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.

Core fucosylation, catalyzed exclusively by fucosyltransferase 8 (FUT8), is an evolutionarily conserved post-translational modification that has emerged as a central regulatory hub linking liver homeostasis, chronic disease progression, and malignant transformation. Liver diseases, particularly hepatocellular carcinoma, remain a leading global health burden characterized by late diagnosis, limited therapeutic options, and poor overall survival. While aberrant glycosylation is now recognized as a hallmark of cancer and inflammatory disorders, existing research on FUT8-mediated core fucosylation in liver diseases remains fragmented: the dynamic functional switch of FUT8 from a homeostatic regulator to a pathological driver across the full disease continuum has not been systematically delineated, and the integrated mechanisms by which core fucosylation modulates oncogenic signaling, metabolic reprogramming, and immune evasion remain poorly understood. This review synthesizes recent advances to establish a unified framework for understanding the dual role of core fucosylation in liver physiology and pathology, and evaluates its translational potential for precision medicine. At the molecular level, FUT8’s unique catalytic specificity makes core fucosylation an irreplaceable modification, as evidenced by the perinatal lethality and severe organ dysfunction in Fut8 knockout mice. In hepatocellular carcinoma, genomic amplification of guanosine 5'-diphosphate-fucose biosynthetic enzymes provides metabolic support for aberrant core fucosylation. FUT8 expression is tightly regulated by a multi-layered network: transcriptional activation via Wnt/β‑catenin and wild-type p53, epigenetic upregulation by lncRNAs, post-transcriptional repression by miR-122-5p and miR-34a, and virus-specific induction by hepatitis B virus/hepatitis C virus. Physiologically, core fucosylation maintains liver homeostasis through four core mechanisms: it acts as a molecular switch for epidermal growth factor receptor/hepatocyte growth factor receptor signaling to enable liver regeneration; directs polarized secretion of hepatocyte-derived glycoproteins into bile ducts; modulates cholesterol metabolism via the hepatocyte nuclear factor 1α-proprotein convertase subtilisin/kexin type 9-low density lipoprotein receptor axis; and regulates aging through insulin‑like growth factor 1 receptor signaling. Pathologically, core fucosylation exhibits context-dependent dual functions: in liver fibrosis, FUT8 upregulation in hepatic stellate cells forms a negative feedback loop that limits excessive fibrogenesis; in hepatocellular carcinoma, however, aberrant FUT8 overexpression drives cell-autonomous malignancy by constitutively activating epidermal growth factor/hepatocyte growth factor receptor, transforming growth factor‑β/Smad, and Wnt/β‑catenin pathways, while simultaneously establishing a multi-layered immune evasion network by stabilizing programmed cell death ligand 1 and cluster of differentiation 47, and impairing natural killer cell homeostasis via interleukin‑2 receptor β glycosylation. Clinically, stage-specific core fucosylation biomarkers enable non-invasive monitoring of liver disease progression: low molecular mass kringle-Fc fusion protein outperforms conventional markers for early fibrosis detection, while alpha-fetoprotein-L3 and novel glycopeptides (α‑2‑macroglobulin N‑linked glycosylation site 1424, lumican core fucosylated peptide) significantly improve early hepatocellular carcinoma diagnosis, especially in alpha-fetoprotein-negative patients. Next-generation detection technologies (chemoenzymatic labeling, site-specific mass spectrometry) overcome the specificity limitations of traditional lectin assays. Therapeutically, four promising strategies are emerging: small-molecule FUT8 inhibitors, afucosylated antibodies with enhanced antibody‑dependent cellular cytotoxicity, Fuc-modified targeted drug delivery systems, and core fucose-specific lectins for NASH treatment. The core challenge for clinical translation lies in FUT8’s inherent “double-edged sword” effect, as systemic inhibition disrupts its essential physiological functions beyond pathological roles. Long-term systemic FUT8 blockade not only impairs post-injury liver regeneration by abrogating epidermal growth factor/hepatocyte growth factor receptor signaling but also disrupts cholesterol homeostasis via the hepatocyte nuclear factor 1α-proprotein convertase subtilisin/kexin type 9-low density lipoprotein receptor axis, leading to dyslipidemia and altered bile secretion. Critically, it compromises immune surveillance by destabilizing interleukin‑2 receptor β on natural killer cells, reducing their cytotoxic activity against malignant and virally infected cells, and impairs IgG Fc-mediated effector functions, increasing susceptibility to infections. This fundamental trade-off between therapeutic efficacy and systemic toxicity necessitates a paradigm shift from non-specific global inhibition to precision modulation of pathological core fucosylation. By addressing these critical challenges, FUT8-mediated core fucosylation has the potential to transform liver disease management from late-stage intervention to early detection and precision therapy, ultimately improving patient outcomes and reducing the global burden of liver diseases.

