1.Construction of the research questions and topic selection evaluation index system of Guideline for Topic Selection for Comprehensive Clinical Evaluation of Drugs based on Delphi method and analytic hierarchy process
China Pharmacy 2025;36(7):789-793
OBJECTIVE To construct the research questions and topic selection evaluation index system of the Guideline for Topic Selection for Comprehensive Clinical Evaluation of Drugs (hereinafter referred to as the Guideline), so as to provide the basis for the formulation of the Guideline. METHODS Through literature research, an expert questionnaire on the research questions and evaluation index system of the Guideline was initially constructed. Experts were selected according to relevant requirements of the guideline formulation and Delphi method; the research questions and evaluation indicators of the Guideline were screened by electronic questionnaire communication, and the weights of evaluation index system of topic selection were assigned by the analytic hierarchy process. RESULTS Five research questions of the Guideline were constructed, including the organization and management of theme selection, evaluation process, evaluation methods, evaluation index system, and index weight assignment. And a theme selection and evaluation index system, including 5 primary indexes, 9 secondary indexes and 17 tertiary indexes, was constructed. Kendall coefficients of the research questions and all indexes were >0.4, and the P values of χ2 test were<0.05, which meant the evaluation results were consistent. The weights of all levels of the evaluation index system were assigned by analytic hierarchy process with consistency ratio of 0.007 6 (<0.1), and the model matrix passed the consistency test. CONCLUSIONS The research questions and topic selection evaluation index system of the Guideline established in this study are highly authoritative, scientific and reliable, which lay a foundation for the standardization of the Guideline.
2.Guideline for the workflow of clinical comprehensive evaluation of drugs
Zhengxiang LI ; Rong DUAN ; Luwen SHI ; Jinhui TIAN ; Xiaocong ZUO ; Yu ZHANG ; Lingli ZHANG ; Junhua ZHANG ; Hualin ZHENG ; Rongsheng ZHAO ; Wudong GUO ; Liyan MIAO ; Suodi ZHAI
China Pharmacy 2025;36(19):2353-2365
OBJECTIVE To standardize the main processes and related technical links of the clinical comprehensive evaluation of drugs, and provide guidance and reference for improving the quality of comprehensive evaluation evidence and its transformation and application value. METHODS The construction of Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs was based on the standard guideline formulation method of the World Health Organization (WHO), strictly followed the latest definition of guidelines by the Institute of Medicine of the National Academy of Sciences of the United States, and conformed to the six major areas of the Guideline Research and Evaluation Tool Ⅱ. Delphi method was adopted to construct the research questions; research evidence was established by applying the research methods of evidence-based medicine. The evidence quality classification system of the Chinese Evidence-Based Medicine Center was adopted for evidence classification and evaluation. The recommendation strength was determined by the recommendation strength classification standard formulated by the Oxford University Evidence-Based Medicine Center, and the recommendation opinions were formed through the expert consensus method. RESULTS & CONCLUSIONS The Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs covers 4 major categories of research questions, including topic selection, evaluation implementation, evidence evaluation, and application and transformation of results. The formulation of this guideline has standardized the technical links of the entire process of clinical comprehensive evaluation of drugs, which can effectively guide the high-quality and high-efficient development of this work, enhance the standardized output and transformation application value of evaluation evidence, and provide high-quality evidence support for the scientific decision-making of health and the rationalization of clinical medication.
