Individualized medicine is the cornerstone of precision medicine, while therapeutic drug monitoring is a crucial part of individualized medicine. According to the clinical needs, the Department of Pharmacy of our hospital relies on the therapeutic drug monitoring platform to carry out individualized medication practices and explorations around antimicrobials and immunosuppressants, so as to empower individualized drug therapy development of precision medicine, enhance the refined management of pharmaceutical services and strengthen the professional influence of the discipline.

The pharmacokinetic and pharmacodynamic processes in neonates differ markedly from those in adults, primarily due to underdeveloped organ systems. Additionally, substantial variability exists among individual neonates. Traditional methods for calculating drug dosages often inadequately account for these individual differences, leading to risks of treatment failure or adverse drug reactions. The widespread off-label use of medications in this population highlights the urgent need for personalized medication strategies. Model-informed precision dosing (MIPD) integrates mathematical models with individual physiological data to optimize dosing regimens, further refined through therapeutic drug monitoring for tailored treatment. MIPD shows significant promise in the administration of antibiotics, analgesics, and antiepileptic medications in neonates. However, challenges remain, including difficulties in clinical data acquisition and the limited accuracy of existing mathematical models.

Vitamin K₁ is a fat-soluble vitamin that is essential for the coagulation mechanism in neonates, especially in the process of hepatic synthesis of coagulation factors Ⅱ, Ⅶ, Ⅸ and Ⅹ. However, neonates are often at risk of bleeding disorders due to insufficient endogenous synthesis of vitamin K₁, so supplementation is generally recommended. On the other hand, the use of vitamin K₁ is not without risk, and its labeling mentions that adverse effects such as hyperbilirubinemia, jaundice and hemolytic anemia may occur in neonates. This article analyzes the adverse reactions and possible causes of its use in neonates, and evaluates the safety of vitamin K₁, so as to provide a basis for the safety of its clinical application in neonates.

Dispensing robot can automate intravenous drug dispensing tasks instead of humans, effectively improve the accuracy of drug dispensing, reduce occupational exposure and lower the mechanical repetitive labor intensity of dispensing personnel. However, the use of dispensing robot in China is still in the exploratory stage, the time for its clinical application is relatively short, and the technology is not fully mature. This article reviews the literature related to the application practice of drug dispensing robot, summarizes its application status and technical characteristics and proposes some suggestions for its improvement in view of its existing problems, so as to provide reference for the continuous improvement of the automatic intravenous drug dispensing ability. Medical institutions can choose different types of dispensing robots according to their needs and circumstances.

Objective: To investigate the dosage accuracy of the intravenous infusion with a dispensing robot in pharmacy intravenous admixture service (PIVAS) to ensure medication efficacy. Methods: Ceftriaxone sodium injection, a commonly used antimicrobial drug in clinic, was selected as the research subject, and the HPLC was used to analyze the compliance rate of drug concentration of finished infusion solutions prepared by dispensing robots compared to those prepared manually. Results: The qualified rate of the finished infusion prepared by the dispensing robot was 95.2% compared with that of the finished infusion prepared manually. Conclusion: Dispensing robot can replace the manual automatic completion of intravenous drug dispensing tasks, and ensure the dispensing accuracy and has the effect of improving the occupational protection and effectively reducing the personnel mechanical repetitive heavy labor intensity, which can be popularized and applied on a large scale in PIVAS in China.

Acute vision loss is a common emergency in ophthalmology. Prompt and accurate diagnosis and treatment are essential to restore or preserve vision. Abnormalities in any part of the visual pathway, from the refractive media to the occipital cortex, can cause vision loss. In this article, we present an emergency diagnostic and treatment plan for acute vision loss based on its etiology.

As a group of neurodegenerative disease with irreversibility and blindness, glaucoma is primarily evidenced by the deterioration of optic nerves and visual field impairments. With the continuous development of the aging population, the number of annual glaucoma patients in the world is increasing year by year and is expected to increase to 111.8 million by 2040. Minimally invasive glaucoma surgery (MIGS) has the advantages of light damage, few complications and good results. This article reviews the research progress in MIGS at home and abroad in recent years.

