OBJECTIVE To provide standardized guidance for the homogenization construction and management of pharmaceutical care in urban medical groups. METHODS This consensus was jointly initiated by the Therapeutic Drug Monitoring Professional Committee of the Chinese Pharmacological Society and the Expert Committee on Precision Clinical Medication of the Guangdong Pharmaceutical Association. Led by Guangzhou Red Cross Hospital， a drafting group of 7 members and an expert group of 36 members were organized. The outline of the Expert Consensus on Homogeneous Construction and Management of Pharmaceutical Care in Urban Medical Groups （hereinafter referred to as the “Consensus”） was discussed and finalized using the nominal group technique， and a preliminary draft was formed. The Delphi method was used for online c orrespondence review， and 12 external experts were invited for evaluation. After analyzing and revising expert opinions， the final Consensus was formed. RESULTS &CONCLUSIONS This Consensus defines the position setting and appointment procedures for the chief pharmacist， and establishes a three-tier professional guidance network of “chief pharmacist-regional/specialist pharmacist-pharmaceutical liaison of member institutions”. It formulates unified management standards for the drug supply catalog， establishes a full-process homogenization mechanism for prescription review， prescription commentation and comprehensive pharmaceutical care， and specifies the core functions and performance requirements of the prescription review system. It also supports by long-term mechanisms including cost allocation and performance assessment. This consensus can serve as a systematic reference for the homogeneous construction and management of pharmaceutical care systems in urban medical groups.

Objective To design an image processing system for skeletal measurement of arch,calcaneus and knee joint.Methods The image processing system had its hardware part composed of an image acquisition system,a body mass measurement system and a height measurement system.The image acquisition system consisted of an arch image acquisition module,a calcaneus image acquisition modue and a knee joint image acquisition module;the height measurement system included mainly a height meter component with a mechanically retractable structure;the body mass measurement system used CZL902 sensor combined with the hardware architecture to determine the body mass.The software system of the image processing system was developed with C#language and the application program interface was constructed by combining WinForm technique.Thirty-two healthy children and adult volunteers without significant foot or knee disease were recruited to assess the reliability and validity of the system by means of the consistency testing method.Results The system developed gained high reliability in the reliability and validity of the data on arch,calcaneus and knee joint(intragroup coefficient>0.75,P<0.05),and all the indexes except ankle sapcing width had higher intra-and inter-tester reliablity for the child volunteers than for the adult ones.Conclusion The system developed with high convenience and accuracy can be used for skeletal measurement of arch,calcaneus and knee joint.[Chinese Medical Equipment Journal,2025,46(10):36-40]

Objective To analyze the correlation between the Patellotrochlear index at different knee flexion angles and recurrent patellar dislocation,and to find the optimal knee flexion angle and the best diagnostic cut-off value for predicting recurrent patellar dislocation.Methods A total of 35 patients clinically diagnosed with recurrent patellar dislocation(study group)were selected.The lengths of the central sagittal plane of the patellar cartilage and the corresponding femoral trochlear cartilage were measured at knee flexion angles ranging from 0° to 70°,in 10° increments.The Patellotrochlear index was calculated and compared with the MRI data from 55 healthy volunteers(control group).Results The Patellotrochlear index in the study group and the control group showed a positive correlation with the knee flexion angle(r=0.935 and 0.909,P＜0.001).Statistically significant differences were found between the two groups at knee flexion angles of 0°,10°,20°,30°,and 40°(t=7.480,5.742,5.200,3.558,4.271,P＜0.05).The predictive efficacy of the Patellotrochlear index for recurrent patellar dislocation varied at different knee flexion angles,with the area under the curve(AUC)and the best diagnostic cut-off values of 0.891,0.834,0.778,0.710,0.741 and 0.195,0.323,0.486,0.606,0.712,respectively.Conclusion There are significant differences in the Patellotrochlear index at different knee flexion angles.A knee flexion angle of 0° is the optimal knee flexion angle for the Patellotrochlear index to predict recurrent patellar dislocation,with a recommended best diagnostic cut-off value of 0.195.

Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.

