OBJECTIVE To build a new workflow of pharmacy intravenous admixture services （PIVAS）， effectively connect intelligent equipment， and promote the intelligent development of PIVAS. METHODS Based on intelligent auxiliary equipment， PIVAS workflow was optimized， and a process-oriented model was established. This model integrated intelligent prescription review （automatic prescription review+manual intervention mode）， intelligent labeling， intelligent allocation， intelligent sorting， and finished infusion quality inspection system. Furthermore， an assessment was conducted to examine unreasonable medical order rate of intelligent prescription review， the working efficiency and error rate of intelligent labeling machine and intelligent sorting machine， and the dispensing efficiency and accuracy of intelligent dispensing robot. RESULTS Under the intelligent prescription review mode， the rate of unreasonable medical orders decreased from 0.157% to 0.050% （P＜0.05）； automatic labeling efficiency reached 21.7 sheets/min， surpassing the manual labeling efficiency of 13.8 sheets/min （P＜0.05）， and the daily labeling error rate decreased from 6.1‰ to 2.5‰ （P＜0.05）. Simultaneously operating two dispensing robots significantly improved the efficiency of batch dispensing and reduced the residual amount of liquid medicine （P＜0.05）； additionally， a quality testing system for finished infusion was established， involving appearance， Tyndall effect， insoluble particles， turbidity， absorbance， pH and osmotic pressure， to ensure the quality of finished infusion and reduce the risk of infusion. CONCLUSIONS The new process of PIVAS connected with intelligent devices in our hospital can improve work efficiency， reduce dispensing errors， ensure the quality of finished infusion， and improve the level of pharmaceutical care.

Background: While observational studies have suggested a potential link between metabolic syndrome (MetS) and an increased risk of colon polyps, the causal nature of this association remains uncertain. This study used a two-sample Mendelian randomization (MR) approach to evaluate the relationship between MetS and colon polyps. Methods: A two-sample MR analysis was performed using data on MetS, its indicators, and colon polyps obtained from publicly available genome-wide association studies in the Integrative Epidemiology Unit (IEU) and MAGIC databases. Outliers were removed using Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO), followed by MR calculations and false discovery rate (FDR) correction. The primary analysis was conducted with the inverse variance-weighted (IVW) method. Results: The IVW results indicated no association between hypertension, hyperlipidemia, or diabetes and the risk of colon polyps. High-density lipoprotein cholesterol (HDL-C) (P=0.005), 2-hour glucose (P=0.004), glycated hemoglobin A1c (P=0.004), and the ratio of omega-6 to omega-3 fatty acids (P<0.001) were negatively associated with colon polyps. Conversely, body mass index (BMI) (P<0.001), body fat percentage (P=0.002), waist-to-hip ratio adjusted for BMI (P=0.001), total cholesterol (TC) (P=0.002), triglycerides (TG) (P<0.001), and both omega-3 (P<0.001) and omega-6 fatty acid levels (P=0.02) were positively associated with colon polyps. The relationships between these metabolic indicators and colon polyps remained significant after FDR correction. Conclusion Obesity-related traits, TC, and TG may increase the risk of colon polyps, while HDL-C may have a protective effect.