The human body and the gut microbiota are mutually beneficial and symbiotic under normal conditions. The gut microbiota has been proven to be associated with various diseases, and the liver, as a neighboring organ, is closely related to the gut both anatomically and functionally. Numerous studies have shown that the composition of gut microbiota undergoes significant changes when suffering from liver disease and the changes can significantly affect the development of liver diseases. This review summarizes the changes in gut microbiota and its metabolites under different liver disease states and their impact on the occurrence and development of liver disease to help colleagues deeply understand the relationship between the changes in gut microbiota and the development of liver disease, and then jointly explore new strategies for the prevention and treatment of liver disease based on gut microbiota.

The gut microbiota-host metabolic axis is defined as a group of high-speed multi-disciplinary, interactive chemical signal pathways that link a specific host cell pathway to a series of gut microbiome species, subecosystems and metabolic activities. Many diseases are related to intestinal microbiota disorders (alterations of the composition or functions of the intestinal microbiota). The present article focus on the gut flora dysfunction classification, the causes and consequences of the dysfunction of intestinal metabolites, as well as their roles in the molecular etiology of various intestinal diseases. Meanwhile, novel diagnostic and therapeutic approaches targeting microbiota and its metabolites are also discussed.

Hydrogen sulfide is a trace gas signaling molecule that is metabolized in the gut by intestinal epithelial cells or intestinal microbiota using cysteine as its substrate. More and more studies have confirmed that patients with colorectal cancer are accompanied by gut flora disturbance and an increase in the level of hydrogen sulfide synthesis in the body. The pathway of hydrogen sulfide production and its physiological and pathological effects in colorectal cancer were reviewed in the present paper. The value of exhaled hydrogen sulfide in screening and early prediction of colorectal cancer as a novel target was also discussed.

In recent years, postbiotics, a new concept related to probiotics, has been used to describe some certain inactivated microorganisms or sterile extracts, which may provide host health benefits through distinct biological activities from those of probiotics. A series of studies have shown that some postbiotics have anti-inflammatory, immunomodulatory, antioxidant and antibacterial activities, which have been used in the adjuvant treatment of metabolic syndrome, anxiety, depression, and even corona virus disease 2019, although their mechanisms and the signaling pathways involved have not been fully elucidated. With the deepening of the research and development of postbiotics, it is expected to be widely used in the healthy food industry and medical health care field in the future.

In the context of the Healthy China Initiative, early diagnosis and early treatment of diseases are new goals and requirements for health management. This article analyzes the key issues of early disease screening in China, such as small disease coverage and low population coverage and finds that the disease selection method of China’s disease screening projects is not yet perfect, and there is still a lack of connection in fund payment. Accordingly, it is suggested that the disease screening scheme can be optimized from the aspects of disease screening criteria and screening process and meanwhile, the basic medical insurance fund and public health service fund can adopt the “secondary classification method” to implement different payment strategies for different types of diseases, strengthen the payment connection and provide financial support for early disease screening.

At present, the national level has clearly proposed to “Coordinate the use of national basic medical insurance and public health funds, and realize the effective connection between public health services and medical services”, which is of great significance for improving the treatment rate and control rate of chronic diseases in China and promoting social stability. Focusing on the treatment and protection of important chronic diseases in China, we summarize the current three mainstream collaborative protection modes, clarifies the characteristics of collaborative protection diseases and the commonalities between the protection modes, and raise targeted questions, and suggest that the selection criteria of diseases should be clarified at the national level and a catalogue of core diseases should be formed to coordinate the protection of diseases. At the same time, the pressure on public health expenditure should be reduced by flexibly adjusting the reimbursement ratio of basic medical insurance and establishing a long-term financing mechanism.