Aim To investigate the regulatory mecha-nisms of donepezil on the expression and enzymatic ac-tivity of cytochrome P450 3A4(CYP3A4),elucidate the synergistic impact of hypoxia on CYP3A4 function,and reveal its potential association with drug-induced cardiotoxicity,particularly QT interval prolongation.Methods Western blot,co-immunoprecipitation,and gene knockdown techniques were employed to evaluate the effects of donepezil and hypoxia on CYP3A4 pro-tein expression.CYP3A4 enzymatic activity was as-sessed using an in vitro incubation system with rat liver microsomes combined with high-performance liquid chromatography(HPLC),and the half-maximal inhib-itory concentration(IC50)was determined.Results Donepezil(10 μmol·L-1)and hypoxia reduced CYP3A4 protein expression to 31.75％and 45.90％of the control levels,respectively.Both interventions activated the gp78-mediated ubiquitin-proteasome path-way,significantly increasing CYP3A4 ubiquitination levels by 2.1-fold compared to the control group,thereby promoting proteasomal degradation.Donepezil inhibited CYP3A4 enzyme activity with an IC50 of 83.4μmol·L-1,and hypoxia synergistically enhanced this inhibitory effect,reducing the IC50 to 20.79 μmol·L-1.Conclusion Donepezil downregulates CYP3A4 function through dual mechanisms involving ubiquitin-mediated proteasomal degradation and direct enzymatic inhibition.Hypoxia potentiates this effect,leading to impaired metabolism of CYP3A4 substrate drugs,ele-vated plasma drug concentrations(1.6-2.3-fold in-crease compared to normal metabolic conditions),and an increased risk of QT interval prolongation and other forms of cardiotoxicity.

The pathological mechanisms and related physiological indicators of acute mountain sickness(AMS)were introduced,and the present situation of wearable devices applied in AMS auxiliary detection and diagnosis were reviewed.The challenges and future development directions of wearable devices applied in auxiliary detection and diagnosis were pointed out.[Chinese Medical Equipment Journal,2025,46(9):100-107]

Objective To investigate the mechanism of Wenhe Decoction in the treatment of febrile seizures through network pharmacology based on NLRP3/Caspase-1/GSDMD signaling pathway;To conduct experimental verification.Methods The active components and targets of Wenhe Decoction were retrieved and screened through TCMSP,BATMAN-TCM,PubChem databases and SwissADME platform.The disease targets of febrile seizures were found in GenCards,OMIM and DisGeNET databases.The intersection targets of Wenhe Decoction and the disease and the active components corresponding to the intersection targets were imported into Cytoscape 3.7.2 software to construct the Chinese materia medica-active components-targets network.The intersection targets were submitted to the STRING database to construct a protein-protein interaction network,and then the intersection targets were imported into the Metascape database for GO and KEGG pathway enrichment analysis.The febrile seizures rat model was established,and Wenhe Decoction of 4.05,8.1 and 16.2 g/kg were given respectively by gavage for 21 days.The rats were placed in batches in(45±0.5)℃constant temperature water bath to induce convulsive seizures,and the convulsive latency time and convulsive duration of rats were recorded.The behavioral differences of mice were observed.The morphology of hippocampal tissue were observed by HE and Nissl staining.The ROS content of hippocampal tissue was detected by DHE fluorescent probe technology.The serum ATP,GABA,Glu,Caspase-1,GSDMD,IL-1β and IL-18 contents were detected by ELISA,and the expression of NLRP3 inflammasome-related protein in hippocampal tissue was detected by Western blot.Results Network pharmacology analysis obtained 98 active components of Wenhe Decoction and 1 838 targets.162 targets were obtained by intersecting with disease targets,the core components for the treatment of febrile seizures were β-sitosterol,quercetin,luteolin,trans-squalene,sitosterol,saponin,etc.,and the core targets were EGFR,TNF,JUN,MTOR,etc.,and mainly through the regulation of inflammatory response,apoptosis,mitochondrial function and energy metabolism,mediating anti-inflammatory pathways such as PI3K-Akt signaling pathway and calcium signaling pathway to exert anticonvulsant effects.The experimental results showed that Wenhe Decoction could prolong the convulsive latency and shorten the duration of convulsions in febrile seizures model rats,decrease the level of convulsions,and the pathological damage of hippocampal tissue was improved and damaged neurons were repaired.The serum contents of ROS,Glu,Caspase-1,GSDMD,IL-1β and IL-18 were significantly reduced,and ATP and GABA contents significantly increased.The protein expressions of NLRP3,ASC,pro-Caspase-1,pro-IL-1β and pro-IL-18 in hippocampal tissue significantly decreased.Conclusion Wenhe Decoction may intervene in febrile seizures rats through NLRP3/Caspase-1/GSDMD signaling pathway,inhibit pyroptosis to reduce the occurrence of neuroinflammation,and then affect the balance of neurotransmitters Glu and GABA to play a role in anti-febrile seizures and prevent brain tissue damage.

