OBJECTIVE To formulate Guidelines for the standardized implementation of pharmacist-managed clinics （ 2026 edition ） in response to the challenges faced by such clinics in China， including uneven development， large discrepancies in service specifications， insufficient patient awareness， and limited medical insurance coverage. METHODS Led by the Pharmaceutical Affairs Professional Committee of the Chinese Hospital Association， the Evidence-based Pharmacy Professional Committee of the Chinese Pharmaceutical Association， and the Hospital Pharmacy Professional Committee of the Cross-strait Medical and Health Exchange Association， a total of 19 domestic hospital pharmacy experts were organized. Through a systematic review of national policies and literature research， current practical experience was summarized. Consensus on the contents of the guidelines was reached after in-depth discussions. RESULTS &CONCLUSIONS The guidelines covered five sections： definition and connotation of pharmacist-managed clinics， establishment requirements， implementation and management， post competency， and practical research. Firstly， the definition and connotation included three operational forms of pharmacist-managed clinics （independent mode， physician-pharmacist joint mode， and online pharmacist-managed clinic mode） and classified service modes （specialty-specific， drug-specific， and disease-specific pharmacist-managed clinics）. The establishment requirements were further refined， covering system construction （pharmaceutical service management system， quality control and assessment mechanism）， personnel qualifications （professional credentials， continuing education and professional training， etc）， service recipients， as well as service venues and facilities. Subsequently， the implementation and management of pharmacist-managed clinics were proposed， involving service procedures， intervention measures， documentation and records， patient education and follow-up， humanistic care， as well as risk management and quality control. Finally， post competency encompassed the competency requirements for pharmacists providing services in pharmacist-managed clinics， as well as the suggestions on teaching methods； practical research encouraged the conduct of high-quality pharmaceutical practice in the setting of pharmacist-managed clinics. The guidelines provide valuable guidance for the standardized implementation of pharmacist-managed clinics in China in terms of establishment， management， teaching， and research， fill the guideline gap in this field， and can promote the high-quality development of pharmacist-managed clinics.

ObjectiveTo investigate the mechanism of Huangqin Tang （HQT） in regulating metabolic reprogramming during the inflammation-cancer transformation in colitis-associated colorectal cancer （CAC）. MethodsCAC mouse model was established using the carcinogen azoxymethane （AOM） combined with the inflammatory agent dextran sulfate sodium （DSS）. HQT treatment was adopted. Serum metabolomics analysis was performed at three stages （inflammation， proliferation， and tumor formation） using liquid chromatography-tandem mass spectrometry （LC-MS/MS） untargeted metabolomics coupled with multivariate statistical analysis to explore the mechanism of HQT intervention in metabolism in CAC. ResultsThe results revealed that HQT significantly reversed the disturbance of key metabolites in CAC mice. A total of 52， 67， and 45 differential metabolites were identified in the model group， compared to the normal group， during inflammation， proliferation， and tumor stages， respectively. Lactate， linoleic acid， oleic acid， elaidic acid， and betaine were characteristic metabolites persistently enriched throughout colitis-cancer transformation. Pathway enrichment analysis of differential metabolites showed that linoleic acid metabolism and arachidonic acid metabolism were the most significantly disturbed in CAC pathogenesis. The proliferation stage featured expanded amino acid metabolic networks， while the tumor stage uniquely exhibited two new pathways of nicotinate and nicotinamide metabolism and phosphoinositide metabolism. HQT exerted stage-specific regulatory effects： targeting arachidonic acid metabolism in the inflammation stage， correcting the dysregulation of choline-carnitine metabolism in the proliferation stage， and rescuing nicotinamide and tryptophan metabolic collapse in the tumor stage. ConclusionHQT exerts regulatory effects on metabolic disorders at various stages of the colitis-cancer transformation process， thereby effectively slowing the progression from colitis to cancer. The study also reveals the dynamic metabolic characteristics of colorectal "inflammation-cancer transformation，"providing new insights for research on the targeted mechanisms of traditional Chinese medicine in anti-tumor therapy based on metabolic reprogramming.

