1.Incentive and constraint factors and optimization strategies for artificial intelligence application in pharmacy based on TAM-TOE-DOI integrated framework
Jian YANG ; Zhichu LI ; Weili ZHAO ; Xiaoyi YU ; Ming XU
China Pharmacy 2026;37(11):1478-1484
OBJECTIVE Identify the incentive and constraint factors of artificial intelligence (AI) application in the pharmaceutical field, and promote the application of AI in the field of pharmacy. METHODS Based on the technology acceptance model (TAM), technology-organization-environment (TOE) framework, and diffusion of innovation theory (DOI), a TAM-TOE-DOI integrated framework was constructed through a four-stage research process of “theoretical review → dimension mapping → mechanism integration → proposition development”. Combining the analytical pathways of the above three theories in AI application in pharmacy with the integration mechanisms and core propositions of the TAM-TOE-DOI, literature review and deductive reasoning were employed to systematically identify the incentive and constraint factors of AI application in pharmacy from three levels:micro (TAM), meso (TOE), and macro (DOI), and to propose optimization strategies. RESULTS & CONCLUSIONS At the micro level, the efficiency transformation and quality improvement brought by AI technology were the main incentive factors for perceived usefulness, while technological complexity and algorithmic opacity were the main constraint factors for perceived ease of use. At the meso level, the completeness of technological infrastructure, the strength of top management support and innovation climate, as well as external institutional pressure and competitive driving forces were the core incentive factors, whereas scarcity of organizational resources and talent shortage were the main constraint factors. At the macro level, relative advantage and observability were typical incentive factors, while technological complexity was a typical constraint factor. China’s health administration, medical insurance authorities, and other relevant departments should coordinate efforts at the macro, meso, and micro levels to advance AI application in pharmacy: optimizing human-computer interaction and implementing tiered training programs at the micro level; reinforcing organizational support systems and capacity building at the meso level; dismantling data barriers and building social trust at the macro level. Differentiated implementation pathways should be developed for medical institutions at different tiers.
2.Chinese expert consensus on the clinical application of recombinant human thyroid-stimulating hormone (2025 edition)
Chentian SHEN ; Yushen GU ; Hui TAN ; Anren KUANG ; Sijin LI ; Yaming LI ; Jing WANG ; Ningyi JIANG ; Jian TAN ; Zhuoying WANG ; Shaoyan LIU ; Xiaoyi LI ; Jugao FANG ; Dingcun LUO ; Youben FAN ; Hui WANG ; Yuetao WANG ; Xuemei WANG ; Feng WANG ; Wei FU ; Feng SHI ; Xuegong LIU ; Zhongwei LÜ ; Yan XING ; Lin LI ; Hui YANG ; Jun XIN ; Yifan ZHANG ; Yue CHEN ; Yansong LIN ; Wei OUYANG ; Shuzhan YAO ; Changjiu ZHAO ; Xinming ZHAO ; Zairong GAO ; Dingde HUANG ; Qiang WEN ; Xingmin HAN ; Cen LOU ; Weibing MIAO ; Wei FAN ; Quanyong LUO ; Hongcheng SHI
Chinese Journal of Clinical Medicine 2026;33(5):932-944
The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before 131I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.