Xeroderma pigmentosum(XP)is a rare autosomal recessive disorder related to XP gene variation,often causing secondary malignant tumors.This article reports a case of a young child with secondary squamous cell carcinoma of the lower lip caused by xero-derma pigmentosum.Through a review of relevant literature,the clinical characteristics,pathogenesis,clinical pathological manifesta-tions,and prognosis of XP are discussed.

Objective To investigate the mechanism of Wenhe Decoction in the treatment of febrile seizures through network pharmacology based on NLRP3/Caspase-1/GSDMD signaling pathway;To conduct experimental verification.Methods The active components and targets of Wenhe Decoction were retrieved and screened through TCMSP,BATMAN-TCM,PubChem databases and SwissADME platform.The disease targets of febrile seizures were found in GenCards,OMIM and DisGeNET databases.The intersection targets of Wenhe Decoction and the disease and the active components corresponding to the intersection targets were imported into Cytoscape 3.7.2 software to construct the Chinese materia medica-active components-targets network.The intersection targets were submitted to the STRING database to construct a protein-protein interaction network,and then the intersection targets were imported into the Metascape database for GO and KEGG pathway enrichment analysis.The febrile seizures rat model was established,and Wenhe Decoction of 4.05,8.1 and 16.2 g/kg were given respectively by gavage for 21 days.The rats were placed in batches in(45±0.5)℃constant temperature water bath to induce convulsive seizures,and the convulsive latency time and convulsive duration of rats were recorded.The behavioral differences of mice were observed.The morphology of hippocampal tissue were observed by HE and Nissl staining.The ROS content of hippocampal tissue was detected by DHE fluorescent probe technology.The serum ATP,GABA,Glu,Caspase-1,GSDMD,IL-1β and IL-18 contents were detected by ELISA,and the expression of NLRP3 inflammasome-related protein in hippocampal tissue was detected by Western blot.Results Network pharmacology analysis obtained 98 active components of Wenhe Decoction and 1 838 targets.162 targets were obtained by intersecting with disease targets,the core components for the treatment of febrile seizures were β-sitosterol,quercetin,luteolin,trans-squalene,sitosterol,saponin,etc.,and the core targets were EGFR,TNF,JUN,MTOR,etc.,and mainly through the regulation of inflammatory response,apoptosis,mitochondrial function and energy metabolism,mediating anti-inflammatory pathways such as PI3K-Akt signaling pathway and calcium signaling pathway to exert anticonvulsant effects.The experimental results showed that Wenhe Decoction could prolong the convulsive latency and shorten the duration of convulsions in febrile seizures model rats,decrease the level of convulsions,and the pathological damage of hippocampal tissue was improved and damaged neurons were repaired.The serum contents of ROS,Glu,Caspase-1,GSDMD,IL-1β and IL-18 were significantly reduced,and ATP and GABA contents significantly increased.The protein expressions of NLRP3,ASC,pro-Caspase-1,pro-IL-1β and pro-IL-18 in hippocampal tissue significantly decreased.Conclusion Wenhe Decoction may intervene in febrile seizures rats through NLRP3/Caspase-1/GSDMD signaling pathway,inhibit pyroptosis to reduce the occurrence of neuroinflammation,and then affect the balance of neurotransmitters Glu and GABA to play a role in anti-febrile seizures and prevent brain tissue damage.

Objective To analyze the correlation between the Patellotrochlear index at different knee flexion angles and recurrent patellar dislocation,and to find the optimal knee flexion angle and the best diagnostic cut-off value for predicting recurrent patellar dislocation.Methods A total of 35 patients clinically diagnosed with recurrent patellar dislocation(study group)were selected.The lengths of the central sagittal plane of the patellar cartilage and the corresponding femoral trochlear cartilage were measured at knee flexion angles ranging from 0° to 70°,in 10° increments.The Patellotrochlear index was calculated and compared with the MRI data from 55 healthy volunteers(control group).Results The Patellotrochlear index in the study group and the control group showed a positive correlation with the knee flexion angle(r=0.935 and 0.909,P＜0.001).Statistically significant differences were found between the two groups at knee flexion angles of 0°,10°,20°,30°,and 40°(t=7.480,5.742,5.200,3.558,4.271,P＜0.05).The predictive efficacy of the Patellotrochlear index for recurrent patellar dislocation varied at different knee flexion angles,with the area under the curve(AUC)and the best diagnostic cut-off values of 0.891,0.834,0.778,0.710,0.741 and 0.195,0.323,0.486,0.606,0.712,respectively.Conclusion There are significant differences in the Patellotrochlear index at different knee flexion angles.A knee flexion angle of 0° is the optimal knee flexion angle for the Patellotrochlear index to predict recurrent patellar dislocation,with a recommended best diagnostic cut-off value of 0.195.