Recent studies have revealed a significant association between Porphyromonas gingivalis(P.gingivalis)infection and poor prognosis in esophageal squamous cell carcinoma(ESCC).Although cer-tain circular RNAs(circRNA)have been shown to suppress ESCC tumorigenesis and progression,their regulatory mechanisms in P.gingivalis infection-associated ESCC remain elusive.In this study,RT-qPCR analysis demonstrated that P.gingivalis infection downregulated hsa_circ_0057552 expression in ESCC cells and tissues in a time-and dose-dependent manner.Actinomycin D assays further confirmed that P.gingivalis infection reduced the RNA stability of hsa_circ_0057552 in ESCC cells(P＜0.05).Functional assays in vitro and a subcutaneous tumor xenograft model in vivo revealed that hsa_circ_0057552 overexpression significantly inhibited ESCC cell proliferation,migration,invasion,and tumor growth(P＜0.05).Additionally,PCR array screening combined with RT-qPCR and Western blotting in-dicated that P.gingivalis infection markedly upregulated human antigen R(HuR)expression at both RNA and protein levels(P＜0.05).Mechanistic investigations demonstrated that HuR knockdown signifi-cantly increased hsa_circ_0057552 expression(P＜0.01),whereas hsa_circ_0057552 overexpression had no regulatory effect on HuR.Finally,si-HuR treatment reversed the inhibitory effect of P.gingivalis on hsa_circ_0057552 transcription.This study demonstrated that P.gingivalis may promote the progression of ESCC through a novel mechanism involving the regulation of HuR/hsa_circ_0057552,thereby identif-ying a novel therapeutic target and molecular marker for P.gingivalis-associated ESCC.

Objectives:To assess the impact of intravascular ultrasound(IVUS)guidance for drug-eluting stent(DES)implantation on the long-term outcomes in coronary artery disease(CAD)patients with chronic kidney disease(CKD).Methods:A retrospective study was conducted on 1 800 CAD and CKD patients who underwent coronary DES implantation at Nanjing First Hospital from January 2018 to December 2022.Patients were divided into IVUS-guided group(IVUS group,n=333)and angiography-guided group(angiography group,n=1 467).Propensity score matching(PSM)was performed at a 1:2 ratio to adjust for differences in baseline clinical and angiographic characteristics between the two groups.Major adverse cardiovascular events(MACE),including cardiac death,target vessel myocardial infarction,and clinically driven target vessel revascularization,were evaluated over a 2-year follow-up.Cox proportional hazards regression was performed to identify independent predictors of MACE.Results:After propensity score matching,333 patients in the IVUS group were matched with 666 patients in the angiography group.Following matching,there were no significant differences in clinical characteristics and angiographic data between the two groups(all P>0.05).Regarding procedural data,IVUS group had a higher number of stents implanted,longer total stent length,larger average stent diameter,more frequent use of post-dilation balloons,larger post-dilation balloon diameter,and greater contrast agent usage(all P<0.05).MACE rate was significantly higher in the angiography group than that in the IVUS group(23.9%vs.18.0%,P=0.037).The difference was mainly attributed to a higher rate of cardiac death in the angiography group(16.1%vs.10.8%,P=0.013).Additionally,patients in angiography group had a significantly higher all-cause mortality rate compared to IVUS group(19.7%vs.13.8%,P=0.022).Multivariate cox regression analysis showed that IVUS guidance(HR=0.73,95%CI:0.55-0.99,P=0.042)was an independent protective factor,while hypertension(HR=1.60,95%CI:1.13-2.26,P=0.008),type 2 diabetes(HR=1.56,95%CI:1.19-2.05,P=0.001),acute coronary syndrome(HR=1.92,95%CI:1.12-3.30,P=0.018),and moderate to severe calcification(HR=1.55,95%CI:1.18-2.04,P=0.002)were independent risk factors for MACE at 2 years after DES implantation in CKD patients.Conclusions:Patients with CAD and CKD,IVUS-guided DES implantation is associated with a reduced risk of MACE and all-cause mortality at 2 years post-procedure compared to coronary angiography-guided implantation.