3.Palpitations, Shortness of Breath, Weakness in Limbs, Edema, and Dyspnea: A Rare Inflammatory Myopathy with Positive Aniti-mitochondrial Antibodies and Cardiac Involvement
Chunsu LIANG ; Xuchang ZHANG ; Ning ZHANG ; Lin KANG ; Xiaohong LIU ; Jiaqi YU ; Yingxian LIU ; Lin QIAO ; Yanli YANG ; Xiaoyi ZHAO ; Ruijie ZHAO ; Na NIU ; Xuelian YAN
Medical Journal of Peking Union Medical College Hospital 2025;16(1):248-255
This article presents a case study of a patient who visited the Geriatric Department of Peking Union Medical College Hospital due to "palpitations, shortness of breath for more than 2 years, limb weakness for 6 months, edema, and nocturnal dyspnea for 2 months". The patient exhibited decreased muscle strength in the limbs and involvement of swallowing and respiratory muscles, alongside complications of heart failure and various arrhythmias which were predominantly atrial. Laboratory tests revealed the presence of multiple autoantibodies and notably anti-mitochondrial antibodies. Following a comprehensive multidisciplinary evaluation, the patient was diagnosed with anti-mitochondrial antibody-associated inflammatory myopathy. Treatment involved a combination of glucocorticoids and immunosuppressants, along with resistance exercises for muscle strength and rehabilitation training for lung function, resulting in significant improvement of clinical symptoms. The case underscores the importance of collaborative multidisciplinary approaches in diagnosing and treating rare diseases in elderly patients, where careful consideration of clinical manifestations and subtle abnormal clinical data can lead to effective interventions.
4.Therapeutic Effect of Wenweishu Granules on Functional Dyspepsia Rats with Spleen-stomach Deficiency Cold Syndrome Based on Bioinformatics Analysis and Experimental Validation
Xinyu YANG ; Xiaoyi JIA ; Zihua XUAN ; Shuangying GUI ; Yanfang WU ; Yuhan MA ; Qin RUAN ; Jia ZHENG ; Zhiyong JIAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):30-40
ObjectiveThis study aims to investigate the therapeutic effects of Wenweishu granule (WWSG) on functional dyspepsia (FD) with spleen-stomach deficiency cold syndrome in rats by integrating network pharmacology, molecular docking, and animal experiments. MethodsActive components and corresponding targets of WWSG were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine (BATMAN-TCM). Disease-related targets for FD with spleen-stomach deficiency cold syndrome were screened using GeneCards and the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP). Core therapeutic targets were identified via Cytoscape and validated by molecular docking. A rat model of FD with spleen-stomach deficiency cold syndrome was established using vinegar gavage combined with tail-clamping. The rats were randomly divided into a model group, low-, medium-, and high-dose WWSG groups (2.0, 4.0, 8.0 g·kg-1), a domperidone group (3.0 mg·kg-1), a Fuzi Lizhong pillwan (0.8 g·kg-1), and a normal control group (n=10 per group). Drugs were administered once daily by gavage for 14 consecutive days. After treatment, body weight, symptom scores, and gastrointestinal motility indices were recorded. Gastric and duodenal pathologies changes were observed via hematoxylin-eosin (HE) staining. Brain-gut peptides were measured in serum and tissue using enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry and Western blot were performed to assess stem cell factor (SCF) and receptor tyrosine kinase (c-Kit) protein expression in gastric tissues. ResultsA total of 305 drug targets, 1 140 disease targets, and 116 overlapping targets were identified. Cytoscape analysis revealed 104 core targets. Enrichment analysis indicated that the SCF/c-Kit signaling pathway was the key mechanism. Molecular docking confirmed a strong binding affinity between active components of WWSG and SCF/c-Kit proteins (binding energy<-5.1 kcal·mol-1). Compared with the normal group, model rats exhibited slower weight gain (P<0.05), reduced gastric emptying and intestinal propulsion (P<0.01), mild gastric mucosal shedding, duodenal inflammatory cell infiltration, decreased levels of gastrin (GAS), 5-hydroxytryptamine (5-HT), and vasoactive intestinal peptide (VIP) (P<0.05, P<0.01), and elevated somatostatin (SS) expression (P<0.05, P<0.01). WWSG treatment ameliorated weight gain, symptom scores, and low-grade inflammation in gastric/duodenal tissues. High-dose WWSG significantly improved gastric emptying and intestinal propulsion, upregulated GAS, 5-HT, and VIP, and downregulated SS expression in serum and tissues (P<0.05, P<0.01). Immunohistochemistry and Western blot demonstrated that SCF and c-Kit protein expression was decreased in the model group (P<0.05, P<0.01), which was reversed by WWSG intervention (P<0.05). ConclusionWWSG exerts therapeutic effects on FD with spleen-stomach deficiency cold syndrome in rats, potentially by regulating the SCF/c-Kit signaling pathway to enhance gastrointestinal motility.
