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.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

Five saponins were isolated from the kernels of Momordica cochinchinensis, by macroporous resin, silica gel, ODS column chromatography, and semi preparative HPLC. Based on MS and NMR analysis, combining with alkaline hydrolysis and acid hydrolysis, their structures were identified as: gypsogenin-3-O-{β-D-galactopyranosyl (1→2)-[α-L-rhamnopyranosyl (1→3)]-β-D-glucuropyranonosyl}-28-O-β-D-xylopyranosyl (1→3)-[β-D-xylopyranosyl (1→4)]-α-L-rhamnopyranosyl (1→2)-β-D-fucopyranoside (1), quillaic acid-3-O-{β-D-galactopyranosyl (1→2)-[α-L-rhamnopyranosyl (1→3)]-β-D-glucuropyranonosyl}-28-O-β-D-xylopyranosyl (1→3)-[β-D-xylopyranosyl (1→4)]-α-L-rhamnopyranosyl (1→2)-β-D-fucopyranoside (2), gypsogenin-3-O-β-D-galactopyranosyl (1→2)-[α-L-rhamnopyranosyl (1→3)]-β-D-glucuropyranonoside sodium (3), quillaic acid-3-O-β-D-galactopyranosyl (1→2)-[α-L-rhamnopyranosyl (1→3)]-β-D-glucuropyranonoside sodium (4), 18α-quillaic acid-3-O-β-D-galactopyranosyl (1→2)-[α-L-rhamnopyranosyl (1→3)]-β-D-glucuropyranonoside (5). Compounds 1-5 were new compounds, and named as mubezhisides A, B, C, D, E, respectively. They all could obviously inhibited the growth of Candida albicans, C. parapsilosis, and C. tropicalis.

Adipose tissue is a critical energy reservoir in animals and humans, with multifaceted roles in endocrine regulation, immune response, and providing mechanical protection. Based on anatomical location and functional characteristics, adipose tissue can be categorized into distinct types, including white adipose tissue (WAT), brown adipose tissue (BAT), beige adipose tissue, and pink adipose tissue. Traditionally, adipose tissue research has centered on its morphological and functional properties as a whole. However, with the advent of single-cell transcriptomics, a new level of complexity in adipose tissue has been unveiled, showing that even under identical conditions, cells of the same type may exhibit significant variation in morphology, structure, function, and gene expression——phenomena collectively referred to as cellular heterogeneity. Single-cell transcriptomics, including techniques like single-cell RNA sequencing (scRNA-seq) and single-nucleus RNA sequencing (snRNA-seq), enables in-depth analysis of the diversity and heterogeneity of adipocytes at the single-cell level. This high-resolution approach has not only deepened our understanding of adipocyte functionality but also facilitated the discovery of previously unidentified cell types and gene expression patterns that may play key roles in adipose tissue function. This review delves into the latest advances in the application of single-cell transcriptomics in elucidating the heterogeneity and diversity within adipose tissue, highlighting how these findings have redefined the understanding of cell subpopulations within different adipose depots. Moreover, the review explores how single-cell transcriptomic technologies have enabled the study of cellular communication pathways and differentiation trajectories among adipose cell subgroups. By mapping these interactions and differentiation processes, researchers gain insights into how distinct cellular subpopulations coordinate within adipose tissues, which is crucial for maintaining tissue homeostasis and function. Understanding these mechanisms is essential, as dysregulation in adipose cell interactions and differentiation underlies a range of metabolic disorders, including obesity and diabetes mellitus type 2. Furthermore, single-cell transcriptomics holds promising implications for identifying therapeutic targets; by pinpointing specific cell types and gene pathways involved in adipose tissue dysfunction, these technologies pave the way for developing targeted interventions aimed at modulating specific adipose subpopulations. In summary, this review provides a comprehensive analysis of the role of single-cell transcriptomic technologies in uncovering the heterogeneity and functional diversity of adipose tissues.