OBJECTIVE To construct a prediction model for tacrolimus trough concentration based on population pharmacokinetics （PPK） information and machine learning， evaluate its predictive performance in clinical therapeutic drug monitoring （TDM） data， and provide evidence-based support for individualized dose adjustment of tacrolimus after renal transplantation. METHODS A retrospective cohort study design was adopted， and consecutive TDM records of kidney transplant recipients treated in the First Affiliated Hospital of University of Science and Technology of China （Anhui Provincial Hospital） from January to June 2025 were included to construct the final analysis set. Based on 29 input variables including previous TDM concentration， previous concentration/dose （ C / D ） ratio， and individual predicted exposure （IPRE）， 13 commonly used regression algorithm models and 1 weighted ensemble model were systematically compared. The dataset was split into training set and test set in an 80∶20 ratio by patient. Five-fold cross-validation based on patient grouping was performed on the training set， and the model performance was evaluated on the obtained evaluation points using the coefficient of determination （ R 2 ）， mean absolute error （MAE）， root mean square error （RMSE）， Pearson correlation coefficient （Corr） and ±20%/±30% accuracy. The SHapley Additive exPlanations （SHAP） method was used for model interpretability analysis to identify core predictive features. RESULTS A total of 809 consecutive TDM records from 83 kidney transplant recipients were included， with 66 cases in the training set and 17 cases in the test set. The SVR model showed the best performance， with R 2 of 0.649 8， MAE of 1.126 0 ng/mL， RMSE of 1.478 6 ng/mL， Corr of 0.819 1， ±20% accuracy of 59.68%， and ±30% accuracy of 79.03%. The Weighted Ensemble model and Extra Trees model ranked second and third， respectively. SHAP interpretability analysis showed that the top 6 features contributing to the prediction were IPRE， previous TDM concentration， previous C/D ratio， dose-normalized concentration， hematocrit （HCT）， and concentration-dose coefficient （ θ cd ）， among which IPRE was the core predictive feature （SHAP mean value 0.915 4）. CONCLUSIONS The machine learning model incorporating PPK information demonstrates good predictive ability for tacrolimus concentration in the current TDM cohort. SVR is the optimal model， IPRE is the core predictive feature of the model， and a few core PK-derived features （IPRE， dose-normalized concentration， θ cd ） together with clinical features （previous TDM concentration， HCT， etc.） constitute the main information sources for model prediction.

Based on the theory of"body fluid and blood sharing the same origin",this paper reveals that the core pathogenesis of atopic dermatitis(AD)lies in the abnormal distribution and transformation of body fluid and blood,which is closely related to dysfunction of the lung,spleen,and kidney.Integrating modern medical research on immune regulation and skin barrier function,we propose that in the early stage of AD,due to deficient endowment,acquired loss of nutrition,insufficiency of the spleen and kidney,and failure of the lung-defense system to protect,external pathogens stagnate in the fleshy exterior.This leads to dysfunction of the lung's governance over the skin,impaired distribution of body fluid,obstruction of qi and blood circulation,and stagnation in the skin,resulting in exudative dampness.The dampness stagnates and transforms into heat.Acupuncture should primarily focus on clearing the lung,dispersing stagnation,distributing body fluid,and unblocking collaterals.In the middle and late stages,as lung disease affects the spleen and kidney,acupuncture should emphasize supplementing and tonifying the spleen and kidney,nourishing blood,and moistening dryness,while simultaneously addressing both the root and the branch.For intractable pruritus,fire needling or pricking-collateral cupping can be employed to control itching and reduce recurrence.