5.Evidence-based study on postoperative chemotherapy guidelines/consensuses for ovarian epithelial tumor
Xiandan LUO ; Yanli LU ; Yihang WU ; Yanxiang GUO ; Xiaoyi YAN ; Yongchao HUO ; Hui YAN ; Zhenjiang YANG ; Hongliang ZHANG
China Pharmacy 2025;36(18):2328-2333
OBJECTIVE To systematically evaluate the methodological quality of the postoperative chemotherapy guidelines/ consensuses for ovarian epithelial tumor. METHODS A search was conducted across databases including PubMed, Embase, Web of Science, CBM, VIP, Chinese Medical Journal Data, Wanfang Data, and CNKI, as well as the official websites of GIN, NICE, Medlive, AHRQ, CSCO, ASCO, and NCCN. The search period was from the establishment of the databases/websites to March 10, 2025. The quality of the included guidelines/consensus was evaluated by using the AGREE-Ⅱ tool. RESULTS A total of 16 guidelines/consensuses were included. The domain scores of AGREE-Ⅱ evaluation were as follows: scope and purpose of 85.07%, participants of 47.92%, rigor of development of 57.49%, clarity of presentation of 88.02%, applicability of 8.20%, and independence of 53.39%. Among them, 14 were recommended at grade B and 2 were recommended at grade C. The subgroup analysis by different countries/regions and different types of studies showed that the scores for participants, rigor of development, and independence of the guidelines/consensuses in China were significantly lower than foreign countries (P<0.05); the scores for participants and rigor of development of the guidelines were significantly higher than consensuses (P<0.05). The guideline/ consensus recommendation results indicated that grade B guidelines/consensus recommend platinum-based combination chemotherapy as the preferred adjuvant chemotherapy regimen for stage Ⅰ high-grade serous carcinoma patients;platinum-based combination chemotherapy±bevacizumab was recommended as the preferred adjuvant chemotherapy regimen for stage Ⅱ-Ⅳ high- grade serous carcinoma patients and for platinum-sensitive recurrent high-grade serous carcinoma patients; non-platinum single- agent chemotherapy±bevacizumab was recommended as the preferred chemotherapy regimen for platinum-resistant recurrent high- grade serous carcinoma patients. CONCLUSIONS The overall quality of postoperative chemotherapy guidelines/consensuses for ovarian epithelial tumor is not high. The methodological quality of guidelines/consensuses in China is still lagging behind that of foreign countries. The recommendations differ from those in foreign countries. It is recommended to improve the aspects of participants, rigor of development, and independence, to recommend treatment plans based on the different stages of ovarian cancer, and develop guidelines/consensuses that align with China’s national conditions.
6.Analyzing the impact of individual and enterprise characteristics on occupational health literacy of key populations
Min YANG ; Huiqing CHEN ; Xinyang YU ; Junle WU ; Bing XIA ; Liping HUANG ; Xiaoyi LI
China Occupational Medicine 2025;52(3):257-263
Objective To analyze the factors influencing the occupational health literacy (OHL) level among workers in key industries from the perspectives of both individual workers and enterprises. Methods A total of 32 336 front-line workers from 12 key industries in the secondary industry in Guangdong Province were selected as the research subjects by a stratified cluster random sampling method. Their OHL level was investigated using Occupational Health Literacy Questionnaire of National Key Populations, and the influencing factors were analyzed. Results The OHL level of the research subjects was 48.5%. The OHL level of the research subjects in four dimensions from high to low was basic knowledge of occupational health protection, occupational health practice and behavior, legal knowledge of occupational health, and basic skills of occupational health protection (80.7%, 61.2%, 48.3% and 29.5%, respectively). The multivariable logistic regression analysis showed that the OHL level of female workers was lower than that of males (P<0.05). Lower OHL was also associated with older age, lower education level, lower personal monthly income of workers (all P<0.01). The workers with length of service < 3 years and ≥ 20 years had lower OHL level than those with length of service 3-<10 years and 10-<20 years, respectively (all P<0.05). Workers in larger enterprises had higher OHL levels (all P<0.01). The OHL level of workers in the sixth category of industries with occupational injuries had higher occupational injury risks than those in the third and fourth categories (all P<0.05). The OHL levels of workers in state-owned enterprises, private enterprises, foreign-funded enterprises, and other enterprises were higher than that of workers in public institutions (all P<0.05). Conclusion The influencing factors of workers′ OHL in key industries of the secondary industry include individual factors (gender, age, education level, personal monthly income, length of service) and enterprise factors (enterprise size, enterprise nature and industry injury risk category). Female, older workers, those with lower education or income, and those with short length of service represent priority groups for OHL interventions, while small and micro enterprises are priority units for future workplace health promotion intervention.