3.Investigation of plague foci in Cangyuan County, Yunnan Province, China-Myanmar border region in 2023
LI Siyu ; SHAO Zongti ; LIU Zhengxiang
China Tropical Medicine 2025;25(2):136-
Objective To understand the situation of plague host vectors, indicator animals and residents infected with plague bacteria in Cangyuan County, Yunnan Province, China-Myanmar border region, and to explore the risk of plague epidemic, so as to provide reference basis for supplementary plague data and prevention and control in this area. Methods A plague survey was carried out in three townships in Cangyuan County in 2023. The collected host animals organs and body surface parasitic fleas were bacterial cultured. Serum collected from border residents, indicator animals, and host animals was tested for plague F1 antibodies using indirect hemagglutination assay (IHA). The positive samples were rejudged by IHA, immune colloidal gold assay(GICA) and up-converting phosphor technology(UPT). Results Totally 294 serum samples were collected from border residents, with an average age of (48.48±14.27) years old, with more females than males. Three were positive for F1 antibody against Yersinia pestis, with a positive rate of 1.02%. And 65 samples of indicator animal serum and 31 samples of Rattus tanezumi serum were collected, and the detection of plague F1 antibody was negative. And 198 rodents belonging to 3 orders, 5 families, 11 genus and 14 species were captured, with a total capture rate of 7.93%, with Rattus tanezumi (46.97%) and Rattus andamanensis (19.19%) as the dominant species. The capture rate in residential indoor areas was 3.72%, and Rattus tanezumi was the absolutely dominant species (100.00%). The capture rate in farming areas was 10.26%, the dominant species were Rattus tanezumi (36.36%), Rattus andamanensis (23.03%), Mus pahari (10.30%) and Hylomys suillus (10.30%). And 60 fleas belonging to 3 families, 5 genera and 6 species were seized, the average infection rate of fleas was 11.62%, and the total flea index was 0.30. The dominant species were Xenopsylla cheopis (28.34%), Palaeopsylla remota (23.33%), Ctenophthalmus quadratus (18.33%), Stivalius aporus (15.00%) and Palaeopsylla incurua (11.67%). A total of 198 murine organ samples were isolated and cultured, and 24 groups of flea samples were obtained, no Yersinia pestis was isolated. Conclusion The investigation has not found any recent infection with Yersinia pestis in rodents, body surface parasitic fleas and indicator animals; however, it is found that there is still a certain proportion of positive population of plague F1 antibody in the serum of residents. Rattus tanezumi and Xenopsylla cheopis are the first dominant species of host and vector in the county, the indoor density of Rattus flavipectus exceeds 3%, reaching the animal pestis IV early warning, and there is a risk of recurrence in the plague foci.
4.Investigation and analysis on the improvement of drug instructions based on the medication needs of parents of pediatric patients
Yilu WANG ; Rong DUAN ; Bin HAN ; Hengjie YUAN ; Zhengxiang LI
China Pharmacy 2025;36(22):2845-2849
OBJECTIVE To analyze the medication needs of parents of pediatric children in our hospital regarding drug instructions, and explore improvement strategies, thereby providing a basis for clinically guiding the rational use of drugs in pediatric patients. METHODS A self-designed questionnaire was used to randomly select the parents of pediatric patients in the pediatric outpatient and emergency departments of our hospital from July 1st to September 30th, 2024. A randomized face-to-face survey was conducted regarding their willingness to read drug instructions, their current understanding status, and their needs. The survey results were then statistically analyzed. RESULTS A total of 300 questionnaires were distributed in this survey, and 299 valid questionnaires were recovered, with an effective recovery rate of 99.7%. Before medication, the parents who “always” and “often” read the drug instructions in detail accounted for 39.1% (117 respondents) and 35.1% (105 respondents), respectively. Statistically significant differences were observed in the willingness to read drug instructions among respondents with varying educational levels and occupations (P<0.05). Among the 299 respondents, only 48 people (16.1%)“ fully understood” the drug instructions, and the average understanding score of all the respondents was (3.77±0.83) points. The stronger the respondents’ willingness to read drug instructions, the higher their understanding scores of drug instructions (P<0.05). A total of 256 respondents thought that drug instructions were of great help to themselves, and the average helpfulness rating score of all the respondents was (4.28±0.78) points. Under the conditions of varying ages, educational levels, occupations, and willingness to read drug instructions, statistically significant differences were observed in the scores representing the degree of helpfulness of drug instructions to the respondents (P<0.05). Respondents paid the most attention to content in drug instructions such as “dosage and administration method”,“ adverse reactions”, and “indications and therapeutic categories”. The most difficult sections for them to understand included “chemical structure and properties”, “pharmacological and toxicological effects” , and “pharmacokinetics”, etc. The demographic characteristics of the respondents were not significantly associated with the content areas of drug instructions they most desired to see improved (P>0.05). Most respondents (86.0%) hoped to improve the instructions mainly by “simplifying professional terms to make them more accessible”. Others included “highlighting key information” (60.5%) and “providing more detailed medication guidance” (49.2%), etc. CONCLUSIONS Parents of pediatric patients in our hospital have a high demand for drug instructions but low comprehension. The pharmacy department should make targeted improvements to drug instructions based on parents’ actual needs, helping them accurately obtain medication knowledge and reduce potential medication safety risks.