Objective To investigate the possible mechanism of ferroptosis induced by lipocalin2(LCN2)and microglial po-larization in intracerebral hemorrhage(ICH).Methods Forty SD rats were divided into sham operation group,ICH group,LCN2 low expression group and Liproxstatin-1 group,with 10 rats in each group.The morphological structure of the brain was observed and recorded,and the cranial nerve function(NIHSS)score was performed.Immunofluorescence staining was used to detect the expression of microglia marker protein(Iba1),and M1 and M2 microglia marker proteins(CD68 and CD206)in brain tissue.Western blot was used to detect the protein levels of LCN2,ferroptosis marker proteins[solute carrier family 7 member 11(SLC7A11)and glutathione peroxidase 4(GPX4)]in brain tissue.The contents of ferrous ion(Fe2+)and malondialdehyde(MDA)in brain tissue were detected by ELISA kits.Results Compared with the sham operation group,the expression of LCN2 protein,the intracerebral hemorrhage,the NIHSS score increased(all P＜0.05),and the expression of CD68 and CD206 in the microglia increased,the expression of ferroptosis-related proteins(SLC7A11 and GPX4)decreased,and the content of Fe2+and MDA increased in the brain tissue of the ICH group(all P＜0.05).Compared with the ICH group,the expression of LCN2 pro-tein,the intracerebral hemorrhage,the NIHSS score and the expression of CD68 in microglia significantly decreased,and the ex-pression of CD206 significantly increased,the expression of SLC7A11 and GPX4 increased,the contents of Fe2+and MDA de-creased in the brain tissue of the LCN2 low expression group(all P＜0.05).The expression of CD68 in brain tissue of Liprox-statin-1 group was significantly decreased,and the expression of CD206 was significantly increased as compared with ICH group(P＜0.05).Conclusion Down-regulation of LCN2 can promote microglial cell polarization by inhibiting ferroptosis,and im-prove nerve function injury in ICH rats.

OBJECTIVE To analyze the plasma-entering components of the ethanol extract of Yu-Ping-Feng-San by ultra-per-formance liquid chromatography-quadrupole-time of flight tandem mass spectrometry(UPLC-Q-TOF-MS)technology,so as to pro-vide a reference for the study of the pharmacological substances of Yu-Ping-Feng-San.METHODS Male BALB/c mice were ga-vaged with the ethanol extract of Yu-Ping-Feng-San(6.5 g·kg-1),and plasma samples were collected before administration(0 h)and 1,2,4,6,8,and 12 h after administration.The UPLC-Q-TOF-MS technology was used to analyze and identify the components absorbed into the plasma.RESULTS A total of 73 chemical components in the ethanol extract of Yu-Ping-Feng-San were identi-fied,and 26 plasma-entering components were identified in all plasma samples.Among the plasma-entering components,11 compo-nents were from Saposhnikoviae Radix,and 15 components were from Radix Astragali.CONCLUSION The chemical components and plasma-entering components of the ethanol extract of Yu-Ping-Feng-San were analyzed comprehensively,which provides a reference for further clarifying the pharmacological substance basis and mechanism of action of Yu-Ping-Feng-San.

Objective To investigate the possible mechanism of ferroptosis induced by lipocalin2(LCN2)and microglial po-larization in intracerebral hemorrhage(ICH).Methods Forty SD rats were divided into sham operation group,ICH group,LCN2 low expression group and Liproxstatin-1 group,with 10 rats in each group.The morphological structure of the brain was observed and recorded,and the cranial nerve function(NIHSS)score was performed.Immunofluorescence staining was used to detect the expression of microglia marker protein(Iba1),and M1 and M2 microglia marker proteins(CD68 and CD206)in brain tissue.Western blot was used to detect the protein levels of LCN2,ferroptosis marker proteins[solute carrier family 7 member 11(SLC7A11)and glutathione peroxidase 4(GPX4)]in brain tissue.The contents of ferrous ion(Fe2+)and malondialdehyde(MDA)in brain tissue were detected by ELISA kits.Results Compared with the sham operation group,the expression of LCN2 protein,the intracerebral hemorrhage,the NIHSS score increased(all P＜0.05),and the expression of CD68 and CD206 in the microglia increased,the expression of ferroptosis-related proteins(SLC7A11 and GPX4)decreased,and the content of Fe2+and MDA increased in the brain tissue of the ICH group(all P＜0.05).Compared with the ICH group,the expression of LCN2 pro-tein,the intracerebral hemorrhage,the NIHSS score and the expression of CD68 in microglia significantly decreased,and the ex-pression of CD206 significantly increased,the expression of SLC7A11 and GPX4 increased,the contents of Fe2+and MDA de-creased in the brain tissue of the LCN2 low expression group(all P＜0.05).The expression of CD68 in brain tissue of Liprox-statin-1 group was significantly decreased,and the expression of CD206 was significantly increased as compared with ICH group(P＜0.05).Conclusion Down-regulation of LCN2 can promote microglial cell polarization by inhibiting ferroptosis,and im-prove nerve function injury in ICH rats.