Cardiovascular disease is one of the leading causes of death worldwide. The comprehensive rehabilitation intervention for patients with heart disease is a major clinical challenge. Traditional Chinese medicine has unique advantages in the rehabilitation of this disease, but currently there is no integrated rehabilitation plan for heart disease in China. The Muscle and Skeleton Integrated Traditional Chinese and Western Medicine Rehabilitation Professional Committee of the Shanghai Rehabilitation Medicine Association has organized experts in relevant fields to combine relevant clinical guidelines in recent years and developed “Guidelines for Integrated the Traditional Chinese and Western Medicine Rehabilitation of Heart Diseases” after repeated discussions with experts in related fields, aiming to guide and standardize the practice of integrated traditional Chinese and Western medicine rehabilitation of heart diseases.

Psychiatric clinical pharmacist training is pre-job professional training. The Pharmacy Management Committee of the Chinese Hospital Association has established requirements for training bases and teachers. Psychiatric clinical pharmacist training theoretical courses and practical skills training have their own characteristics. As a training base for psychiatric clinical pharmacists, Shanghai Mental Health Center has established an information-based clinical pharmacy work and teaching path based on the requirements of the training syllabus to enable trainees to master pharmaceutical service methods as soon as possible while learning theories and skills, improve clinical thinking ability, and become a qualified psychiatric clinical pharmacist. Driven by the reform of the three-medicine linkage, the work of psychiatric clinical pharmacists will be increasingly recognized and valued by hospitals and society.

Objective: To explore the application effect of in situ simulation teaching method in standardized training of psychiatric resident physicians. Methods: One hundred and forty-seven resident trainees from Shanghai Mental Health Center were selected as the research subjects, with 46 resident trainees in the first year. In situ simulation projects included inquiring about medical history and oral shift handover. In the second year, there were 51 resident trainees, and the in situ simulation projects included negotiation, informed consent, and conveying bad news. In the third year, there are 50 resident trainees, and the in situ simulation project is to inform of medical errors and end-of-life conversations. Using the entrustable professional activities evaluation method to assess the competency of resident training physicians, the entrustable professional activities evaluation scores were recorded and compared before and after in situ simulation teaching. Results: The score after in situ simulation teaching was significantly higher than before, and there was a significant difference in the excellent rate (P<0.05). Conclusion: The use of in situ simulation teaching method can enhance the job competence of psychiatric resident physicians and can be applied to standardized training of psychiatric resident physicians.

OBJECTIVE: To explore the application effect of hierarchical and progressive teaching mode in the standardized training of psychiatric resident physicians. Methods: Through the hierarchical training of teaching objectives, content, process and examination, the effect of the hierarchical and progressive training was evaluated through the examination of licensed doctors and the outbound examination of resident physicians. Results: The passing rate of the medical practitioner exam and the final exam of the standardized training of psychiatric resident physicians in the progressive teaching group was higher than that in the traditional teaching group, and there was a significant difference in the passing rate of the medical practitioner examination (P<0.05). Conclusion: The hierarchical and progressive teaching mode is beneficial to the standardized training of psychiatric resident physicians and can improve the quality of residential training, which is worthy of further popularization and research.

The Chinese government thoroughly launched the program of standardized training for resident physicians in 2014, which has been lasted for more than ten years. This article systematically reviews the practice of psychiatric residency training in the Shanghai Mental Health Center in past ten years, summarizes the experience of management and analyzes the current challenges faced.

Drug abuse can cause a range of psychotic and psychological problems and is a serious social hazard. China and most countries in the world exercise strict control over narcotic drugs and other psychoactive drugs. However, it is difficult to establish timely legal control over some psychoactive drugs and chemical variants of controlled substances, which has led to the emergence of new psychoactive substance abuse. It caused great harm, especially to the youth population. This review provides an overview of the types and characteristics of new psychoactive substance abuse among adolescents and young people in China in recent years and recommends basic principles for intervention.