5.Interpretation of the group standard of Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs
China Pharmacy 2025;36(23):2893-2898
In order to standardize the workflow for the clinical comprehensive evaluation of drugs, enhance the assessment of research evidence, and improve the application value of research outcomes in translational practice, the Chinese Pharmaceutical Association issued the Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs (T/CLPA 5-2025) in June 2025. The core points include clarifying the concept of clinical comprehensive evaluation of drugs and standardizing the main work processes and technical essentials. This article provides a detailed interpretation of the technical methods for standard formulation, the operational logic of the four core processes (theme selection, evaluation implementation, evidence evaluation, result application transformation), and the key points of core technologies. The aim is to assist medical institution technicians, policymakers and researchers in accurately grasping the connotation of the standards, resolving practical concerns such as process connection and technology application, and enhancing the quality and homogenization of evaluation work. It provides support for the scientific decision-making of healthcare and health, and the rational clinical medication.
6.Pharmacovigilance Signal Mining and Analysis of Ustekinumab versus Upadacitinib for Inflammatory Bowel Disease Based on the FAERS Database
Dong XIE ; Yu WANG ; Haojia LIN ; Qiuyue TU ; Hetong ZHANG ; Huizhen LI ; Qinghua YI ; Zhengxiang LI ; Hengjie YUAN ; Xiaocang CAO
Medical Journal of Peking Union Medical College Hospital 2025;16(6):1376-1383
To analyze potential adverse drug events(ADEs) associated with ustekinumab and upadacitinib in the treatment of inflammatory bowel disease(IBD) based on an international authoritative database, thereby providing evidence for clinical medication safety. Data were extracted from the Food and Drug Administration Adverse Event Reporting System(FAERS) database using OpenVigil 2.1. ADE reports were collected for ustekinumab(from Q3 2017 to Q1 2025) and upadacitinib(from Q3 2019 to Q1 2025), where each drug was identified as the primary suspected medication for IBD. Signal detection and statistical analysis were performed using the reporting odds ratio(ROR) and proportional reporting ratio(PRR) methods. A total of 3648 ADE reports for ustekinumab and 3812 for upadacitinib, with each as the primary suspected drug in IBD treatment, were retrieved. Using the ROR-PRR combined detection method, relevant ADE signals were identified. High-frequency ADEs associated with ustekinumab included hypersensitivity reactions, various infections, and brain fog, while those associated with upadacitinib included acne, flatulence, and herpes zoster. System organ class(SOC) analysis of positive signals indicated that both drugs commonly caused ADEs in categories such as Infections and infestations, Gastrointestinal disorders, Nervous system disorders, Skin and subcutaneous tissue disorders, and Respiratory, thoracic, and mediastinal disorders. Among these, Infections and infestations were the most frequent SOC, involving preferred terms such as Escherichia sepsis and Pneumococcal pneumonia. Ustekinumab and upadacitinib exhibit distinct safety profiles in the treatment of IBD. In addition to known ADEs described in the prescribing information, ustekinumab requires close monitoring for hypersensitivity reactions, opportunistic infections, and potential neurological risks. For upadacitinib, attention should be paid to risks of acne, herpes zoster, hypercholesterolemia, and thrombotic events. These findings provide important safety information to support individualized clinical decision-making in IBD management.