Objective:To observe the clinical efficacy of the modified crowbar-assisted minimally invasive Chevron osteotomy for the treatment of hallux valgus.Methods:A total of 42 patients with hallux valgus who underwent modified crowbar-assisted minimally invasive Chevron osteotomy at Huashan Hospital of Fudan University for hallux valgus from January 2019 to July 2022 were retrospectively analyzed. There were 3 males and 39 females, aged 42.3±8.7 years (range, 26-60 years); 18 left-sided and 24 right-sided, with body mass index 22.9±2.3 kg/m 2. According to the size of the hallux valgus angle (HVA), 26 patients were divided into the mild group (15°≤HVA<20°) and 16 patients were divided into moderate group (20°≤HVA≤40°). All patients were treated with modified crowbar-assisted Chevron osteotomy. The preoperative and postoperative HVA, intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society metatarsophalangeal interphalangeal scale (AOFAS Hallux MTP-IP scale) were compared. Results:All patients successfully completed the operation and were followed up for an average of 22.3±6.5 months (range, 18-30 months). The HVA, IMA, and DMAA in the mild group at the last follow-up were 6.6°±1.8°, 8.1°±1.8°, and 4.3°±1.1°, respectively, which were significantly lower than those before operation 17.8°±1.4°, 12.5°±1.5°, and 7.6°±2.4° ( P<0.05). The HVA, IMA, and DMAA in the moderate group at the last follow-up were 7.6°±2.1°, 8.8°±1.6°, and 4.8°±2.9°, respectively, which were significantly lower than those before operation 32.3°±3.5°, 14.8°±3.5°, and 12.7°±5.4° ( P<0.05). At the last follow-up, there was no significant difference in HVA, IMA, or DMAA between the two groups ( P>0.05). The differences of HVA, IMA, and DMAA before and after operation in the moderate group were 24.7°±2.6°, 6.0°±2.3°, and 7.9°±3.8°, respectively, which were greater than those in the mild group 11.2°±1.7°, 4.4°±1.6°, and 3.3°±1.6°, and the differences were statistically significant ( P<0.05). At the last follow-up, the VAS score of the mild group decreased from 2.6±2.0 before surgery to 0.4±0.2, and the difference was statistically significant ( t=6.014, P<0.001). The VAS score of the moderate group decreased from 3.2±2.2 before surgery to 0.4±0.3, the difference was statistically significant ( t=8.777, P<0.001). The preoperative AOFAS Hallux MTP-IP scale of the toe metatarsal joint in the mild group and the moderate group were 71.6±5.9 and 64.3±7.8, respectively, which increased to 93.3±6.0 and 92.3±6.0 at the last follow-up, and the difference was statistically significant ( P<0.05). At the last follow-up, there was no significant difference in AOFAS Hallux MTP-IP scale between the two groups ( P>0.05). Twenty-two of the 26 patients in the mild group were satisfied, and 14 of the 16 patients in the moderate group were satisfied, and the difference in satisfaction between the two groups was not statistically significant ( P>0.05). Conclusion:The clinical efficacy of the modified crowbar-assisted minimally invasive Chevron osteotomy in the treatment of hallux valgus is satisfactory, and it can effectively correct the hallux valgus deformity and improve the function of the metatarsophalangeal joint.

AIM:To explore the mechanism of berberine on breast cancer cells based on network pharmacology and in vitro cell experiments.METH-ODS:Firstly,berberine and breast cancer were tak-en as the research objects,the intersection targets of the two were screened by VEEN diagram,GO function and KEGG enrichment analysis were per-formed by R language,and molecular docking and visualization were carried out by Autodock Vina and Pymol software.Then,berberine treated breast cancer MCF-7 cells for 24 h,and then in vi-tro cell experiments were performed.CCK-8 was used to detect cell viability,Edu and plate cloning were used to detect cell proliferation and cloning,and apoptosis was detected by An-nexin V-FITC/PI double staining and Western blot.Laser confocal and CETSA were used to verify the binding effect of berberine and AKT1 protein.RESULTS:The results of network pharmacology showed that berberine had a good binding to the core targets AKT1,AKT2 and MAPK3.Berberine(20,40,80 μmol/L)signifi-cantly inhibited the proliferation and cloning ability of MCF-7 cells in a concentration-dependent man-ner(P＜0.05,P＜0.01).The results of laser confocal and CETSA experiments showed that berberine and AKT1 had a binding effect,and the stability of the two was enhanced after the combination.CONCLU-SION:Berberine inhibits MCF-7 cell proliferation and induces apoptosis in human breast cancer cells by targeting binding to AKT1 protein.