Following the announcement by China of the adoption of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) on “Continuous manufacturing of drug substances and drug products. Q13”, the implementation of this guidance has become a widespread concern in the pharmaceutical industry. The residence time distribution (RTD) and its mode serve as crucial tools outlined in the guidance designed for facilitating material traceability and support diversion strategies in continuous manufacturing. This article begins by introducing the concepts of residence time, RTD and its mode and then details the draft process of this guidance. The relevant sections on RTD are also summarized, aiming to enhance comprehension of the guidance and their associated requirements and thereby to aid in the successful implementation of continuous manufacturing technology in China.

Stem cells refer to a class of cells with self-renewal and multi-directional differentiation potential, which have broad application prospects in the field of regenerative medicine. In 2018, Stemirac was conditionally approved as an autologous bone marrow mesenchymal stem cell therapy product in Japan. This article introduces the regulatory system and approval standards for mesenchymal stem cell products in Japan, analyzes and studies the review report of Stemirac, aiming to provide ideas and reference for the research and development, clinical trials and evaluation of mesenchymal stem cell products in China.

With the development of nuclear medicine, nuclear technology and molecular biology, radioligand therapy has become an important development direction of precision medicine. In China, radioligand therapy drugs are usually called radionuclide drug conjugates (RDC). These drugs deliver radionuclides to specific tumor sites by coupling targeted ligand molecules to realize different functions of diagnosis or treatment. This article analyzes the research progress of RDC and the issues faced at the level of technical evaluation, and puts forward relevant reflections and research paths, aiming to provide reference for China's drug regulatory authorities to formulate corresponding policies and measures.

Sponsor, drug clinical trial institution, regulation are all important for the quality management (QM) of drug clinical trials. Sponsor is ultimately responsible for the quality of drug clinical trial. Drug clinical trial institution is responsible for the operation management of drug clinical trial. Regulation is responsible for the supervision of drug clinical trials. Meanwhile, sponsor and drug clinical trial institution are also important evaluated objects for their QM. At present, the development of scientific methods for QM evaluation of drug clinical trial is attracting increasing interests. However, at present, the studies mainly focus on evaluating hardware construction levels other than managing abilities, partially due to the complexity of drug clinical trials. In this study, existing QM theories were summarized, the existing strategies were reviewed, and the evaluating challenges for QM were discussed. In the view of evidence-based decision-making, potential evaluation strategies were discussed based on the concept of quality management system in drug related fields.

The taste of drugs can significantly affect the clinical application effect. The traditional evaluation methods for the taste of drugs include human mouth test, animal preference test, and in vitro analysis methods such as in vitro dissolution test. A new tool for drug taste evaluation, electronic tongue, was introduced in this paper. Electronic tongue is an in vitro bionics technology, which can output the taste of drugs with the overall taste information of samples. It has good objectivity and fast detection speed, and can avoid the potential safety risks and subjective factors in human mouth test. This paper introduces the development of electronic tongue and its application in drug taste evaluation, and puts forward some suggestions for further application and development of electronic tongue.

Objective: To evaluate the anti-inflammatory effects of Zigui lip balm both in vitro and in vivo. Methods: The model of inflammation was established using lipopolysaccharide-induced RAW 264.7 cells to detect the impact of Zigui alcohol extract on nitric oxide production. The model of atopic dermatitis-like mice induced by capsaicin was established to study the effects of Zigui lip balm on ear skin thickness, severity of ear skin inflammation, histopathology, and safety. Results: Zigui alcohol extract at 25-200 μg/mL could significantly promote the growth of RAW 264.7 cells and reduce nitric oxide levels. Meanwhile, Zigui lip balm could also significantly reduce ear thickness, eczema area and severity index (EASI) scores, inflammatory cell infiltration and decrease epidermal thickening and improve inflammation of the atopic dermatitis-like mice ear skin and in addition, Zigui lip balm had no effect on the liver, spleen, and kidneys of mice with capsaicin-induced atopic dermatitis. Conclusion: Zigui lip balm exhibits significant anti-inflammatory effects and is safe for use.