7.Signal mining and analysis of adverse events of sacituzumab govitecan
Yilu WANG ; Ke ZHANG ; Zhengxiang LI
China Pharmacy 2024;35(20):2527-2532
OBJECTIVE To mine the adverse drug event (ADE) signals of sacituzumab govitecan and provide a reference for its clinical safety application. METHODS The data of sacituzumab govitecan-related ADE reports were collected from the FDA Adverse Event Reporting System (FAERS) database from April 1, 2020 to April 30, 2024. The reporting odds ratio(ROR) method, the United Kingdom Medicines and Healthcare Products Regulatory Agency comprehensive standard method (MHRA) and Bayesian confidence propagation neural network (BCPNN) method were used for data mining. Systematic organ classification (SOC) and preferred term (PT) in the ADE terminology set of version 27.0 of the Medical Dictionary for Regulatory Activities (MedDRA) were used for data classification and statistics. RESULTS A total of 753 ADE reports were obtained for sacituzumab govitecan, including 46 ADE signals, involving 12 SOCs, and 13 new suspicious ADE signals not recorded in the instructions. Top 5 PTs in terms of occurrence frequency were disease progression, death, diarrhea, off label use and inappropriate schedule of product administration. Top 5 PTs in terms of signal strength were febrile bone marrow aplasia, neutropenic colitis, disease progression, pulmonary sepsis, general physical condition abnormal. New ADE not recorded in the drug instructions included neutropenic sepsis, hepatic cytolysis, meningitis, aplasia, etc. CONCLUSIONS When using sacituzumab govitecan in clinical practice, special attention should be paid to ADE with highly reported cases and strong signal intensity, such as febrile neutropenia, febrile bone marrow aplasia, weight fluctuations, colitis. We should also be alert to new suspected ADE such as neutropenic sepsis, hepatic cytolysis, meningitis, and aplasia to ensure patient medication safety.
8.Effects of formononetin on the apoptosis of intestinal epithelial cells in rats with inflammatory bowel disease by regulating the Hippo/YAP signaling pathway
Dong XIE ; Yuanyuan LIU ; Zhengxiang LI ; Hengjie YUAN ; Xiaocang CAO
China Pharmacy 2024;35(13):1564-1569
OBJECTIVE To investigate the effects of formononetin (FMN) on the apoptosis of intestinal epithelial cells in inflammatory bowel disease (IBD) rats and its possible mechanism. METHODS IBD rat model was constructed by using trinitrobenzene sulfonic acid (TNBS) induction. Forty-eight rats with successful modeling were divided into model group (normal saline), low-dose and high-dose FMN groups (20 and 40 mg/kg FMN), and high-dose FMN+YAP inhibitor Verteporfin (VTPF) group (40 mg/kg FMN+10 mg/kg VTPF), with 12 rats in each group. Another 12 rats were set as the normal group (normal saline). They were given drug/normal saline, once a day, for 7 consecutive days. After the last administration, the disease activity index (DAI) of rats was calculated, and the colon length of rats in each group was measured. The pathological changes in the colon tissue of rats were observed. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10 in serum were detected, and the apoptosis of intestinal epithelial cells was detected. The expressions of Yes associated protein (YAP), cleaved cysteine-containing aspartate proteolytic enzyme 3 (cleaved-caspase-3), B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) were detected in colon tissue of rats. RESULTS Compared with the normal group, DAI score, the levels of TNF-α and IL- 6, the apoptotic rate of intestinal epithelial cells, and the expressions of cleaved-caspase-3 and Bax protein in the model group were increased greatly (P<0.05); the length of the colon was greatly decreased (P<0.05), and the serum level of IL-10 and the protein expressions of YAP and Bcl-2 were greatly reduced (P<0.05). The cell morphology of colon tissue was abnormal, with disordered arrangement and inflammatory cell infiltration. Compared with IBD group, the above indexes of rats were improved significantly in low-dose and high-dose FMN groups (P<0.05), in dose-dependent manner (P<0.05). VTPF significantly alleviated the effects of FMN on the above indexes of IBD rats (P<0.05). CONCLUSIONS FMN may promote the expression of YAP by inhibiting the Hippo/YAP signaling pathway, thereby inhibiting apoptosis of intestinal epithelial cells in IBD rats.
