes fMRI data to construct functional connectivity matrices that represent interaction patterns among brain regions. These matrices are interpreted as graphs, where brain regions are nodes and the strength of functional connectivity between them serves as edges. The proposed TI-GNN model integrates a Transformer module to effectively capture global interactions across the entire brain network, enabling a comprehensive understanding of high-level connectivity patterns. Additionally, a spatial attention mechanism is employed to selectively focus on informative inter-regional connections while filtering out irrelevant or noisy features. This design enhances the model’s ability to learn meaningful neural representations crucial for classification tasks. A key innovation of TI-GNN lies in its built-in causal interpretation module, which aims to infer directional and potentially causal relationships among brain regions. This not only improves predictive performance but also enhances model interpretability—an essential attribute for clinical applications. The identification of causal links provides valuable insights into the neuropathological basis of addiction and contributes to the development of biologically plausible and trustworthy diagnostic tools. ResultsExperimental results demonstrate that the TI-GNN model achieves superior classification performance on the smoking addiction dataset, outperforming several state-of-the-art baseline models. Specifically, TI-GNN attains an accuracy of 0.91, an F1-score of 0.91, and a Matthews correlation coefficient (MCC) of 0.83, indicating strong robustness and reliability. Beyond performance metrics, TI-GNN identifies critical abnormal connectivity patterns in several brain regions implicated in addiction. Notably, it highlights dysregulations in the amygdala and the anterior cingulate cortex, consistent with prior clinical and neuroimaging findings. These regions are well known for their roles in emotional regulation, reward processing, and impulse control—functions that are frequently disrupted in nicotine dependence. ConclusionThe TI-GNN framework offers a powerful and interpretable tool for the objective diagnosis of smoking addiction. By integrating advanced graph learning techniques with causal inference capabilities, the model not only achieves high diagnostic accuracy but also elucidates the neurobiological underpinnings of addiction. The identification of specific abnormal brain networks and their causal interactions deepens our understanding of addiction pathophysiology and lays the groundwork for developing targeted intervention strategies and personalized treatment approaches in the future.

OBJECTIVE To screen characteristic peaks of hypervirulent Klebsiella pneumoniae(hvKP)using ma-trix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)combined with EX-Smartspec software and establish a rapid detection model for hvKP.METHODS Based on identification criteria of any positive peg-344,iroB,iucA,rmpA,prmpA2 genes or siderophore production＞30 μg/ml,89 hvKP and 72 classical Klebsiella pneumoniae(cKP)strains were initially collected and validated for virulence via Galleria mellonella assays.A diagnostic model distinguishing hvKP from cKP was constructed using EX-Smartspec soft-ware and a convolutional neural network algorithm,integrating characteristic peaks and cluster analysis to provide a rapid and accurate clinical diagnostic tool.RESULTS MALDI-TOF MS analysis identified a characteristic hvKP peak at(3 835±100)ppm.Receiver operating characteristic(ROC)curve analysis revealed optimal performance in distinguishing hvKP with an area under the curve(AUC)=0.741.When AUC ≥0.089,the model demonstra-ted high sensitivity(86.41％),specificity(69.90％),accuracy(78.16％),positive predictive value(74.17％),and negative predictive value(83.72％)in differentiating hvKP from cKP.Cluster analysis further validated the model's classification accuracy.Additionally,the typing classification model exhibited high accuracy(approxi-mately 0.95 and 0.90 in training and validation phases,respectively)and low loss values(-0.18 and 0.30).Val-idation of 6 randomly selected hvKP and 5 cKP strains showed a 100.00％pass rate.CONCLUSION The estab-lished diagnostic model for hvKP and cKP provides a rapid and accurate clinical tool for timely treatment of hvKP-related infections.