Objective: To explore the effects of Qudou formulae (QF) extract on the epidermal barrier repair, anti-inflammatory, sebum control and antibacterial function. Methods: The epidermal barrier repair, anti-inflammatory, sebum control and antibacterial effects of QF extract were evaluated by detecting its effects on sodium dodecyl sulfate (SDS)-induced proliferation of HaCaT cell damage model, lipopolysaccharide (LPS)-induced nitric oxide (NO) production in RAW 264.7 cells, proliferation of SZ95 cells and neutral lipid synthesis, and inhibition of Staphylococcus aureus (S. aureus) and Propionibacterium acnes (P. acnes). Results: QF extract could improve the survival rate of SDS-induced HaCaT cells, inhibit the secretion of NO from LPS-treated RAW 264.7 cells, promote the growth of SZ95 cells and inhibit its neutral lipid synthesis, and had the inhibitory activity against S. aureus and P. acnes. Conclusion: QF extract has significant epidermal barrier repair, anti-inflammatory, oil control and antibacterial effects, and is expected to become a new raw material for Chinese medicine acne skin care products.

Objective: To explore the effects of lyophilized essence of compound traditional Chinese medicine extracts on scalp tissue aging. Methods: Normal human scalp tissues cultured in vitro were selected as the experimental subjects, which were divided into a control group and an extracts essence treatment group. The tissues were cultured in William's complete medium, and the effects of the extracts essence on the key proteins associated with scalp aging were evaluated by enzyme-linked immunosorbent assay and immunofluorescence detection. Results: In scalp tissues cultured in vitro, the extracts essence could significantly reduce the expression level of interleukin 6 to below 1% of the baseline at the concentrations of x/5, x/3, and x/2. In addition, the extracts essence could decrease the expression levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) by 25%, versican by 48% and myelin protein zero-like 3 (MPZL3) by 19% at a concentration of x/10 (all P<0.01), and the expression of 8-OHdG by 24%, versican by 24% and MPZL3 by 33% at a concentration of x/5 (all P<0.01), respectively. Conclusion: The lyophilized essence of compound Chinese medicine extracts has anti-inflammatory, antioxidant and anti-aging effects on human scalp tissues cultured in vitro and a value of further clinical research.

Objective: To comprehensively evaluate the soothing effects of a novel efficacy complex (referred to as “Penta-Ring essence”) on the skin of individuals with oily sensitivity. Methods: An in vivo experimental approach with 34 healthy female subjects aged 18-60 years with oily skin from the Shanghai area was employed. The soothing effect of a long-term use of Penta-Ring essence on oily and sensitive skin was evaluated by a method of autologous before-and-after control. Results: A number of physiological indicators of the skin were significantly improved after the Penta-Ring essence was continuously used for 4 weeks, including 13.29% increase in the water content of the stratum corneum, 11.72% decrease transepidermal water loss, 1.91% decrease in skin temperature, 21.21% decrease in skin sebum, 7.70% decrease in skin E value, 4.54% decrease in M value, 5.84% decrease in skin chroma a^* value, 5.68% increase in skin chroma L^* value and 58.16% decrease in the score after 2.5 min lactate irritation (all P<0.01). Conclusion: For oily and sensitive skin, the Penta-Ring essence can effectively increase skin hydration, reduce oil secretion and pigmentation, relieve inflammation, brighten skin tone with minimal irritation and significantly improve skin barrier function, which demonstrate its efficacy in skin soothing and repair.

