主办单位：上海医药行业协会
10 February 2025, Volume 46 Issue 2
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 3-6.
Psoriasis is an immune-mediated chronic, relapsing, inflammatory, systemic disease, and metabolic dysfunction-associated fatty liver disease (MAFLD) is one of the most common co-morbidities of psoriasis. This paper interpreted the traditional Chinese medicine (TCM) etiology of psoriasis complicated with MAFLD. The two co-morbidities are located in the blood, involving the liver, spleen and kidney, and their TCM pathogenesis has evolved through three stages, from dampness-heat in the early stage to phlegm-heat in the middle stage and then to stasis-heat in the late stage, with blood-heat being the key to driving this evolutionary process. In TCM syndrome differentiation system of viscera, blood-heat damage to the liver complex and the beginning of the disease, the condition of the deficiency and reality of the existence of mutual transformation exacerbated. In the treatment of co-morbidities, the stage of the disease should be identified, emphasis should be placed on eliminating invisible heat and visible dampness, phlegm and stasis, and attention should be paid to the care of Qi and Yin.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 7-11.
The comorbidity of psoriasis with inflammatory bowel disease (IBD) is characterized by a pathological focus in the blood aspect, with a syndrome that is fundamentally deficient and superficially excessive. The root cause is the deficiency of lung and spleen Qi, with pathogenic factors lurking in the collaterals, while the superficial manifestation is the accumulation of heat-toxicity in the Jueyin blood aspect. The pathological changes are marked by early-stage lung meridian heat, mid-stage blood heat-toxicity, and late-stage spleen-kidney Yang deficiency. Treatment should be tailored to the different stages of pathogenesis transformation, with early-stage treatment focusing on purging fire and detoxification, and late-stage treatment aiming to nourish the root and consolidate the foundation. This study aims to delve deeper into the theoretical system of traditional Chinese medicine for the comorbidity of psoriasis and IBD, providing a more precise basis for syndrome differentiation and treatment in clinical practice.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 12-16.
Psoriasis, a chronic, recurrent, and inflammatory skin disease mediated by immune factors under a polygenic genetic background, has a long course, is prone to recurrence and difficult to heal. It not only causes physical discomfort to patients but also may be comorbid with psychosis disorders, severely affecting patients’ quality of life. This article briefly analyzes the etiology and pathogenesis of psoriasis comorbid with psychosis disorders. The dysfunction of the heart in governing the mind and blood vessels serves as the basis for comorbidity. Emotional factors such as long-term anxiety and depression, constitutional factors like heart deficiency or excessive heart fire, exogenous factors such as wind pathogen, dietary factors like overconsumption of spicy foods, and overwork and stay up late can all impact the function of the heart. The pathogenesis encompasses disorders of the heart meridian and disharmony of Qi and blood, dysfunction of the heart and viscera, imbalance of Yin and Yang of the heart, and accumulation of damp-heat and toxic pathogens in the heart meridian.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 17-20.
Atopic dermatitis (AD) is a common chronic inflammatory skin disease with complex pathogenesis, involving abnormal immune regulation, skin barrier dysfunction, and neuroimmune interaction. In recent years, with the in-depth AD research, the role of secreted frizzled-related protein 5 (SFRP5) and Wnt signaling pathway in AD has gradually attracted attention. This article reviews the research progress of SFRP5 and Wnt signaling pathway in AD, and discusses its possible pathogenesis and potential therapeutic targets.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 21-26.
Skin adverse reactions are the common adverse events of immune checkpoint inhibitors, while bullous pemphigoid is a rare type with an incidence of <1%. This article described an 81-year-old malnourished advanced gastric cancer patient who was treated with an immune checkpoint inhibitor combined with chemotherapy. The nutritional status was significantly improved, and the tumor achieved partial remission. However, refractory pruritus, rash and bullous lesions occurred during the course of treatment, and he was finally diagnosed with bullous pemphigoid caused by immune checkpoint inhibitors after multidisciplinary consultation. The balance between antitumor therapy and skin adverse reactions was achieved after treatment with multiple regimens. The skin lesions were well controlled, and the tumor continued to be stable after stopping immune checkpoint inhibitor therapy for one year.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 27-33.
