OBJECTIVE To establish a Chinese drug-related problem （DRP） classification system applicable to pharmacist-led pharmaceutical care in China， providing pharmacists with an effective and practical tool for pharmaceutical care. METHODS A multi-stage process was employed to construct the DRP classification system， including literature review and analysis， comparison of existing classification systems， refinement of classification items and framework development， two rounds of standard case validation， expert discussion， and system revision. The Fleiss′ kappa test was used to calculate the consistency coefficient κ， assessing the reliability of pharmacists participating in evaluating the classification system. An electronic questionnaire comprising six items was employed to evaluate the system’s applicability. RESULTS The constructed Chinese DRP classification system comprised six sections [problem（including potential problems）， DRP evaluation， cause （including possible causes of potential problems）， intervention， acceptance of intervention and DRP status]， with 24 primary codes and 96 secondary codes. In the first round of case validation， κ values exceeded 0.4 for all sections except “intervention” and “DRP status”. In the second round， κ values exceeded 0.4 for all sections. In the applicability evaluation of the classification system， positive ratings （“strongly agree” or “agree”） exceeded 85% for all items. Specifically， positive ratings for“the classification system can provide appropriate category selection”，“ the classification system is comprehensive”，“ the classification system is convenient to use” and “the classification system is highly satisfactory” exceeded 92%. CONCLUSIONS The Chinese DRP classification system developed demonstrates both high reliability and applicability， providing an effective and practical classification tool for pharmacists in China to conduct pharmaceutical care.

AIM: To investigate differences in ocular biological parameters and refractive status among children with unilateral congenital ptosis.METHODS:This was a retrospective cohort study enrolling patients with unilateral congenital ptosis in the Department of Ophthalmology, Xi'an Children's Hospital between August 2018 and March 2025, with the contralateral healthy eyes serving as the control group. All patients underwent a detailed ophthalmic examination to assess the degree of ptosis and evaluate refractive errors. Biometric measurements were performed using the IOL Master 700 biometer, including axial length(AL), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), and astigmatism(AST).RESULTS:A total of 100 eyes from 100 children(affected eye group)with unilateral congenital ptosis were enrolled, and their 100 contralateral normal eyes without ptosis were set as the control group(healthy eyes group). Among the subjects, there were 67 males(67%)and 33 females(33%), with a mean age of 6.43±2.47 y; 45 affected eyes were the right eye and 55 were the left eye. Among the 100 patients, mild, moderate, and severe ptosis accounted for 7%, 21%, and 72%, respectively. The incidence of amblyopia in patients with unilateral congenital ptosis was 32%, all of which occurred in the affected eye. Compared with the healthy eye group, K2(total)and K2(severe ptosis)in eyes with severe ptosis were significantly lower(P<0.05), indicating that the cornea in the ptotic eye was flatter. In patients with moderate ptosis, the affected eye had a significantly greater corneal thickness(CCT)compared to the healthy eye(P<0.05), indicating that the corneas of eyes with moderate ptosis were thicker. The incidence of against-the-rule and oblique astigmatism in the affected eye group(39%)was significantly higher than that in the healthy eye group(14%); there was a significant difference in the corneal astigmatism axis between the affected and healthy eye groups(P<0.01). There were no differences in refractive status or biological parameters such as AL, K1, AST, ACD, and LT between the affected and healthy eyes.CONCLUSION:Congenital ptosis can affect refractive errors, lead to oblique and against-the-rule astigmatism, increase the prevalence of amblyopia, and also result in corneal thickening and flattening. However, it has minimal effects on AL, LT, and ACD.