Objective:To observe the clinical efficacy of the modified crowbar-assisted minimally invasive Chevron osteotomy for the treatment of hallux valgus.Methods:A total of 42 patients with hallux valgus who underwent modified crowbar-assisted minimally invasive Chevron osteotomy at Huashan Hospital of Fudan University for hallux valgus from January 2019 to July 2022 were retrospectively analyzed. There were 3 males and 39 females, aged 42.3±8.7 years (range, 26-60 years); 18 left-sided and 24 right-sided, with body mass index 22.9±2.3 kg/m 2. According to the size of the hallux valgus angle (HVA), 26 patients were divided into the mild group (15°≤HVA<20°) and 16 patients were divided into moderate group (20°≤HVA≤40°). All patients were treated with modified crowbar-assisted Chevron osteotomy. The preoperative and postoperative HVA, intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society metatarsophalangeal interphalangeal scale (AOFAS Hallux MTP-IP scale) were compared. Results:All patients successfully completed the operation and were followed up for an average of 22.3±6.5 months (range, 18-30 months). The HVA, IMA, and DMAA in the mild group at the last follow-up were 6.6°±1.8°, 8.1°±1.8°, and 4.3°±1.1°, respectively, which were significantly lower than those before operation 17.8°±1.4°, 12.5°±1.5°, and 7.6°±2.4° ( P<0.05). The HVA, IMA, and DMAA in the moderate group at the last follow-up were 7.6°±2.1°, 8.8°±1.6°, and 4.8°±2.9°, respectively, which were significantly lower than those before operation 32.3°±3.5°, 14.8°±3.5°, and 12.7°±5.4° ( P<0.05). At the last follow-up, there was no significant difference in HVA, IMA, or DMAA between the two groups ( P>0.05). The differences of HVA, IMA, and DMAA before and after operation in the moderate group were 24.7°±2.6°, 6.0°±2.3°, and 7.9°±3.8°, respectively, which were greater than those in the mild group 11.2°±1.7°, 4.4°±1.6°, and 3.3°±1.6°, and the differences were statistically significant ( P<0.05). At the last follow-up, the VAS score of the mild group decreased from 2.6±2.0 before surgery to 0.4±0.2, and the difference was statistically significant ( t=6.014, P<0.001). The VAS score of the moderate group decreased from 3.2±2.2 before surgery to 0.4±0.3, the difference was statistically significant ( t=8.777, P<0.001). The preoperative AOFAS Hallux MTP-IP scale of the toe metatarsal joint in the mild group and the moderate group were 71.6±5.9 and 64.3±7.8, respectively, which increased to 93.3±6.0 and 92.3±6.0 at the last follow-up, and the difference was statistically significant ( P<0.05). At the last follow-up, there was no significant difference in AOFAS Hallux MTP-IP scale between the two groups ( P>0.05). Twenty-two of the 26 patients in the mild group were satisfied, and 14 of the 16 patients in the moderate group were satisfied, and the difference in satisfaction between the two groups was not statistically significant ( P>0.05). Conclusion:The clinical efficacy of the modified crowbar-assisted minimally invasive Chevron osteotomy in the treatment of hallux valgus is satisfactory, and it can effectively correct the hallux valgus deformity and improve the function of the metatarsophalangeal joint.

AIM:To explore the mechanism of berberine on breast cancer cells based on network pharmacology and in vitro cell experiments.METH-ODS:Firstly,berberine and breast cancer were tak-en as the research objects,the intersection targets of the two were screened by VEEN diagram,GO function and KEGG enrichment analysis were per-formed by R language,and molecular docking and visualization were carried out by Autodock Vina and Pymol software.Then,berberine treated breast cancer MCF-7 cells for 24 h,and then in vi-tro cell experiments were performed.CCK-8 was used to detect cell viability,Edu and plate cloning were used to detect cell proliferation and cloning,and apoptosis was detected by An-nexin V-FITC/PI double staining and Western blot.Laser confocal and CETSA were used to verify the binding effect of berberine and AKT1 protein.RESULTS:The results of network pharmacology showed that berberine had a good binding to the core targets AKT1,AKT2 and MAPK3.Berberine(20,40,80 μmol/L)signifi-cantly inhibited the proliferation and cloning ability of MCF-7 cells in a concentration-dependent man-ner(P＜0.05,P＜0.01).The results of laser confocal and CETSA experiments showed that berberine and AKT1 had a binding effect,and the stability of the two was enhanced after the combination.CONCLU-SION:Berberine inhibits MCF-7 cell proliferation and induces apoptosis in human breast cancer cells by targeting binding to AKT1 protein.