Pruritus is a common dermatologic condition characterized by only itching without primary skin lesions. Pruritus is also the most common symptom of many dermatologic conditions, causing discomfort and leading to problems with sleep, mood, and social interaction. These issues can significantly impact the daily activities, mental health and overall quality of life. In clinical practice, the subjective nature of itching and the complexity of its etiology make it challenging for physicians to assess the severity of itch in patients. We summarize the common unidimensional and multidimensional pruritus assessment tools from the perspective of pruritus degree assessment, introduce the scales that can be used to evaluate the efficacy of pruritus patients, and describe their application methods, advantages and limitations, in order to provide reference for dermatology clinicians to select and apply these assessment tools.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 34-38.
Objective: To investigate the effects of subanesthetic dose of esketamine on postoperative fatigue (POF) in 120 patients undergoing thoracoscopic radical surgery for lung cancer. Methods: The patients were randomly divided into an esketamine group (group E) and a sufentanil group (group S) with 60 patients each. The primary indicator was the fatigue severity scale (FSS) score and the secondary indicator was the incidence of adverse events within postoperative 48 hours. Serum concentrations of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-8 were measured on the day 1 before surgery and the day 1 or 3 after surgery. Results: Compared with the group S, the FSS scores in the group E were significantly reduced on postoperative day 1, 3 and 7 (P<0.05); the incidence of POF was lower in the group E than the group S (15.0% vs. 38.3%, P<0.05). Serum concentrations of TNF-α, IL-6, and IL-8 on postoperative day 1 or 3 and the incidence of nausea and vomiting within postoperative 48 hours were significantly lower in the group E compared with the group S (P<0.05). Conclusion: Subanesthetic dose of esketamine can inhibit postoperative inflammatory response and alleviate POF in patients undergoing thoracoscopic radical surgery for lung cancer.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 39-41.
Chinese Medicine Master ZHANG Zhen, a renowned figure in traditional Chinese medicine (TCM), pioneered the “Two States and Three Three Configuration” theory for TCM syndromes. This article briefly introduces the “Two States and Three Three Configuration” theory and it is discussed in the form of clinical case analysis.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 42-46.
Cough and asthma is a common and frequent disease among elderly people in the community and it is also a refractory disease. When complicated by infection, the pathogenic factors can enter the interior, causing rapid transformation and easily leading to severe and critical conditions. Based on the traditional Chinese medicine (TCM) theory of “Treating Flaccidity through the Yang Ming Meridian” and taking into account the physiological characteristics of “Qi deficiency” in the elderly population, professor FANG Bangjiang has innovatively proposed the “Regulating Yang Ming” approach of internal and external therapy for treating elderly cough and asthma, which focuses on strengthening the spleen to treat the root cause, advocating for “treating the root even in critical situations” to eliminate the source of phlegm. This approach has yielded good clinical results and can provide new ideas and techniques for community-level traditional Chinese medicine treatment of elderly cough and asthma.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 47-50.
Objective: To investigate the clinical efficacy of Chaihu plus Longgu Muli decoction on sleep disorders (liver Qi stagnation turning into fire syndrome) after acute cerebral infarction (ACI) using polysomnography (PSG). Methods: A total of 92 patients with sleep disorders after ACI were randomly divided into a control group and an observation group with 46 cases each. The control group received conventional treatment, while the observation group was treated with Chaihu plus Longgu Muli decoction on the basis of the control group, with a treatment course of 4 weeks. The efficacy of the two groups was compared. Results: After treatment, the total effective rate and sleep efficiency were higher, and the insomnia severity index, Pittsburgh sleep quality index, micro-arousal index, and the times of awakenings were lower in the observation group than the control group. The total sleep time was longer and the sleep onset time was shorter in the observation group than the control group (P<0.05). There were no significant differences in adverse reactions between the two groups (P>0.05). Conclusion: Chaihu plus Longgu Muli decoction for the treatment of the patients can reduce the severity of insomnia, improve sleep quality, sleep efficiency, PSG indicators and therapeutic effects.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 51-53.