Objective To investigate the effect of the mutant of adenovirus-mediated HIF-1α triple mutant(Ad-HIF-1α-Trip)on the apoptosis of H9c2 cardiomyocytes under high glucose and hypoxia conditions.Methods H9c2 cardiomyocytes were cultured under hypoxic conditions in vitro and randomly divided into four groups based on glucose concentration and viral transfection status:low oxygen+normal glucose concentration group(LO+NG group),low oxygen+high glucose concentration group(LO+HG group),low oxygen+high glucose+adenoviral null vector group(LO+HG+Ad-Null group),and low oxygen+high glucose+adenovirus HIF-1α triple mutant group(LO+HG+Ad-HIF-1α-Trip group).After 12 hours of hypoxia,HIF-1α,PI3K,and Akt expression were measured via qRT-PCR and Western blot,and apoptosis of H9c2 cardiomyocytes was assessed by flow cytometry.Results HIF-1α,PI3K,and Akt expression decreased in cardiomyocytes under high glucose and hypoxia,while Ad-HIF-1 α-Trip enhanced their expression.Flow cytometry revealed increased apoptosis under high glucose and hypoxia,which was reduced by Ad-HIF-1α-Trip.Conclusion Ad-HIF-1α-Trip upregulates HIF-1α,PI3K,and Akt in H9c2 cardiomyocytes under high glucose and hypoxia,likely reducing apoptosis via PI3K-Akt pathway activation.

Objective To investigate the clinical effect of percutaneous injection of calcitonin and methylprednone in the treatment of aneurysmal bone cyst in children.Methods From June 2020 to March 2023,19 patients with aneurysmal bone cysts were admitted and all were treated with percutaneous puncture injection of calcitonin and methylprednisolone.After percutaneous puncture biopsy,200 iu of calcitonin and 120 mg of methylprednone were injected into the cyst of aneurysmal bone cyst.Compare the volume of the cyst cavity and the thinnest cortical bone thickness around the cyst cavity before and after the operation.All patients were followed up,while preoperative and postoperative tumor cavity and the thinnest peritumor cortical thickness were compared.Results 19 patients were followed up for an average of 16 months(12-52 months).Of the 19 patients,17 were effective,the effective rate was 89.5％,and no serious complications occurred in all cases.At the last follow-up,the volume of the tumor cavity was significantly lower than that before surgery[(37.05±21.17)cm3,(110.95±45.67)cm3],and the difference was statistically significant(P＜0.05).The average thinnest cortical bone thickness around the tumor cavity was(0.71±0.37)mm before surgery and(1.87±0.60)mm after surgery.The difference was statistically significant(P＜0.05).Conclusion Percutaneous injection of calcitonin and methylprednone in the treatment of aneurysmal bone cysts in children is minimally invasive,safe and effective.It can be used as the first-line treatment for aneurysmal bone cyst in children.

To further investigate the molecular genetic characteristics of enzomatic nasal tumor vi-rus of goats(ENTV-2)in Yunnan Province,this study measured and analyzed the entire genome of ENTV-2 in Yunnan Province.The results showed that the complete genome sequence of the EN-TV-2 YN2023 strain(GenBank accession number:PP682590.1)was successfully obtained.The YN2023 strain has a total length of 7 307 bp and a typical structure of 5'-M5-gag-pro-pol-env-M3-3'.Whole genome sequence homology analysis showed that the nucleotide homology between YN2023 strain and 41 reference strains ranges from 85.3％to 95.5％.The whole genome evolution-ary tree indicates that the YN2023 strain is closely related to the prevalent strains in China,with certain genetic diversity and geographical clustering.The analysis of the gag gene evolutionary tree shows that the gag gene cluster of YN2023 strain is on a branch of the ENTV-2 gag gene,and YN2023 is clustered on the same small branch as enENTV-FJ1 and GDQY2017 strains,with the closest genetic relationship.The env gene evolutionary tree shows that YN2023 is on the same branch as GDQY2017,GDZJ2022,ENTV-2CHN1-6,ENTV-FJ1,and ENTV-FJ3,and is also on the same branch as GDQY2017,indicating a close genetic relationship.Recombination analysis showed that the YN2023 strain underwent a potential recombination event between breakpoint positions 6378-7478 bp,with the Chinese Chongqing strain enENTV-CQ1(OR669623.1)as the primary parent and the Chinese Sichuan strain BH(MT254062.1)as the secondary parent.This study enriches the genomic information of the ENTV-2 strain in Yunnan Province and provides data sup-port for the genetic variation of ENTV-2 in Yunnan Province.

The inter-hospital transport of critically ill children involves the use of professional knowledge,technology,and methods to transfer these patients between hospitals without interrupting medical monitoring and treatment.Currently,inter-hospital transport system of critically ill children in China faces challenges such as uneven distribution of medical resources,inadequate training systems,and changes in the disease spectrum.There is a lack of unified documents and guidelines,leading to new trends and challenges in inter-hospital transport.In the future,with technological innovation,regional cooperation,and the establishment of standardized processes,inter-hospital transport will become increasingly professionalized,and survival rates will be significantly improved.This article reviewed the current situation,trends,and progress of inter-hospital transport of critically ill children.