7.Analyzing the occupational health literacy level and its influencing factors among workers in non-metallic mineral product industry in Yunfu City
Xiaoyue CHEN ; Xiaotang SU ; Jiabin CHEN ; Min YANG ; Huiqing CHEN ; Xiaoyi LI ; Jichao CHEN
China Occupational Medicine 2025;52(1):94-98
Objective To analyze the occupational health literacy (OHL) level and its influencing factors of workers in non-metallic mineral product industry in Yunfu City. Methods A total of 947 frontline workers from 24 non-metallic mineral products enterprises in Yunfu City were selected as the research subjects using the stratified random sampling method. The OHL level of the workers were assessed using the Occupational Health Literacy Questionnaire of National Key Populations. Results The overall OHL level of the research subjects was 58.3% (552/947). The OHL levels across four dimensions, from highest to lowest, were basic knowledge of occupational health protection (94.7%), healthy work practices and behaviors (81.8%), legal knowledge of occupational health (65.5%), and basic skills of occupational health protection (25.9%). The results of binary logistic regression analysis showed that workers with 2.0-<10.0 years and ≥10 years of work experience had higher OHL levels than those with <2.0 years of work experience (all P<0.01). Workers with a high school education or above had higher OHL levels than those with a junior high school education or below (all P<0.01). Workers in large- and medium-sized enterprises had higher OHL levels than those in small and micro-sized enterprises (both P<0.01). Conclusion The OHL levels of workers in Yunfu City's non-metallic mineral products industry can be further improved, particularly the occupational health protection skills and related legal knowledge. Workers with short seniority, low educational level, and in small and micro enterprises should be the key groups for improving OHL levels.
8.Mechanism of Si Junzitang in Treatment of Liver Injury in Rats with Spleen Qi Deficiency Syndrome Based on Liver and Spleen Correlation
Peng PENG ; Min BAI ; Jin JIN ; Qihui YUAN ; Xiaoyi YANG ; Juan DU ; Yongqiang DUAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):11-20
ObjectiveTo investigate the mechanism of Si Junzitang in treating liver injury in rats with spleen Qi deficiency syndrome based on transcriptomics and to experimentally verify its effects. MethodsSixty male SD rats were randomly divided into blank group, model group, low-dose Si Junzitang (6 g·kg-1·d-1), medium-dose Si Junzitang group (12 g·kg-1·d-1), high-dose Si Junzitang group (24 g·kg-1·d-1), and natural recovery group, with 10 rats in each group. A composite multifactorial modeling method (forced swimming + intragastric administration of Xiao Chengqitang + irregular diet) was used to establish a spleen Qi deficiency model. After 30 days of continuous intervention, body weight and 3-hour food intake were measured, and macroscopic symptom scores for spleen Qi deficiency syndrome were evaluated. Serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in each group were detected, and hematoxylin and eosin (HE) staining was used to observe histopathological changes in liver tissue. Transcriptome sequencing (RNA-Seq) was used to identify differentially expressed genes (DEGs) among the blank, model, and high-dose Si