Objective: To compare the extraction process of highland barley seeds to maximize their antioxidant activities. Methods: Three methods, namely, biofermentation, aqueous extraction and alcohol extraction, were used to comparatively analyze the extraction efficiency of β-glucan and total phenols from barley seed grain extract. The antioxidant capacity of the three barley seed extracts was detected by ferric reducing antioxidant power (FRAP), 2,2'-binamine-di-3-ethylbenzothiazolin-6-sulfonic acid (ABTS) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay. Meanwhile, the identification of metabolite from the extracts was performed using high performance liquid chromatography with tandem mass spectrometry (LC-MS/MS). Results: The alcoholic extraction method showed optimal extraction, yielding 2.03 µg/mL β-glucan and 8.88 µg/mL gallic acid equivalent of total phenols, and the strongest antioxidant activity in all the three antioxidant activity assays, FRAP, ABTS, and DPPH. Twenty-five compounds were screened out by metabolite analysis, 23 of which possessed antioxidant properties. Conclusion: This study reveals the metabolic composition of highland barley seed extract and its antioxidant activity, which provides a scientific basis for an in-depth understanding of the nutritional properties of barley and its potential health benefits, as well as theoretical support for the application of barley in the development of pharmaceuticals and nutraceuticals.

In recent years, with the continuous advancement of technology and the increasing focus on health and beauty, the cosmetics industry has been facing new challenges and opportunities. One of them is how to better penetrate the effective components of cosmetics into the skin to maximize their effectiveness. Deuterium-depleted water may be an effective transdermal agent and has now attracted widespread attention. This study examines the solubility, permeability of deuterium-depleted water, and its potential application as a new transdermal strategy in cosmetics.

The penetration of active ingredients in cosmetics through the skin barrier is a hot topic in the cosmetics industry. Microneedle technology creates microchannels on the skin surface using tiny needles, which can facilitate the penetration of active ingredients from cosmetics into the deeper layers of the skin, bringing innovation to traditional skincare methods. This article reviews the pathways of transdermal absorption and methods to enhance transdermal absorption, as well as the research progress of microneedle technology in transdermal absorption of cosmetics. The development prospects and challenges of microneedle technology in the cosmetics industry are discussed so as to provide references for future research and development.

Objective: To observe the characteristics of basement membrane barrier damage caused by UVB irradiation in cell models and isolated skin tissues. Methods: HaCaT cells were irradiated with 40 mJ/cm² UVB, and the expression characteristics of basement membrane barrier-related genes were analyzed by RNA-seq data. In addition, transmission electron microscopy and immunofluorescence staining were used to observe the changes of basement membrane structure and key barrier protein content in three groups of isolated skin tissues after continuous irradiation with 50 mJ/cm² UVB for 3 days. Results: Eighteen genes related to basement membrane were found, of which the expression of 17 genes were down-regulated. The expression levels of COL4A4, COL4A5, COL4A6, ITGB1, ITGA3, ITGA4, ITGA6 and LAMA5 was down-regulated by more than 1.5 times (P<0.05), while the expression level of HPSE was up-regulated by 2.4 times (P<0.000 1). In the in vitro skin tissue experiment, the transparent layer and dense layer of the basement membrane were observed to be broken after UVB irradiation, the hemidesmosomes were destroyed and their integrity and continuity were damaged, and the integrin protein content was decreased (P<0.05). Conclusion: UVB irradiation can down-regulate the expression of genes related to the structure of the basement membrane barrier, up-regulate the expression of heparanase gene, cause the disorder of the basement membrane structure and the degradation of the key barrier protein of the basement membrane, and damage the basement membrane.

Objective: To establish new indicators representing skin aging phenotypes using non-invasive measurement techniques to extract facial skin physicochemical parameters in a Chinese population. Methods: A total of 100 healthy subjects with different age were recruited and skin parameters such as moisture content and so on were measured by non-invasive skin testing instruments. Subsequently, principal component analysis (PCA) and generalized linear model (GLM) analyses were performed. Results: Correlation analysis showed that collagen density was significantly negatively correlated with age (r=−0.31, P<0.01). Parameters such as the elasticity index R5 at the corner of the eyes (r=−0.612, P<0.000 1) significantly decreased with the increase of age. The skin aging index (SAI) established by the GLM showed a more significant relationship with age (r=0.699, P<0.000 1). Conclusion: Facial skin aging is primarily characterized by collagen loss, reduced elasticity, and changes in skin pigmentation. SAI established using non-invasive measurement parameters and GLM can be used to characterize the complex aging of facial skin.