Objective:To investigate the feasibility and safety of high-speed railway (HSR) transport for critically ill pediatric patients.Methods:A single-center retrospective analysis was conducted.A total of 39 children transported via HSR (HSR group) and 420 children transported via ambulance (ambulance group) from May 2019 to December 2024 at the Seventh Medical Center of the PLA General Hospital were included.Demographic data,disease types,transport distances,and outcomes were compared between the two groups,and the vital signs,blood gas analysis,mechanical ventilation parameters,and vasoactive drug usage before and after HSR transport were also compared.Results:Over the five-year period,39 HSR transports and 420 ambulance transports were completed.No significant differences were observed in gender,age,or weight between HSR group and ambulance group( P>0.05).The proportion of circulatory system diseases was significantly higher in the HSR group (74.4% vs.55.1%, P = 0.020).HSR transports covered longer distances [855(855,1 075)km vs.84(23,273) km, P<0.001] and achieved faster speeds [150(150,216) vs.80(79,80)km/h, P<0.001].No significant differences were found in heart rate,body temperature,or diastolic pressure before and after HSR transport ( P>0.05).However,systolic blood pressure and partial pressure of oxygen increased slightly post-HSR transport [(82.97±15.44) vs.(85.15 ± 14.82)mmHg, P=0.003；(84.22±25.45)mmHg vs.(88.95±28.70)mmHg, P=0.029].Mechanical ventilation parameters remained stable during HSR transport ( P>0.05). Conclusion:HSR transport is feasible and safe for critically ill children and represents a promising option for long-distance interhospital transfers of pediatric patients.

Objective:To retrieve, evaluate, and summarize the evidence on prevention and management of chronic venous disease of the lower extremities, so as to provide reference for clinical practice.Methods:Clinical decisions, guidelines, evidence summaries, and expert consensus on chronic venous diseases of the lower extremities were systematically retrieved from UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center Database, National Institute for Health and Clinical Excellence, Registered Nurses' Association of Ontario, New Zealand Guidelines Group, National Health and Medical Research Council, Guidelines International Network, Medlive, PubMed, Embase, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data, and specialized collaborative websites including the Society for Vascular Surgery, American Vein and Lymphatic Society, American Venous Forum, and European Society for Vascular Surgery. The search period was from the establishment of the database to March 31, 2025.Results:A total of 18 articles were included, including three guidelines, five clinical decisions, four evidence summaries, and six expert consensus. Ultimately, 19 pieces of evidence were integrated from six aspects of diagnosis, clinical-etiology-anatomy-pathophysiology (CEAP) classification and severity assessment, risk factor assessment, prevention, lifestyle modification, stress management, and patient education and follow-up.Conclusions:Evidence included in this study indicates that the diagnosis of chronic venous disease of the lower extremities, along with CEAP classification and severity assessment, has been widely adopted. In clinical practice, emphasis should be placed on assessing risk factors, implementing preventive management and health education for high-risk patients, and conducting long-term follow-up to alleviate symptoms and thereby improve quality of life. It is recommended that clinical nursing staff conduct targeted evidence transformation based on specific clinical contexts to enhance the quality of clinical nursing.

Objective To investigate internal arsenic exposure levels and influencing factors in infants and young children from low-arsenic regions.Methods A total of 390 urine samples from 130 children aged 0-7 years in Wuhan(central China)and Shenzhen(southern China)were analyzed using high performance liquid chromatography-inductively coupled plasma mass spec-trometry.A linear mixed model was applied to assess factors influencing arsenic exposure levels,and risk evaluation was conduc-ted based on biomonitoring equivalents.Results The average urinary total arsenic level in children was 15.6 μg/L.The concen-trations of these species increased with age,except for arsenate(AsⅤ).Children in Shenzhen had higher level of arsenobetaine(AsB)than in Wuhan(P＜0.05).The urinary levels of monomethyl arsenic acid(MMA)and dimethyl arsenic acid(DMA)were significantly higher in winter than in autumn(P＜0.05).Total urinary arsenic levels in 72％of the children exceeded the bio-monitoring equivalent.Conclusion Arsenic exposure among children shows an increasing trend with age,and there are regional and seasonal differences.More than half of the children may suffer potential health risks of As exposure,highlighting the urgent need for improved monitoring and preventive measures.