Objective: To explore the efficacy of modified bipolar radiofrequency ablation of atrial fibrillation combined with heart valve replacement in patients with rheumatic heart valve disease with atrial fibrillation. Methods: One hundred cases of the patients were randomly divided into a control group (n=50) and an observation group (n=50). Both groups underwent heart valve replacement, while the observation group was additionally treated with modified bipolar atrial fibrillation radiofrequency ablation. The improvement of the cardiac function, cardiac structure, and complications in the 2 groups were compared. Results: Compared with the control group, the observation group showed higher overall effective rate and LVEF and lower complication rate, and the post-treatment cardiac structural indexes of LVESD and LVEDD were lower than those of the control group (all P<0.05). Conclusion: The combined therapy has significant efficacy in treating these patients, can improve the cardiac structure of patients and reduce the risk of postoperative complications.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 54-58.
Objective: To evaluate the efficacy of low-frequency pharyngeal electrical stimulation combined with swallowing mirror visual feedback training in treating post-acute stroke dysphagia. Methods: Two hundred and forty cases of patients were enrolled and divided into an observation group (116 completed) and a control group (115 completed) based on a randomized controlled trial. The observation group received a combined therapy, while the control group underwent visual feedback training alone, and the treatment was lasted for 4 weeks. Outcomes included clinical efficacy, video fluoroscopy swallowing study (VFSS), functional oral intake scale (FOIS), dysphagia outcome and severity scale (DOSS) scores, surface electromyography parameters, serum biomarker levels (GFAP, EGR1), and complication rates. Results: The observation group showed higher total efficacy (94.83% vs 86.96%, P<0.05) and more significant improvement in VFSS, FOIS, DOSS scores and electromyographic amplitude, shorter swallowing duration, lower serum glial fibrillary acidic protein (GFAP) and early growth response factor 1 (EGR1) levels and complication rates (all P<0.05). Conclusion: The combined therapy demonstrates superior efficacy in improving swallowing function, enhancing swallowing-related muscle strength, and can promote the recovery of patients with post-acute stroke dysphagia.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 59-62.
The incidence of chronic pain in perineum area is high, with pain accompanied by various other symptoms as the main manifestation. The common clinical treatment methods are limited and their effects are poor, and patients suffer from physical and mental pain, which is a common clinical problem. Sacral nerve stimulation is a relatively new treatment method. With the widespread application and development in clinical practice, it has been gradually found to have good effects in treating chronic pain in the perineal area, bringing benefits to patients.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 63-66.
Objective: To explore the nephrotoxicity of tacrolimus in a perioperative patient with kidney transplantation to provide a reference for the clinically safe medication. Methods: The information about this patient was collected by the HIS system and then the association between acute kidney injury and excessive tacrolimus blood concentrations was evaluated. Results: The tacrolimus concentration at C0 on postoperative D3 reached 40.60 ng/mL and then tacrolimus was discontinued. The urine volume on postoperative D16 was reduced to 100 mL, the renal puncture showed diffuse tubular epithelial injury, and the urine volume returned to normal after symptomatic treatment with glutathione. The correlation between acute kidney injury and tacrolimus levels was assessed as probable. Conclusion: Acute injuries caused by high blood concentrations of tacrolimus are largely reversible early by a decrease of blood concentrations and symptomatic management.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 67-71.
