The detection rate of macrolide resistant mycoplasmapneumoniae （MRMP） in China remains high， leading to a marked increase in refractory mycoplasma pneumoniae pneumonia （RMPP）. The clinical management of RMPP faces dual challenges of selecting alternative antimicrobial agents and implementing immunomodulation. Among alternative agents， tetracyclines are the preferred choice for children over 8 years old and are effective against drug-resistant strains. However， potential risks such as tooth discoloration associated with short-term use require careful consideration and should be weighed against benefits. Fluoroquinolones are another option， but concerns about joint toxicity in children limit their use. Immunomodulatory therapy is crucial， with serum biomarkers guided glucocorticoids as the core approach， and intravenous immunoglobulin is appropriate for specific severe cases or complications. Current controversies include whether resistance increases disease severity， the safety of using alternative antimicrobials in younger children， and the standardization of immunomodulatory regimens. Future efforts should focus on achieving breakthroughs in rapid diagnosis resistance prevention and control， new drug development， and targeted therapies to achieve precise， stratified management.

Multiple myeloma （MM）， a prevalent hematological malignancy， has witnessed transformative therapeutic advancements from traditional chemotherapeutic agents to targeted therapies including proteasome inhibitors （PIs）， immunomodulatory drugs （IMiDs）， monoclonal antibodies， and emerging cellular therapies such as chimeric antigen receptor （CAR） T-cell therapy and bispecific antibodies in recent years. This paradigm shift has significantly improved patient outcomes and survival rates. However， MM remains an incurable disease， with drug resistance and disease relapse constituting major clinical challenges. This review systematically examines the molecular targets and resistance mechanisms of current therapeutic agents， providing a theoretical basis for how to optimize treatment efficacy through rational drug combinations， development of novel targeted therapies， and implementation of personalized treatment approaches.

Trace elements play a significant role in human physiological processes， their deficiency or imbalance in proportion can lead to various diseases. As a parenteral nutrition additive， multi-trace element injection can supplement the trace elements required by the human body and prevent and treat related diseases. At present， there are four domestic varieties of multi-trace element injections on the market in China， which are widely used in the clinical treatment of various diseases. However， problems exist in aspects such as quality control， clinical research， and drug label management. This article provides a review of the composition， mechanism of action， domestic and international market availability， clinical application， domestic regulatory issues， and future development trend.

Iron deficiency （ID） is common among cancer patients and may impair immune surveillance and alter the tumor microenvironment， thereby exacerbating tumor progression and recurrence. To counteract this pathological process and correct the resulting anemia， iron supplementation plays a significant role in improving both ID and iron deficiency anemia （IDA）. This review summarizes the epidemiological characteristics and etiological mechanisms of ID and IDA in cancer patients， as well as the impact of ID on immune surveillance and the tumor microenvironment. It also discusses the influence of ID on tumor development and prognosis， and reviews the current status and advances in iron therapy for cancer patients with ID.

Revumenib， a highly selective menin inhibitor， was approved by the U.S. Food and Drug Administration （FDA） on November 15， 2024， for the treatment of patients aged ≥1 year with acute leukemia harboring KMT2A gene translocation. This approval makes revumenib the first targeted therapy specifically indicated for this patient population. The present review summarizes revumenib's mechanism of action， pharmacokinetic characteristics， clinical efficacy， and safety， with the aim of providing references for its rational application in clinical practice.

Objective To investigate the effects of Jinlida granules combined with mecobalamin on nerve conduction velocity in patients with diabetic peripheral neuropathy （DPN）. Methods A total of 120 DPN patients were enrolled and randomly assigned to a control group （n=60） or an observation group （n=60）. Both groups received standardized blood glucose management as the foundational therapy. The control group received mecobalamin alone， while the observation group received mecobalamin plus Jinlida granules for 12 weeks. The primary endpoint was the between-group difference in the change from baseline in motor nerve conduction velocity （MCV） of the common peroneal nerve after 12 weeks of treatment. Secondary endpoints included changes in sensory conduction velocity （SCV） of the common peroneal nerve， MCV and SCV of the median nerve， blood glucose levels， Toronto Clinical Scoring System （TCSS） score， oxidative stress markers， inflammatory cytokine levels， and the incidence of adverse events. Results After treatment， compared with the control group， the observation group showed significantly greater improvements in nerve conduction velocities： common peroneal nerve MCV （44.32±0.17） m/s and SCV （45.85±0.17） m/s， and median nerve MCV （54.68±0.18） m/s and SCV （51.65±0.19） m/s were all significantly increased （all P<0.0125， corrected by the Bonferroni method）. The TCSS score was significantly lower in the observation group （6.85±0.86）. Serum inflammatory factors ［CRP （7.23±4.09） mg/L， IL-6 （21.44±5.70） pg/ml， and TNF-α （28.43±5.47） pg/ml］ and the oxidative stress marker malondialdehyde （MDA） （2.73±1.45） µmol/L were significantly decreased， whereas superoxide dismutase （SOD） activity （78.02±6.56） U/ml was significantly increased （after FDR correction for the aforementioned indicators， Q=0.002）. However， the between-group differences in HbA1c， Fasting Blood Glucose （FBG）， and 2-hour Postprandial Blood Glucose （2hPG） were not statistically significant after multiple comparison corrections （all P>0.05）. Conclusion Jinlida granules combined with mecobalamin can increase nerve conduction velocity， alleviate clinical symptoms， reduce inflammatory cytokine levels， and improve the oxidative stress response in DPN patients.