Objective To explore the mechanism of Prunella vulgaris and Scutellaria barbata herb pair against breast cancer based on network pharmacology and in vitro cell experiments.Methods The effective components and targets of Prunella vulgaris and Scutellaria barbata herb pair were screened.GeneCards and OMIM databases were used to find breast cancer targets,and then drug-active ingredient-key target network and protein-protein inter-action(PPI)were constructed.R language was used to perform GO function and KEGG pathway enrichment analy-sis and survival analysis.Then the screened active components and core targets were verified by molecular docking.Cell viability was detected by CCK-8 assay.EdU and flow cytometry were used to detect cell proliferation and apop-tosis.The protein expression levels of p-AKT1,AKT1,β-catenin and c-MYC were detected by Western blot.Results Through databases analysis,a total of 36 active components and 105 intersection targets were screened out,the core components were quercetin,luteolin,kaempferol,wogonin and baicalein.Through PPI and survival analysis,the key targets were AKT1,ESR1,CASP3 and MYC.GO analysis contained 4 303 enrichment results,KEGG analysis contained 232 pathways.Molecular docking showed that the core components had strong binding ability with the key targets.Cell experiments showed that the core active ingredient quercetin could inhibit the proliferation of breast cancer cells and promote their apoptosis(P＜0.05),and down-regulate the expression levels of p-AKT1,β-catenin and c-MYC proteins(P＜0.05).Conclusion The active components quercetin in Prunella vulgaris and Scutel-laria barbata herb pair may play a role through AKT1/β-catenin signaling pathway,which provides a scientific refer-ence for the study of its mechanism of action in the treatment of breast cancer.

Objective To observe the effects of different frequencies of electroacupuncture on the degree of atrophy of quadriceps femoris in rabbits with anterior cruciate ligament(ACL)injury model;To explore the possible mechanisms of electroacupuncture in treating ACL injury.Methods Totally 24 New Zealand rabbits were randomly divided into blank group,model group,low-frequency electroacupuncture group and high-frequency electroacupuncture group,with 6 rabbits in each group.Except for the blank group,ACL injury models were established in the other groups.On the 7th day after modeling,the low-frequency electroacupuncture group and the high-frequency electroacupuncture group performed electroacupuncture treatment(continuous wave,frequency of 2 Hz and 100 Hz respectively,and left the needle in place for 20 min)at"Xuehai"and"Liangqiu"of the operation side,and the remaining groups were only grasped and immobilized,for 21 days.The mass ratio of the quadriceps femoris was calculated,the histopathological morphology of the quadriceps femoris tissue of the rabbits in each group was observed by HE staining,the expressions of NO,iNOS in quadriceps femoris tissue were detected by ELISA,the content of ROS in quadriceps femoris tissue was detected by fluorescent probe,the protein expressions of PERK,ATF6,IRE1,MuRF1,MAFbx in quadriceps femoris tissue were detected by Western blot.Results Compared with the blank group,the quadriceps femoris muscle mass ratio of the model group rabbits was significantly reduced(P<0.01),with irregular arrangement of muscle cells,accompanied by swelling and atrophy,significant interstitial edema,and extensive inflammatory infiltration,the contents of NO,iNOS and ROS in quadriceps femoris tissue significantly increased(P<0.01),while the expressions of PERK,ATF6,IRE1,MuRF1 and MAFbx proteins significantly increased(P<0.01).Compared with the model group,the quadriceps femoris muscle mass ratio in the low-frequency and high-frequency electroacupuncture groups significantly increased(P<0.01),with regular arrangement of muscle cells,improved swelling and atrophy of cells,and reduced interstitial edema and inflammation,the contents of NO,iNOS and ROS in quadriceps femoris tissue were significantly reduced(P<0.01),and the expressions of PERK,ATF6,IRE1,MuRF1 and MAFbx proteins significantly decreased(P<0.01).Moreover,the low-frequency electroacupuncture group had better effects than the high-frequency electroacupuncture group(P<0.05).Conclusion Different frequencies of electroacupuncture intervention in ACL injury rabbits can better delay the degree of quadriceps femoris atrophy,and its mechanism may be related to reducing the expressions of oxidative metabolites NO,iNOS,ROS,and reducing the expressions of endoplasmic reticulum stress-related proteins PERK,ATF6,IRE1 in quadriceps fermoris,which in turn inhibit the expressions of quadriceps atrophy factors MuRF1,MAFbx,and delaying the degradation of quadriceps muscle proteins.The effect of low-frequency electroacupuncture is superior to the high-frequency electroacupuncture.