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.

The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.

Objective To explore the application value of quadriceps fat fraction(FF)in the early diagnosis of patellofemoral arthritis(PA).Methods A total of 98 patients were selected for conventional knee MRI examination and IDEAL-IQ sequence imaging.The FFm,FFl and FFt of quadriceps were measured.The patient group[chondromalacia patellae(CMP)(CMP group)and PA group]was compared with normal control(NC)(NC group).The receiver operating characteristic(ROC)curve was applied to assess diag-nostic efficacy.Results FFm,FFl,and FFt in the NC group were significantly lower than those in the patient group(P＜0.001).The FFm and FFl in the PA group were significantly higher than those in the CMP group(P=0.015,P=0.011).Additionally,within both CMP and PA groups,FFl was significantly higher than FFm(P＜0.01).The diagnostic efficacy of FFm was the highest for early PA diagnosis,with an optimal threshold of 8.4％.Conclusion The quadriceps FF can effectively quantify muscle fat infiltration in PA patients,especially in the lateral muscle.An increase in FF value can serve as an early quantitative biomarker for PA,providing sig-nificant reference value for clinical diagnosis and disease progression monitoring.

Objective To explore the application value of quadriceps fat fraction(FF)in the early diagnosis of patellofemoral arthritis(PA).Methods A total of 98 patients were selected for conventional knee MRI examination and IDEAL-IQ sequence imaging.The FFm,FFl and FFt of quadriceps were measured.The patient group[chondromalacia patellae(CMP)(CMP group)and PA group]was compared with normal control(NC)(NC group).The receiver operating characteristic(ROC)curve was applied to assess diag-nostic efficacy.Results FFm,FFl,and FFt in the NC group were significantly lower than those in the patient group(P＜0.001).The FFm and FFl in the PA group were significantly higher than those in the CMP group(P=0.015,P=0.011).Additionally,within both CMP and PA groups,FFl was significantly higher than FFm(P＜0.01).The diagnostic efficacy of FFm was the highest for early PA diagnosis,with an optimal threshold of 8.4％.Conclusion The quadriceps FF can effectively quantify muscle fat infiltration in PA patients,especially in the lateral muscle.An increase in FF value can serve as an early quantitative biomarker for PA,providing sig-nificant reference value for clinical diagnosis and disease progression monitoring.

The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.

Objective To investigate the effects of 16-channel dedicated craniocerebral coil on brain magnetic resonance imaging(MRI)image quality in infants aged 0-6 months.Methods Thirty-two infants aged 0-6 months receiving craniocerebral MRI examination with 16-channel dedicated craniocerebral coil were enrolled as observation group,while 32 infant aged 0-6 months receiving craniocerebral MRI examination with conventional head and neck combined coil in the same period were enrolled as control group.The scanning sequences included transverse T1 weighted imaging(T1WI),T2 weighted imaging(T2WI),T2 fluid-attenuated inversion recovery(FLAIR)and diffusion-weighted imaging(DWI)sequences.The scanned images were evaluated subjectively and objectively.Results In the subjective evaluation,T1WI,T2WI and FLAIR sequences scored higher than 4,and DWI sequence scored higher than 3.There were high consistency between two raters for T1WI,T2WI and FLAIR sequences(Kappa value=0.717,0.652,and 0.784,respectively;P<0.05),and moderate consistency for DWI sequence(Kappa value=0.321;P<0.05).In the objective evaluation,the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of each sequence in the dedicated coil group were highly consistent in the left and right lobes of the brain,and the differences in the SNR and CNR between the left and right lobes of the brain were trivial(P>0.05).The SNR and CNR of each sequence in the dedicated coil group increased as compared with the conventional coil group,and the differences in the SNR and CNR of T1WI sequence and the SNR of DWI sequence were statistically significant(P<0.05).Conclusion The brain images of infants aged 0-6 months obtained with a dedicated craniocerebral coil can better meet the clinical needs,and the image quality of the dedicated coil group is superior to that of the conventional coil group in both subjective and objective evaluations.

Objective:To evaluate the safety of ensartinib in the treatment of anaplastic lymphoma kinase (ALK) -positive non-small cell lung cancer (NSCLC) in the real-world clinical setting.Methods:Clinical data of 2 221 patients with ALK-positive locally advanced or metastatic NSCLC who received ensartinib treatment (225 mg/d) from December 16, 2020 to December 16, 2021 were collected and analyzed to assess drug adverse reactions in all population including elderly patients (≥ 65 years old) .Results:Among the total 2 221 patients, 511 patients (23.01%) experienced adverse events, including 8 patients (0.36%) who experienced serious adverse events. Adverse events led to dose modification in 67 patients (3.02%) and discontinuation in 18 patients (0.81%). The common adverse events were rash (407/2 221, 18.33%), pruritus (41/2 221, 1.85%), constipation (41/2 221, 1.85%), and facial edema (31/2 221, 1.40%). Thirty-six patients (1.62%) experienced ≥grade 3 adverse events. After symptomatic treatment of 511 patients with adverse reactions, 50 patients (9.78%) were healed, 271 patients (53.03%) were improved, 120 patients (23.48%) were persisted, and 70 patients (13.71%) were unknown due to loss of follow-up or other reasons. Forty-three patients (1.94%) reported 57 unintended adverse reactions. Among the 599 elderly patients, 116 patients (19.37%) experienced adverse events, including 1 patient (0.17%) who experienced serious adverse events. Adverse events led to dose modification in 25 patients (4.17%) and discontinuation in 5 patients (0.83%). The common adverse events of elderly patients were rash (88/599, 14.69%), constipation (14/599, 2.34%), facial edema (12/599, 2.00%), and pruritus (10/599, 1.67%). Twelve patients (2.00%) experienced ≥grade 3 adverse events. Among the 116 elderly patients with adverse reactions following the symptomatic treatment, 11 patients (9.48%) were healed, 58 patients (50.00%) were improved, 28 patients (24.13%) were persisted, and 19 patients (16.39%) were unknown due to loss of follow-up or other reasons. During the treatment, 1 patient (0.05%) experienced grade 2 interstitial lung disease, and no patient died due to adverse events.Conclusion:Ensartinib has a favorable safety profile in the real-world populations, with the most frequent adverse events being rash, mostly mild, and low incidence of ≥grade 3 adverse events. Overall, adverse reactions were tolerable and manageable.