Objective:To investigate the effects of long non-coding RNA(lncRNA)endogenous Bornavirus-like nucleoprotein 3 pseudogene(EBLN3P)on the proliferation,migration and epithelial-mesenchymal transition(EMT)of thyroid cancer B-CPAP cells by regulating the miR-369-3p/CCND1 axis.Methods:20 samples of thyroid cancer and corresponding adjacent tissue specimens surgically removed at Hainan Cancer Hospital between May 2020 and May 2021,as well as thyroid cancer B-CPAP cells were collected.The levels of EBLN3P,miR-369-3p and CCND1 mRNA in cancer tissues and cells were detected using qPCR and Western blot(WB)methods.The dual-luciferase reporter gene assay was used to validate the targeting relationship among lncRNA EBLN3P,CCND1 and miR-369-3p.B-CPAP cells were randomly divided into the control group,sh-NC group,sh-EBLN3P group,sh-EBLN3P+anti-NC group and sh-EBLN3P+anti-miR-369-3p group.The colony formation assay was used to detect the number of colony formation in each group.The scratch wound healing assay and Transwell assay were performed to evaluate cell migration ability.WB was used to detect the expression of EMT-related proteins.The nude mouse xenograft model of B-CPAP cells was constructed to observe the effect of silencing EBLN3P on the growth of xenograft tumors.Results:The expressions of lncRNA EBLN3P and CCND1 mRNA were up-regulated,and the expression of miR-369-3p was down-regulated in thyroid cancer tissues and B-CPAP cells(all P<0.05).lncRNA EBLN3P had binding sites with miR-369-3p,and CCND1 had binding sites with miR-369-3p,and there was a targeting relationship.Compared with those in the sh-NC group,the number of clone formation,the scratch healing rate and the number of cell migration in the sh-EBLN3P group decreased(all P<0.05);the expressions of EBLN3P,CCND1,Ki67,MMP-2,N-cadherin and vimentin was down-regulated;the expressions of miR-369-3p and E-cadherin was up-regulated(all P<0.05).Compared with those in the sh-EBLN3P+anti-NC group,the expression of miR-369-3p in the sh-EBLN3P+anti-miR-369-3p group was down-regulated;the number of clone formation,scratch healing rate and the number of cell migration increased(all P<0.05);the expressions of CCND1,Ki67,MMP-2,N-cadherin and vimentin was up-regulated;the expression of E-cadherin was down-regulated(all P<0.05).Compared with those in the sh-NC group,the volume and weight of B-CPAP cell nude mouse xenograft tumors in the sh-EBLN3P group were significantly reduced(both P<0.05).Conclusion:The expression of lncRNA EBLN3P is up-regulated in thyroid cancer cells and tissues.Silencing EBLN3P can inhibit the proliferation,migration and EMT of thyroid cancer B-CPAP cells by targeting and regulating the miR-369-3p/CCND1 axis.

Objective To analyze the influencing factors of lymph node metastasis(DLN)metastasis in patients with differentiated thyroid carcinoma(DTC)and construct a column chart.Methods A total of 245 DTC patients who underwent surgical treatment in our hospital from January 2018 to December 2023 were selected.They were separated into two groups based on whether DLN metastasis occurred:the DLN metastasis group(119 cases)and the non DLN metastasis group(126 cases).Logistic regression analysis was applied to screen for risk factors for DLN metastasis in DTC patients.R software was applied to draw a nomogram prediction model for predicting DLN metastasis in DTC patients.Receiver operating characteristic(ROC)curves,calibration curves,and Hosmer-Lemeshow goodness of fit tests were applied to evaluate column charts.Results Logistic regression analysis revealed that gender of"male",multiple lesions,capsule invasion,intranodular calcification,and antithyroglobulin antibodies(TGAb)positivity were independent risk factors for DLN metastasis in DTC patients(P＜0.05).The area under the ROC curve was 0.807(95％CI:0.753-0.861).The slope of the calibration curve was close to 1,and the Hosmer-Lemeshow goodness of fit test showed x2=8.983,P=0.344.Conclusion A column chart constructed based on five independent risk factors,including male,multiple lesions,capsule invasion,intranodular calcification,and TGAb positive,can effectively predict the risk of DLN metastasis in DTC patients.

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.