Hemodialysis patients exhibit compromised immune function and require long-term repeated vascular punctures as therapeutic approach,the risk of infection increases.Hospital-associated infection in hemodialysis de-partment(center)happens from time to time,which has already become a concern for the medical community,patients and social media.This paper outlines the task origin of China's"Standard for infection prevention and control in hemodialysis department(center)"(WS/T854-2025),the compilation basis and explanations for its key content,feasibility and implementation recommendations,as well as the clarifications on common issues encoun-tered during its promotion and enforcement.

Objective To observe the correlation between cortical thickness and pathological deposition of β-amyloid(Aβ)in patients with Alzheimer disease(AD)induced mild cognitive impairment(MCI)or dementia.Methods Totally 22 AD patients were prospectively enrolled and divided into dementia group(n=12)and MCI group(n=10)based on the degree of cognitive impairment,while 17 healthy individuals without cognitive impairment were recruited as control group.MR examination and 18F-florbutaben(18F-FBB)PET imaging were performed,the cortical thickness and Aβ deposition value(Centiloid[CL]value)were calculated and compared among 3 groups and between each 2 groups,then the correlation between the above two indexes was analyzed.Results The cortical thickness in dementia group,MCI group and control group was(2.18±0.14),(2.35±0.08)and(2.36±0.09)mm,respectively,with significant difference among 3 groups(P＜0.05).The cortical thickness in dementia group was significantly thinner than that in MCI group and control group(both P＜0.05).CL value in dementia group,MCI group and control group was 77.97(63.07,95.55),65.51(54.54,90.50)and-1.17(-9.66,4.88),respectively,with significant difference among 3 groups(P＜0.05).CL value in dementia group and MCI group were significantly higher than in control group(both P＜0.05).The cortical thickness was moderately negatively correlated with CL value in MCI group(r=-0.580,P=0.048)but not in the other 2 groups(both P＞0.05).Conclusion The cortical thickness was moderately negatively correlated with abnormal deposition of Aβ in patients with AD induced MCI,but was not during dementia.

Objective To evaluate the clinical outcome of neurosurgical robot-assisted stereotactic puncture and drainage for brain abscess.Methods A retrospective analysis was conducted on the clinical data of 53 patients with brain abscess admitted to our hospital from January 2018 to December 2024.Among them,29 cases underwent craniotomy for abscess resection(craniotomy group),while 24 cases received neurosurgical robot-assisted stereotactic puncture and drainage(robot-assisted group).The operation time,intraoperative blood loss,decompressive craniectomy rate,proportion of postoperative antibiotic regimen adjustment,postoperative hospital stay,incidence of postoperative complications,mortality rate and Glasgow outcome scale(GOS)scores 6 months after surgery of patients were compared between the two groups.Results Compared with the craniotomy group,the robot-assisted group demonstrated significantly shorter operation time,less intraoperative blood loss,and lower incidence of postoperative complication,the differences were all statistically significant(P<0.05).However,there were no statistically significant differences in terms of decompressive craniectomy rate,postoperative hospital stay,mortality rate,GOS score,or proportion of the postoperative antibiotic regimen adjustment between the two groups(P>0.05).Conclusion As a precise and minimally invasive surgical method,neurosurgical robot-assisted stereotactic puncture and drainage for patients with brain abscess can effectively improve the operational efficiency,shorten the operation time,reduce intraoperative injury,and lower the risk of postoperative complications.It has high clinical application value and potential for widespread adoption.