Objective:To investigate the ocular pathogen spectrum and drug sensitivity characteristics of patients to be diagnosed with infectious keratitis within 10 years in two tertiary hospitals in Nantong City, Jiangsu Province, eastern China.Methods:A cross-sectional study was conducted.Microbial culture specimens from consecutive 1 404 patients with suspected infectious keratitis admitted to the Department of Ophthalmology at the First People's Hospital of Nantong City and Nantong University Affiliated Hospital from January 2014 to October 2023 were collected.The patients' general data, etiology and drug sensitivity test results were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Nantong First People's Hospital (No.2021KT273) and Nantong University Affiliated Hospital (No.2019-K068).Results:Among 1 404 patients with suspected infectious keratitis, the positive rate of microbial culture was 37.04%(520/1 404).A total of 537 strains were isolated and cultured, with fungi accounting for 69.09%(371/537) and bacteria accounting for 30.91%(166/537).The common bacterial genera in fungal keratitis were Fusarium (47.17%, 175/371), Alternaria (15.90%, 59/371), Aspergillus (14.56%, 54/371), Certospora (10.78%, 40/371) and Penicillium (3.50%, 13/371).The annual composition ratio of Fusarium showed a downward trend, while Certospora showed an upward trend.The common bacteria in bacterial keratitis were Staphylococcus epidermidis (24.10%, 40/166), Streptococcus pneumoniae (17.47%, 29/166), Pseudomonas aeruginosa (13.25%, 22/166), Staphylococcus aureus (6.63%, 11/166) and Corynebacterium macginleyi (4.22%, 7/166).The annual composition ratio of Pseudomonas aeruginosa showed an increasing trend.The resistance rates of gram-positive bacteria to levofloxacin and vancomycin were 36.26% and 0% respectively, and the resistance rates of gram-negative bacteria to aminoglycosides and ceftazidime were <10%.A total of 61 bacterial strains (40.94%) were multi-drug resistant. Conclusions:Fusarium is common in fungal keratitis, and Corynebacterium macginleyi in bacterial keratitis may be a microbial feature in Nantong City.Levofloxacin may no longer be suitable as a first-line antibiotic for topical ocular use.

Objective:To evaluate the safety and efficacy of the TiRobot assisted screw placement in patients with lumbar degenerative diseases.Methods:The clinical data of 165 patients with lumbar degenerative diseases from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyze, and all patients were treated with posterior lumbar decompression and instrumentation. Among them, 46 patients were used the TiRobot assisted screw placement during surgery (robotic-assisted group), and 119 patients underwent freehand screw placement by C-arm X-ray machine fluoroscopy (freehand group). The operation time, intraoperative blood loss, complication and skelalgia visual analogue scale (VAS), Oswestry disability index (ODI) before and after operation were recorded. The accuracy of screw placement and rate of proximal facet joint violation were compared between two groups.Results:There were no statistical difference in operation time, intraoperative blood loss and incidence of complication between two groups ( P>0.05). In the two groups, the 3 d VAS and ODI after operation were significantly lower than those before operation, robot-assisted group: (3.33 ± 1.40) scores vs. (6.54 ± 2.00) scores and (16.96 ± 8.03) scores vs. (43.09 ± 5.48) scores; freehand group: (3.56 ± 1.29) scores vs. (6.55 ± 1.65) scores and (18.89 ± 6.74) scores vs. (44.91 ± 4.96) scores, and there were statistical differences ( P<0.01); there were no statistical difference in VAS and ODI before operation and 3 d after operation between two groups ( P>0.05). A total of 234 screws were implanted in robot-assisted group, and 590 screws were implanted in freehand group. The accuracy of screw placement in robot-assisted group was significantly higher than that in freehand group: 80.77% (189/234) vs. 74.58% (440/590), the rate of proximal facet joint violation was significantly lower than that in freehand group: 2.56% (6/234) vs. 7.29% (43/590), and there were statistical differences ( χ2 = 3.56 and 6.68, P<0.05). Conclusions:The TiRobot assisted screw placement for lumbar degenerative diseases is safe and effective. Compared to freehand technique, the TiRobot assisted method demonstrates higher screw placement accuracy and a lower rate of proximal facet joint violation.

Objective:To investigate the ocular pathogen spectrum and drug sensitivity characteristics of patients to be diagnosed with infectious keratitis within 10 years in two tertiary hospitals in Nantong City, Jiangsu Province, eastern China.Methods:A cross-sectional study was conducted.Microbial culture specimens from consecutive 1 404 patients with suspected infectious keratitis admitted to the Department of Ophthalmology at the First People's Hospital of Nantong City and Nantong University Affiliated Hospital from January 2014 to October 2023 were collected.The patients' general data, etiology and drug sensitivity test results were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Nantong First People's Hospital (No.2021KT273) and Nantong University Affiliated Hospital (No.2019-K068).Results:Among 1 404 patients with suspected infectious keratitis, the positive rate of microbial culture was 37.04%(520/1 404).A total of 537 strains were isolated and cultured, with fungi accounting for 69.09%(371/537) and bacteria accounting for 30.91%(166/537).The common bacterial genera in fungal keratitis were Fusarium (47.17%, 175/371), Alternaria (15.90%, 59/371), Aspergillus (14.56%, 54/371), Certospora (10.78%, 40/371) and Penicillium (3.50%, 13/371).The annual composition ratio of Fusarium showed a downward trend, while Certospora showed an upward trend.The common bacteria in bacterial keratitis were Staphylococcus epidermidis (24.10%, 40/166), Streptococcus pneumoniae (17.47%, 29/166), Pseudomonas aeruginosa (13.25%, 22/166), Staphylococcus aureus (6.63%, 11/166) and Corynebacterium macginleyi (4.22%, 7/166).The annual composition ratio of Pseudomonas aeruginosa showed an increasing trend.The resistance rates of gram-positive bacteria to levofloxacin and vancomycin were 36.26% and 0% respectively, and the resistance rates of gram-negative bacteria to aminoglycosides and ceftazidime were <10%.A total of 61 bacterial strains (40.94%) were multi-drug resistant. Conclusions:Fusarium is common in fungal keratitis, and Corynebacterium macginleyi in bacterial keratitis may be a microbial feature in Nantong City.Levofloxacin may no longer be suitable as a first-line antibiotic for topical ocular use.