Junzitang groups. Gene ontology(GO) and Kyoto encyclopedia of genes and genome(KEGG) enrichment analyses were performed on the DEGs. Immunofluorescence (IF) and Western blot were used to detect NOD-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein (ASC), Caspase-1, and the N-terminal domain of gasdermin D (GSDMD-N). Immunohistochemistry (IHC) was used to detect the expression of downstream inflammatory cytokines interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-18 (IL-18). ResultsCompared with the blank group, the model group showed significantly reduced body weight and 3-hour food intake, significantly increased macroscopic symptom scores, and elevated serum AST and ALT levels (P<0.01), with mild inflammatory liver injury observed histologically. Compared with the model group, Si Junzitang at all doses significantly improved these parameters and alleviated liver injury in a dose-dependent manner (P<0.05,P<0.01). RNA-Seq analysis revealed 1 254 DEGs between the blank and model groups, and 842 DEGs between the model and high-dose Si Junzitang groups. GO and KEGG enrichment analyses indicated that the NOD-like receptor signaling pathway was activated in liver injury associated with spleen Qi deficiency, suggesting that the NLRP3 inflammasome may be a key target. Results from IF, IHC, and Westernblot showed that compared with the blank group, the expression of NLRP3, ASC, Caspase-1, GSDMD-N, and the downstream inflammatory cytokines IL-1β, IL-6, and IL-18 were significantly increased in the model group (P<0.01), while these levels were markedly decreased in the high-dose Si Junzitang group (P<0.01). ConclusionSi Junzitang effectively improves mild inflammatory liver injury in rats with spleen Qi deficiency syndrome in a dose-dependent manner. Its mechanism may be associated with inhibition of the NLRP3/ASC/Caspase-1 signaling pathway, downregulation of the pyroptosis executioner protein GSDMD-N, and reduction of pyroptosis-related inflammatory cytokine release.
9.Pro-tumorigenic mechanisms of tumor-associated macrophages in oral cancer
Xu XIAOYI ; Wang BIN ; Yang MENGMENG ; Shen JUN
Chinese Journal of Clinical Oncology 2025;52(15):783-790
Oral cancer is a common inflammation-associated malignant tumor of the head and neck.In recent years,the role of the tumor microenvironment in the progression of oral cancer has received increasing attention.In the microenvironment of solid tumors,including or-al cancer,tumor-associated macrophages(TAMs)are among the most common type of immune cell and are closely associated with the poor prognosis of more than 80%of human malignant tumors.An increasing body of evidence indicates that TAMs play important roles in the oc-currence and progression of oral cancer.On the basis of the most recent research progress,both domestic and international,we systematic-ally reviewed the phenotypic characteristics,clinicopathological correlations,and molecular regulatory mechanisms of TAMs in the microen-vironment of oral squamous cell carcinoma(OSCC).In particular,we focus on the key signaling pathways promoting tumorigenesis and de-velopment and immune escape mechanisms,with the aim of constructing a systematic theoretical framework for developing therapeutic strategies targeting TAMs and providing a scientific basis for clinical translational research.