Aim To explore the mechanism by which dioscin regulates IL-17+γδT cells in the treatment of arthritis.Methods A collagen-induced arthritis(CIA)model was established in DBA/1 mice using bovine type Ⅱ collagen.The mice were randomly divid-ed into the CIA model group,methotrexate(MTX)positive control group,and dioscin low-dose(Dioscin-L),medium-dose(Dioscin-M),and high-dose(Dios-cin-H)groups.After intervention,the therapeutic effects were evaluated using scoring methods.Joint pathological damage was analyzed by hematoxylin and eosin(HE)staining.The levels of anti-collagen-spe-cific antibodies and the pro-inflammatory cytokine IL-17 were measured by ELISA.The expressions of γδT cells and their subtypes,as well as the secretion level of IL-17,were detected by flow cytometry.Results Dioscin significantly reduced the arthritis severity score in collagen-induced arthritis(CIA)mice,alleviated joint pathological damage,inhibited the production of IL-17 by splenic lymphocytes and the levels of anti-col-lagen-specific antibodies total IgG and IgG3,and de-creased the proportion of γδT cells in the lymph nodes,splenic γδT cells,and the Vδ4+T-cell subset.The level of IL-17 produced by the Vδ4 subtype in the lymph nodes of the intervention groups was lower than that in the model group,but the difference was not sta-tistically significant.Conclusion Dioscin has signifi-cant therapeutic effect on CIA,and its mechanism may be through the inhibition of γδT cells,but it is unlikely to be related to IL-17 derived from γδT cells.

AIM To study the chemical constituents from ethyl acetate fraction of Balanophora harlandii Hook.f.and their tyrosinase inhibitory activity.METHODS Separation and purification were performed using silica gel,MCI,ODS,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The monophenolase inhibitory activity was determined by the tyrosinase-catalyzed oxidation of L-tyrosine.RESULTS Twenty-four compounds were isolated and identified as sesamin(1),methyl caffeate(2),quercetin(3),5,7-dihydroxychromanone(4),methyl 3,4-dihydroxybenzoate(5),esculetin(6),kaempferol(7),naringenin(8),pyrogallic acid(9),pinosylvin(10),methyl propionate(11),caffeic acid(12),saccharinol(13),ferulic acid(14),trans-p-hydroxycinnamic acid(15),cinnamic acid(16),vanillic acid(17),vanillin(18),4-hydroxyacetophenone(19),4-hydroxybenzaldehyde(20),apigenin(21),(-)-isolariciresinol(22),(-)-secoisolariciresinol(23)and meso-2,3-di(3′,4′-methylenedioxybenzyl)butane-1,4-diol(24).The IC50 values of compounds 3,5,7,8,19,and 20 ranged from(0.246 5±0.028 3)to(1.278 2±0.021 3)mmol/L.CONCLUSION Compounds 1-9、11、15、17-21、24 are isolated from this plant for the first time,and 1,6,9,17-19,24 are first isolated from genus Balanophora.Compounds 3、5、7、8、19 and 20 have tyrosinase inhibitory activity.

AIM To establish the near-infrared spectroscopy quantitative models for moisture,23-acetylalismol B and 23-acetylalismol C in Alismatis Rhizoma decoction pieces.METHODS The near-infrared spectroscopy(NIRS)data were collected in 95 batches of decoction pieces,after which drying method was adopted in the content determination of moisture,HPLC was applied to determining the contents of 23-acetylalismol B and 23-acetylalismol C,the quantitative models were established by partial least squares method combined with feature extraction algorithms.RESULTS The model training determination coefficients were 0.952 6,0.958 1 and 0.920 8,along with the prediction determination coefficients of 0.930 0,0.905 2 and 0.906 4,the residual prediction deviations(PRD)of 4.00,3.58 and 3.46,and the root mean square error ratios of prediction values to calibration values(RMSEP/RMSEC)of 1.15,1.11 and 1.06,respectively.CONCLUSION The quantitative models based on NIRS exhibit good prediction effects,which can be used for the rapid quality detection of Alismatis Rhizoma decoction pieces.

Mechanical pain is one of the most common causes of clinical pain, but there remains a lack of effective treatment for debilitating mechanical and chronic forms of neuropathic pain. Recently, neurotoxin GsMTx4, a selective mechanosensitive (MS) channel inhibitor, has been found to be effective, while the underlying mechanism remains elusive. Here, with multiple rodent pain models, we demonstrated that a GsMTx4-based 17-residue peptide, which we call P10581, was able to reduce mechanical hyperalgesia and neuropathic pain. The analgesic effects of P10581 can be as strong as morphine but is not toxic in animal models. The anti-hyperalgesic effect of the peptide was resistant to naloxone (an μ-opioid receptor antagonist) and showed no side effects of morphine, including tolerance, motor impairment, and conditioned place preference. Pharmacological inhibition of TRPV4 by P10581 in a heterogeneous expression system, combined with the use of Trpv4 knockout mice indicates that TRPV4 channels may act as the potential target for the analgesic effect of P10581. Our study identified a potential drug for curing mechanical pain and exposed its mechanism.