9.Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults (version 2023)
Fan FAN ; Junfeng FENG ; Xin CHEN ; Kaiwei HAN ; Xianjian HUANG ; Chuntao LI ; Ziyuan LIU ; Chunlong ZHONG ; Ligang CHEN ; Wenjin CHEN ; Bin DONG ; Jixin DUAN ; Wenhua FANG ; Guang FENG ; Guoyi GAO ; Liang GAO ; Chunhua HANG ; Lijin HE ; Lijun HOU ; Qibing HUANG ; Jiyao JIANG ; Rongcai JIANG ; Shengyong LAN ; Lihong LI ; Jinfang LIU ; Zhixiong LIU ; Zhengxiang LUO ; Rongjun QIAN ; Binghui QIU ; Hongtao QU ; Guangzhi SHI ; Kai SHU ; Haiying SUN ; Xiaoou SUN ; Ning WANG ; Qinghua WANG ; Yuhai WANG ; Junji WEI ; Xiangpin WEI ; Lixin XU ; Chaohua YANG ; Hua YANG ; Likun YANG ; Xiaofeng YANG ; Renhe YU ; Yongming ZHANG ; Weiping ZHAO
Chinese Journal of Trauma 2023;39(9):769-779
Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.
10.Monitoring results of plague vector fleas in Yulong ,Yunnan Province from 2019 to 2021
Yuqiong LI ; Fahong WANG ; Zongti SHAO ; Ennian PU ; Jian WANG ; Meiqi LIU ; Pan CHENG ; Zhengxiang LIU
Shanghai Journal of Preventive Medicine 2023;35(9):879-884
ObjectiveTo analyze the community structure and dynamics of parasitic fleas on the body surface of host animals and nested fleas in different seasons in the natural foci of wild rat plague in Yulong County,Yunnan Province, to explore the relationship between seasonal fluctuation of fleas and the prevalence of plague among animals, so as to provide evidence for plague prevention and control in the natural foci. MethodsNanxi Village, Huangshan Town, the core area of plague epidemic in Yulong County, was selected as the monitoring sample area in December 2019 (winter), August 2020(summer), October 2020(autumn) and March 2021(spring). Host animals were captured by rattrap at night and rat nests were excavated for collecting parasitic fleas on host animals and rat nest fleas in different seasons. Excel 2010 and SPSS 26.0 software were used to analyze the data, and Chi square test was used to compare the rate. Community ecological indicators were used to analyze the community structure and species diversity of the host animals and their parasitic fleas. ResultsA total of 355 vector fleas were captured, belonging to 7 species of 5 genera in 2 families. 441 small animals were captured and 138 rat body fleas were detected with the flea infection rate of 14.51% and the flea index 0.31. 96 effective rat holes were excavated and 217 fleas were detected with the flea infection rate of 35.42% and the flea index 2.26. Among the four seasons, the flea infection rates of rat body and rat nests were higher in summer and winter, showing a significant difference in general (χ2=15.851, P<0.01; χ2=16.398, P<0.01). The dominant species of flea community were Ctenophthalmus quadratus, Stenischia humilis, Neopsylla specialis and Frontopsylla spadix, with a dominance index of 0.434, 0.254, 0.180 and 0.110, respectively. The diversity and evenness of rat body fleas showed a distribution characteristic of decreasing, increasing and then decreasing again with season changes, and both were the highest in spring, while the ecological dominance showed an opposite trend. The diversity and evenness of rat nest fleas showed a distribution characteristic of increasing first and then decreasing in summer, autumn and winter, with the highest in autumn, while the ecological dominance was diametrically opposite. ConclusionThe fleas community structure is relatively stable in Yulong County, but the number of species in the community is unevenly distributed by seasons, and the status of dominant species is prominent. Local authorities should carry out timely preventive deratization and depulization measures according to the results of daily monitoring, so as to effectively avoid the prevalence and spread of plague among animals in plague foci.

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