Transuranics radionuclides are ubiquitous in the environment. Long term intake will cause internal radiation hazards, and it is also an important source of radioactive contamination to the environment in the future. In this paper, the source and migration behavior of transuranic radionuclides are reviewed, the existing problems in China are summarized, and the suggestions for future work are put forward.

Objective:To analyze the status of first viral load (VL) suppression for newly diagnosed HIV/AIDS on antiretroviral therapy (ART) from 2014 to 2016 in Shandong province, to provide theoretical evidence for improvement of ART effectiveness.Methods:Based on a retrospective cohort study, logistic regression model was used to identify influencing factors about VL suppression.Results:There were 4 833 newly diagnosed HIV/AIDS cases who received ART from 2014 to 2016 in Shandong province, and 3 449 cases achieved VL suppression at the first VL testing. The rate of first VL suppression was 71.36%. The possibilities of first VL suppression among patients on ART with education at junior high school, junior college and above were higher than those with education at primary school and below, with OR values at 1.75 and 2.00, separately. The possibilities of first VL suppression for patients treated at medical institutions was higher than those by CDC, with OR value 1.29. The possibilities of first VL suppression among patients whose CD4 count level at 201-350, 351-500 and ≥501 cells/μl were higher than that of the patients whose CD4 count level at ≤200 cells/μl, with OR values at 2.36, 2.11 and 2.66, respectively. The possibilities of first VL suppression among patients who missed doses was lower than those who did not miss doses, with OR value at 0.55. All the Pvalues for the above comparisons was <0.05. Conclusions:The suppression of viral load for HIV/AIDS on ART was influenced by culture level, CD4 count level at the entry of ART, treatment institutions and adherence to the therapy. Earlier diagnosis, treatment services provided by medical institutions and improvement of drug adherence can enhance ART effectiveness.

Objective To investigate the value of cytokines in bile combined with clinical indices in predicting the degree of liver injury after liver transplantation. MethodsA total of 16 patients undergoing liver transplantation who were hospitalized in Center of Organ Transplantation, The Affiliated Hospital of Qingdao University, from January to December 2018 were enrolled, and according to the level of alanine aminotransferase (ALT) on day 1 after surgery, the patients were divided into mild liver injury (ALT ＜500 U/L) group with 10 patients and severe liver injury (ALT ＞500 U/L) group with 6 patients. Bile samples were collected on days 1, 3, 5, and 7 after surgery, and MILLIPLEX assay was used to measure the levels of 17 cytokines. R software was used to perform principal component analysis (PCA) of bile cytokines and clinical indices and gene ontology (GO) enrichment analysis of bile cytokines. The two-independent-samples t-test was used for comparison of normally distributed continuous data between two groups; The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. A Spearman correlation analysis was performed to evaluate the correlation between clinical indices and bile cytokines. ROC curve analysis was used to evaluate the predictive value of cytokines in bile and clinical indices for liver injury after liver transplantation. ResultsCompared with the mild liver injury group, the severe liver injury group had significantly higher expression levels of bile Fractalkine (Z=-2.828, P=0.003), soluble CD40 ligand (sCD40L) (Z=-2.850, P=0.008), interleukin-4 (Z=-2.398, P=0.017), CXCL10 (Z=-2.475, P=0.023), and macrophage inflammatory protein-1α (Z=-1844, P=0.043). The correlation analysis showed that on day 1 after liver transplantation, aspartate aminotransferase, ALT, and lactate dehydrogenase were positively correlated with the levels of several cytokines in bile (all P＜0.05). The area under the ROC curve of Fractalkine, sCD40L and AST were 0.933 (0.812-1.000), 0.833 (0.589-1.000) and 0.917 (0.779-1.000), respectively, suggesting that AST and Fractalkine and sCD40L in bile on the first day after liver transplantation have significant predictive value for liver injury. The results of PCA showed that bile cytokines combined with clinical indices on day 1 after liver transplantation could better distinguish the patients with mild liver injury from those with severe liver injury. GO analysis showed that bile cytokines were associated with positive feedback regulation of external stimulus, cell chemotaxis, receptor ligand activity, cytokine activity, and cytokine-cytokine receptor interaction. ConclusionFractalkine and sCD40L in bile can predict the degree of liver injury after liver transplantation.