Objective To develop dynamic prediction models based on multiple postnatal time points to support early diagnosis and individualized intervention for bronchopulmonary dysplasia(BPD)in preterm infants with gestational age<32 weeks.Methods Clinical data of 472 preterm infants with gestational age<32 weeks admitted to the Second Xiangya Hospital of Central South University between January 2016 and November 2020 were retrospectively analyzed.Multivariable logistic regression was applied to develop five independent prediction models at postnatal days 1,7,14,21,and 28.The performance of the models was assessed using the area under the receiver operating characteristic curve(AUC)and the Hosmer-Lemeshow test.Results Baseline characteristics such as gestational age and birth weight differed significantly between the BPD group(n=147)and the non-BPD group(n=325)(P<0.05).Predictors of BPD evolved across time points:on day 1,key predictors included gestational age,birth weight,Score for Neonatal Acute Physiology II(SNAP-II),invasive mechanical ventilation,and fraction of inspired oxygen>30%;by day 7,additional variables emerged,including fasting duration>2 days,mean feeding advancement rate<8.5 mL/(kg·d),neonatal respiratory distress syndrome,apnea of prematurity,and positive sputum culture;from day 14 onward,nutrition-and treatment-related indicators were incorporated additionally.The models demonstrated good discrimination at postnatal days 1,7,14,21,and 28,with AUCs of 0.917,0.927,0.939,0.944,and 0.968,respectively,and good calibration(Hosmer-Lemeshow P>0.05).Internal validation showed AUCs ranging from 0.899 to 0.958,indicating robust performance.Conclusions Dynamic postnatal prediction models incorporating indicators spanning perinatal factors,respiratory support,nutritional management,and therapeutic interventions demonstrate high predictive performance and facilitate dynamic risk assessment for BPD in preterm infants with gestational age<32 weeks.

Objective:To investigate the effect of triglyceride-glucose(TyG) index and alkaline phosphatase(ALP) on brachial-ankle pulse wave conduction velocity(baPWV) in postmenopausal women.Methods:A cross-sectional study was conducted, enrolling 3 483 postmenopausal women who underwent health checkup at Taihu Sanatorium in Jiangsu Province from March 2020 to June 2021. The physical activity, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol(HDL-C), low-density lipoprotein-cholesterol(LDL-C), ALP, and baPWV were collected.Results:Age, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, and LDL-C levels were significantly lower in the normal baPWV group( n=1 971) than those in the elevated baPWV group( n=1 512; P<0.001). Logistic regression identified the TyG index( OR=1.75) and ALP level( OR=1.20) as independent risk factors for elevated baPWV( P<0.001), besides with age, body mass index, systolic blood pressure, diastolic blood pressure, and regular exercise. Individuals with both high TyG index and elevated ALP had a 2.51-fold higher risk of elevated baPWV(95% CI 2.01-3.14). Adjusted interaction measures(including age, body mass index, systolic blood pressure, diastolic blood pressure, and regular exercise) showed RERI=2.825(95% CI 1.255-3.905), AP=0.348(95% CI 0.180-0.875), and SI=1.657(95% CI 0.628-3.374). Conclusions:The TyG index and ALP levels are independent risk factors for elevated baPWV in postmenopausal women and exhibit an additive interaction effect on arterial stiffness in this population.