Objective To analyze the influencing factors of lymph node metastasis(DLN)metastasis in patients with differentiated thyroid carcinoma(DTC)and construct a column chart.Methods A total of 245 DTC patients who underwent surgical treatment in our hospital from January 2018 to December 2023 were selected.They were separated into two groups based on whether DLN metastasis occurred:the DLN metastasis group(119 cases)and the non DLN metastasis group(126 cases).Logistic regression analysis was applied to screen for risk factors for DLN metastasis in DTC patients.R software was applied to draw a nomogram prediction model for predicting DLN metastasis in DTC patients.Receiver operating characteristic(ROC)curves,calibration curves,and Hosmer-Lemeshow goodness of fit tests were applied to evaluate column charts.Results Logistic regression analysis revealed that gender of"male",multiple lesions,capsule invasion,intranodular calcification,and antithyroglobulin antibodies(TGAb)positivity were independent risk factors for DLN metastasis in DTC patients(P＜0.05).The area under the ROC curve was 0.807(95％CI:0.753-0.861).The slope of the calibration curve was close to 1,and the Hosmer-Lemeshow goodness of fit test showed x2=8.983,P=0.344.Conclusion A column chart constructed based on five independent risk factors,including male,multiple lesions,capsule invasion,intranodular calcification,and TGAb positive,can effectively predict the risk of DLN metastasis in DTC patients.

Objective To design a shared appointment pool system to realize shared appointment resources for on-line and off-line ways based on data synchronization and information sharing.Methods The system was designed with Internet Plus on-line and off-line intelligent medical appointment platform,which used Oracle 11g database for data storage and the front-end server and data center server for data exchange.PowerBuilder language and Java language were used for the development of the system,and there were five functional modules included in the system for appointment resource definition,appointment resource generation,appointment resource distribution,appointment list adjustment and outpatient consultation arrangement.Results The system developed contributed to unified managment of on-line and off-line appointment resources,and could be used for tracing,summarization and analysis of appointment resources.Conclusion The system developed realizes the synch-ronization of multi-way consultation data and the maximum sharing of appointment resources under the background of smart healthcare,which is of conducive for improving the utilization rate of medical resources.[Chinese Medical Equipment Journal,2025,46(3):42-47]

Apolipoprotein D(APOD)is a protein that is widely present in animal tissues and is in-volved in the reproductive regulation of the body.In order to investigate the expression regularity of APOD in bactrian camel epididymis and its regulation effect on sperm maturation,this study took the epididymis of bactrian camel during estrus and anestrus as materials,and first cloned the complete sequence of APOD coding sequence(CDS)region.The physicochemical properties of AP-OD were analyzed by ProParam,SOPMA,SWISS-MODEL and MEGA7.0 software.Meanwhile,the expression and distribution of APOD in epididymis were detected by qRT-PCR,Western blot and IHC.The cloning results showed that:the length of the CDS region of APOD gene was 624 bp,encoding 207 amino acids.The APOD sequence of Bactrian camel was highly conserved with the nucleotide and amino acid sequence of alpaca,and the homology of APOD sequence with elk was the lowest.The results of qRT-PCR showed that the mRNA levels of APOD in the head,body and tail of epididymis in estrus were significantly higher than those in estrus(P＜0.01).Western blot results showed that the APOD protein expression and mRNA expression trend was similar in the head and body of the epididymis during anestrus,but the APOD expression level in the tail of the epididymis during anestrus was opposite to the mRNA expression level(P＜0.05).The results of H&E and IHC showed that there were significant differences in epididymal tissue between estrus and anestrus.In addition,APOD showed positive reactions in epididymal epithelial cells,smooth muscle cells,sperm and connective tissue to varying degrees,suggesting that APOD may be in-volved in the maturation of sperm during estrus and anestrus,providing evidence for further explo-ring the regulatory mechanism of APOD's involvement in seasonal estrus.

Objective To explore the pharmacokinetic(PK)characteristics of desloratadine tablets and reference drugs in healthy subjects,and evaluate their bioequivalence and safety.Methods The random,open,two-period,cross-over pharmacokinetic study method was adopted,each subject received a single oral dose of desloratadine tablets test drug(T)or reference drug(R)for 5 mg.The concentrations of desloratadine and 3-hydroxy desloratadine in plasma were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS);and the PK parameters were calculated by WinNonlin 8.1 software to evaluate the bioequivalence.Results The main PK parameters of T and R of desloratadine were as follows:the fasting condition Cmax were respectively(3 809.82±1 016.54)and(3 642.36±777.07)pg·mL-1;AUC0-120h were respectively(5.75 ×104±5.03 ×104)and(5.51 × 104±4.00 × 104)pg·h·mL-1;AUC0-∞ were respectively(6.85× 104±1.03× 104)and(6.37 × 104±7.92 × 104)pg·h·mL-1.The fed condition Cmax were respectively(4 398.98±1 191.22)and(4 744.4±1 511.97)pg·mL-1;AUC0-120h were respectively(5.25 × 104±1.82 × 104)and(5.55 × 104±1.98 × 104)pg·h·mL-1;AUC0-∞ were respectively(5.37 × 104±1.86 × 104)and(5.68 × 104±2.04 × 104)pg·h·mL-1.The 90％confidence interval of Cmax,AUC0-t and AUC0-∞ of desloratadine were all within 80.00％～125.00％.Conclusion There was no significant difference in the main PK parameters between T tablets and R under fasting or high-fat postprandial conditions,and desloratadine tablets were bioequivalent,safe and well tolerated.