This study summarizes proactive nursing strategies for a patient with relapsed/refractory diffuse large B-cell lymphoma (DLBCL, Ann Arbor stageⅣ) caused by TP53 mutation and multiple genetic abnormalities, who underwent autologous hematopoietic stem cell transplantation bridged with chimeric antigen receptor T-cell (CAR-T) therapy. Key interventions included multi-modal prevention of skin breakdown and pressure ulcers at the right upper limb mass site, pain management adhering to WHO analgesic ladder principles, personalized psychological support, strict infection control during neutropenic phase with continuous monitoring of cytokine release syndrome (CRS), and tailored neurotoxicity assessment for CAR-T therapy. The patient achieved clinical stabilization and was discharged 30 days post-transplantation, demonstrating significant reduction of the right upper limb mass with arm circumference nearly matching that of the left side.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 72-75.
This article begins by examining the differences in efficacy among various types of traditional Chinese herbal pieces, as well as the purposes of processing, based on the principle of “differing treatments for raw and processed herbs”. It analyzes the risk points in production control during their processing and offers insights and regulatory recommendations for improving production control.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 76-80.
Objective: To explore the construction and practice of a teaching mode with “clinical pharmacy consultation practice” as the core. Methods: Fifty pharmacy interns were divided into group A (n=18, receiving traditional pharmacy teaching mode) and group B (n=32, receiving the teaching mode with “clinical pharmacy consultation practice” as the core). Monthly pharmaceutical service practices per student, pharmaceutical service competency assessments and teaching satisfaction evaluations were compared between the two groups. Results: Under the teaching mode with “clinical pharmacy consultation practice” as the core, the number of pharmacy service practices per person per month and the excellent rate of pharmacy service ability per person were higher than those of the traditional teaching mode, and the teaching satisfaction was also higher. Conclusion: The teaching mode with “clinical pharmacy consultation practice” as the core is helpful to improve the pharmacy service ability of pharmacy interns.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 81-84.
Objective: To provide reference for the rational medication use in rare disease patients with Castleman disease. Methods: Clinical pharmacists participated in the formulation of treatment regimen and provided pharmaceutical care for a patient with severe idiopathic multicentric Castleman disease (iMCD). Results & Conclusion: The initial R-CHOP regimen had poor efficacy in this patient with severe iMCD. After treatment with siltuximab combined with high-dose glucocorticoids, the disease status was stable without obvious adverse drug reactions and drug-drug interactions. Clinical pharmacists can use their professional knowledge to escort the treatment of rare diseases.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 85-89.
Small interfering RNA (siRNA) is a new therapeutic method based on RNA interference (RNAi) technology that finally achieves the therapeutic effect by silencing the expression of disease-related genes, which has the characteristics of high therapeutic efficacy and strong specificity. Since the first siRNA drug was approved in 2018, it has become one of the most concerned small RNA drugs and is regarded as another new technological revolution in the pharmaceutical field. At present, siRNA drugs are in a period of rapid development, attracting many pharmaceutical companies to join the track. This review briefly summarizes the mechanism of action, advantage and challenges, key technological breakthroughs, research status and trends of siRNA drugs, hoping to provide references for relevant R&D personnel or project managers in pharmaceutical enterprises.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(2): 90-95.
Objective: To analyze the published papers on packaging materials in China based on CiteSpace software, and investigate their research status to provide a reference for future study of packaging materials. Methods: The relevant literature on packaging materials on CNKI was retrieved. The visual knowledge graphs of authors, institutions and keywords were drawn and analyzed using the software. Results: A total of 1 583 sample literature was retrieved and processed, and the overall number of publications showed a stable upward trend over the years. There were 363 authors and 338 institutions involved, with a maximum publication volume of 52 and 31 articles for institutions and core authors, respectively. Relevant packaging material regulatory units were the core force for publishing. The research hotspots were mainly focused on pharmaceutical packaging materials. In the future, research directions in this field would tend to focus more on antioxidants, vulcanizing agents, packaging systems, residues, medical devices, compatibility, integrity, rubber stoppers and so on, and the issuance of relevant regulations and guidelines would be the guidance of the research direction. Conclusion: This article can provide a reference for future research hotspots and directions.