Aim To investigate the therapeutic effects of a newly developed Tadalafil tablets on pathological myocardial hypertrophy induced by abdominal aortic constriction(AAC)in rats,as well as its influence on the activation of the NF-κB signaling pathway in myo-cardial cells.Methods SD rats were randomly divid-ed into 4 groups:the sham operation group(Sham),the model group(AAC),the tadalafil new tablet treat-ment group(N-Tad,5 mg·kg-1),and the positive control drug treatment group(Cialis,10 mg·kg-1g).The AAC model group and treatment group rats under-went blunt dissection and constrictive ligation of the abdominal aorta at the left renal artery branch point during surgery,while the Sham group rats only had their arteries separated without any constrictive liga-tion.Rats in the treatment groups received either N-Tad or Cialis via gavage three days after modeling,while rats in the sham group and the model group re-ceived physiological saline daily for 8 weeks.Small an-imal ultra-high-resolution echocardiography and hemo-dynamic assessment were applied to evaluate left ven-tricular function in each group of rats,and the calcula-tion of the left ventricular mass index was conducted.By employing Western blot and RT-PCR.we assessed the impact of this treatment on the expression of the hy-pertrophy factor atrial natriuretic peptide(ANP),phosphorylated NF-κB p65 protein(p-NF-κB p65),and phosphorylated IκB-α in the left heart tissue of rats and in H9c2 cardiomyocytes.Results Compared to the Sham group,the AAC rats exhibited a significant decrease in left heart function,an increase in left ven-tricular mass index,and a notable increase in ANP and p-p65 expression in the left heart tissue(P＜0.05).Both N-Tad and Cialis treatments could significantly enhance left ventricular function,decrease left ventric-ular mass index,and inhibit the expression of ANP and phosphorylated NF-κB p65 in rats with myocardial hy-pertrophy(P＜0.05).Notably,the therapeutic effect of low-dose N-Tad was comparable to that of high-dose Cialis.At the cellular level,Tadalafil significantly in-hibited the activation of the NF-κB signaling pathway and reduced the expression of associated proteins in H9c2 cardiomyocytes.Conclusions N-Tad can sig-nificantly inhibit p65 and IκB-α phosphorylation,and the activation of the NF-κB signaling pathway,reduce ANP expression,and improve pathological myocardial hypertrophy,as well as mitigate left heart function damage caused by abdominal aortic constriction.

Objective:This study aims to investigate the risk factors of venous thromboembolism(VTE)in patients with chronic heart failure(CHF),and establish a model for predicting the risk of VTE.Methods:A nested case-control study was conducted on CHF patients admitted in Pengzhou People's Hospital between June 2022 and June 2023.A total of 66 patients were diagnosed with VTE among the 960 CHF patients.Then another 66 patients paired by age and gender to those with VTE were selected from the remaining non-VTE patients as control group.Gener-al data,D dimer(D-D),thrombin-antithrombin complex(TAT),plasmin-α2-antiplasmin complex(PIC),tissue plasminogen activator-inhibitor complex(t-PAIC),thrombomodulin(TM)and Padua score were compared between two groups.Multivariate Logistic regression analysis was used to screen the independent risk factors of VTE in CHF patients.The receiver operating characteristic(ROC)curve analysis was applied to assess the efficacy of each indicator in predicting the risk of VTE in CHF patients.Results:Compared to patients in the non-VTE group,those in the VTE group had significantly higher D-D[3.26(1.87,6.19)mg/L vs.0.81(0.56,1.26)mg/L],TAT[5.60(4.90,8.80)ng/ml vs.2.60(1.70,3.30)ng/ml],TM[16.40(13.50,20.03)TU/ml vs.9.65(7.60,11.20)TU/ml],PIC[1.24(0.94,1.68)μg/ml vs.0.84(0.65,1.22)μg/ml],t-PAIC[12.60(9.38,17.05)ng/ml vs.7.70(5.53,9.70)ng/ml],proportion of atrial fibrillation/flutter(54.5％vs.22.7％)and Padua score[4(3,4)points vs.3(2,3)points](P＜0.001 all),and significantly lower lymphocyte count[0.99(0.60,1.38)×109/Lvs.1.20(0.76,1.67)×109/L,P=0.020].Multivariate Logistic regression analysis indicated that after adjusting confounders,TM(OR=2.456,95％CI 1.389～14.296,P=0.012)and Padua score(OR=3.257,95％CI 1.270～13.073,P=0.037)were independent risk factors for VTE in CHF patients.A predictive model was constructed using above-mentioned two indexes.The area under the ROC curve(AUC)of the combined prediction was 0.941(95％CI 0.901～0.980),which was significantly higher than those of TM(AUC=0.889,95％CI 0.833～0.945)and Padua score(AUC=0.801,95％CI 0.731～0.871)alone(Z=2.672,4.063,P=0.008,＜0.001).Conclusion:Padua score and TM were independent risk factors for VTE in CHF patients,and their combined detec-tion could better predict the risk of VTE in these patients.