Objective:To investigate the application of the conjugate gradient (CG) algorithm to treatment plan optimization for intensity-modulated brachytherapy (IMBT).Methods:The general Monte Carlo software TOPAS was utilized to simulate the 192Ir source of IMBT, and the unit dose contribution matrix was calculated. An objective function was established using the weighted least squares method and was solved using the CG algorithm to achieve optimized IMBT treatment plans. The optimization was validated using five clinical cervical cancer cases under modulation width 60°. The dose distributions of IMBT treatment plans under 45°, 60°, 90°, 120°, and 180° modulation widths were compared using the Wilcoxon test to determine the optimal IMBT treatment plan for cervical cancer treatment. Results:The CG algorithm successfully optimized IMBT treatment plans under modulation width 60° for five cases within 22.2 s on average. On the premise of sufficient target dose coverage, the average D2 cm 3 values of the bladder and rectum in IMBT treatment plans were 3.66 and 1.97 Gy, respectively, representing reductions of 0.54 and 0.69 Gy compared to traditional brachytherapy plans. For the five modulation widths, the D90% values of all IMBT treatment plans reached 6 Gy, without statistically significant differences ( P > 0.05). The average D2 cm 3 values of the bladder in IMBT treatment plans were significantly lower than those in the traditional brachytherapy plans( P<0.05), with modulation width 60° associated with the greatest reduction of 0.61 Gy. In contrast, the average D2 cm 3 values of the rectum under 45°, 60°, and 90° modulation widths decreased by 0.63, 0.54, and 0.45 Gy, respectively, compared to traditional plans, with statistically significant differences( P<0.05). Conclusions:The CG method enables rapid achievement of optimized IMBT treatment plans that meet clinical requirements, and modulation width 60° contributes to valid dosimetric optimization. This study can serve as a guide for the clinical implementation of IMBT.

Objective:To develop a rapid assessment scale for healthy aging suitable for the Chinese population.Methods:Based on existing healthy aging assessment scales, national standards, and expert consensus, an initial Healthy Aging Rapid Assessment Scale was drafted through two rounds of expert consultation. A pre-survey was conducted with 3 220 subjects recruited from Guangzhou between July 2023 and July 2024. Items were screened through item analysis and exploratory factor analysis to form the final scale. Reliability and validity of the final scale were validated across five cities: Guangzhou, Dongguan, Shenzhen, Baoding, and Chuxiong.Results:The initial version comprised 36 items, while the finalized scale contained 18 items across three dimensions: metabolic health, mental health, and cognitive health. Test-retest reliability ranged from 0.71 to 0.81 across all study sites. The Spearman-Brown coefficient varied between 0.91-0.96, Cronbach′s α between 0.77-0.83, comparative fit index (CFI) between 0.90-0.98, goodness-of-fit index (GFI) between 0.90-0.99, and root-mean-square error of approximation (RMSEA) between 0.03-0.09. For the three dimensions, reliability and validity metrics demonstrated consistency: Spearman-Brown coefficients 0.87-0.99, Cronbach′s α 0.77-0.83, CFI 0.90-0.98, GFI 0.90-0.99, and RMSEA 0.03-0.09 across four regions.Conclusion:The developed Healthy Aging Rapid Assessment Scale for the Chinese population exhibits robust reliability and validity.

To satisfy the growing healthcare demands of the public, it is essential to develop a public service platform for vaccination. This initiative aligns with national policies, optimizes resource allocation, innovates service models, enhances service efficiency, and reduces service costs. Drawing on relevant national policies and regulatory requirements, as well as the notable achievements and practical experiences gained through the exploration and innovation of vaccination service models across various regions, this paper proposes expert recommendations. It defines the essential components and functional specifications for public service platforms, focusing on public needs such as electronic vaccination record management, appointment management, the promotion of electronic vaccination certificates, vaccination certificate verification for school enrollment, vaccination site navigation, and science communication and public engagement. The recommendations aim to serve as a reference for the development of vaccination public service platforms nationwide.