10.Preliminary study on botulinum toxin type A bladder injection for the treatment of autonomic dysreflexia related to bladder dysfunction
Maping HUANG ; Hui CHEN ; Conghui HAN ; Tianhai HUANG ; Heyi ZHEN ; Xiaoyi YANG ; Qiuling LIU ; Mengxia GUO ; Hongge PAN ; Jing LIU ; Shuqing WU ; Keji XIE
Chinese Journal of Urology 2025;46(10):759-763
Objective:To investigate the clinical efficacy of botulinum toxin type A(BTX-A)bladder injection in the treatment of neurogenic detrusor overactivity(NDO)with autonomic dysreflexia(AD).Methods:The patients with spinal cord injury at or above T6,who were treated at Guangdong Provincial Work Injury Rehabilitation Hospital from January 2018 to December 2022,were included in this study prospectively. Inclusion criteria:①chronic spinal cord injury patients over 18 years old(with no progression of neurological symptoms within 3 months);② presence of NDO and AD;③ inadequate response or intolerance to oral antimuscarinic agent(M-receptor antagonists or β 3-receptor agonists)④ perform clean intermittent catheterization to empty the bladder. Exclusion criteria:① primary disease in the acute or progressive phase;② previous surgeries that would affect lower urinary tract function,such as transurethral sphincterotomy,bladder neck resection,prostatectomy,or bladder surgery;③ allergy to BTX-A or its adjuvants,or those with allergic predisposition ④ patients who were pregnant,breastfeeding,or planning for pregnancy in the near future;⑤ patients did not accept or were unable to perform intermittent catheterization. Before treatment,all patients were required to maintain 3-5 day urine diary,along with urodynamic studies(UDS),incontinence specific quality of life instrument(I-QOL)and AD symptom severity assessment,and blood pressure monitored. Key UDS parameters recorded included maximum bladder capacity,maximum detrusor pressure during filling phase,changes in maximum systolic blood pressure(SBP)relative to baseline(ΔSBP)during UDS examination,and the frequency of 24-hour blood pressure exceeding baseline by 20 mmHg. After general anesthesia or epidural anesthesia,BTX-A(200 U)was injected into the bladder at 30 points(including the triangle)under the cystoscope using a special injection needle,6.7 U per injection,and then the catheter was kept for 3-5 days after treatment. Three months later,relevant indicators were collected and compared with pre-treatment data. Results:A total of 43 patients were included in this study,including 34 males and 9 females. The age was(39.23±13.17)years old and the disease course was(2.69±3.27)years old. There were 33 cervical and 10 thoracic cases. The American Spinal Injury Association Injury Scale score distribution was as follows:26(60%)A,4(9%)B,9(21%)C,and 4(9%)D. The presence of AD was confirmed in all patients during urodynamic examination(UDS),that was the systolic blood pressure(SBP)suddenly increased and exceeded 20 mmHg(1 mmHg = 0.133 kPa). Before treatment,The AD symptoms severity score(consist of headache,sweating,goose bumps,anxiety and palpitation)were(14.53±2.51),Bladder-related AD frequency was 10.67 episodes/day. Baseline SBP was(103.51±9.64)mmHg,the maximum SBP was(150.40±22.75)mmHg,and the change in SBP(ΔSBP)from maximum to baseline SBP during UDS examination was(43.83±21.01)mmHg. The UDS indicated that the maximum detrusor pressure during storage phase was(54.95±24.68)cmH 2O,and the bladder capacity was(131.70±75.29)ml. Bladder diary showed the volume of catheterization each time from was(181.16±49.86)ml,and The I-QOL score was(44.07±8.60). Three months after treatment,the AD symptoms severity score(consist of headache,sweating,goose bumps,anxiety and palpitation)were(11.37±2.39). The frequency of bladder-related AD episodes was(7.51±2.37)episodes/day,showing statistically significant differences compared to pre-treatment( P<0.05).The SBP before UDS examination was(102.12±10.28)mmHg,with no statistically significant difference from baseline( P = 0.518). The maximum SBP in perfusion phase and the ΔSBP were(132.84±16.30)mmHg and(28.72 ± 14.02)mmHg,respectively,both demonstrating statistically significant differences( P < 0.05). The UDS examination revealed that the maximum detrusor pressure during the storage phase was(29.77±13.72)cmH 2O,showed a significant decrease,and the bladder capacity was(272.63±79.75)ml,which were both statistically different before and after surgery. Bladder diary showed the volume of catheterization each time was(326.74±63.71)ml;I-QOL score was(71.86±11.45),both were significant different after treatment( P < 0.01). Conclusion:BTX-A intravesical injection in the treatment of NDO can also alleviate the severity and frequency of bladder related AD.

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