Objective To investigate the relationship between neutrophil to lymphocyte ratio （NLR） and all-cause mortality in aspirin users. Methods People answered the questionnaire “whether taking aspirin for prevention of cardiovascular disease” was extracted from the National Health and Nutrition Examination Survey （NHANES） database in the United States. The all-cause mortality information of this population was obtained from the National Center for Health Statistics. The relationship between NLR and all-cause mortality was studied using Cox regression analysis. Results A total of 3498 participants were included in this study， including 1906 men and 1592 women. Among the participants with lower NLR values， 1583 were still alive at the end of the follow-up period， while 160 died. Among those with higher NLR values， 1436 were still alive， with 319 died. The cox regression analysis showed a significant correlation between NLR and all-cause mortality （HR=1.10， 95%CI：1.06-1.15） after adjusting for multiple risk factors. Further dividing NLR into quartiles， we found that compared with participants with lower NLR values， a higher NLR was significantly associated with an increased risk of all-cause mortality （HR=1.44，95%CI：1.09-1.89）. Conclusion In the population taking aspirin for prevention of cardiovascular diseases， a higher NLR is closely related to all-cause mortality.

Objective To conduct a clinical comprehensive evaluation of cephalosporins， with a focus on cefditoren pivoxil， for the treatment of infectious diseases in children. Methods Domestic and international guidelines/consensus documents were reviewed， and literature and relevant data were retrieved and analyzed to comprehensively assess six dimensions： effectiveness， safety， economy， appropriateness， accessibility， and innovativeness. Results A total of 34 studies were included. The evaluation results showed that cefditoren pivoxil had comparable clinical efficacy to other third-generation oral cephalosporins in treating bacterial infections， but a lower bacterial eradication rate than cefpodoxime proxetil. The overall incidence of adverse drug reactions （ADRs） and neurological ADRs associated with cefditoren pivoxil showed no significant difference compared with other third-generation oral cephalosporins， while the incidence of gastrointestinal ADRs was significantly higher than cefpodoxime proxetil （12.5% vs. 5.4% P=0.001）. Cefditoren pivoxil did not demonstrate economic advantages over other third-generation cephalosporins. Cefditoren pivoxil granules are a pediatric-specific preparation， with indications similar to cefixime and cefdinir for children over 1 month old， whereas cefpodoxime proxetil is indicated for children over 5 months. Cefditoren pivoxil has lower institutional coverage than other third-generation oral cephalosporins. The cost of a single course of third-generation oral cephalosporins accounts for 0.09% to 1.19% of annual household disposable income， indicating affordability. Cefditoren pivoxil granules， as an originator drug， and cefdinir each possesses one conversion patent. Conclusion Current evidence indicates that cefditoren pivoxil granules are comparable to commonly used third-generation oral cephalosporins in terms of efficacy and safety. Although they do not have advantages in economic value or accessibility， they are pediatric-specific and therefore show advantages in appropriateness and innovativeness.

Objective To understand the current situation of children's concern for drug instructions in our country and analyze the factors affecting the concerns， so as to provide a scientific basis for promoting the safety of children's medication. Method From October 2023 to March 2024， a cross-sectional study was conducted using the questionnaire Survey on Medication Literacy of Children aged 8-18 in 30 provinces were surveyed using stratified sampling and quota sampling. Results A total of 4431 valid questionnaires were collected. Logistic regression analysis revealed that the behavior of reading drug package inserts among the respondents was associated with the child's gender （OR=1.139，95%CI：1.008-1.287，P<0.05）， educational level （OR=1.445，95%CI：1.057-1.976，P<0.05）， maternal educational level （OR=0.657，95%CI：0.445-0.968，P<0.05）， frequency of outpatient visits （OR=0.750，95%CI：0.635-0.901，P<0.05）， family residence in the last three months （OR=0.840，95%CI：0.718-0.982，P<0.05）， whether cohabitants had long-term medication use （OR=0.843，95%CI：0.726-0.978，P<0.05）， and monthly household income per capita （monthly income≤3000 yuan： OR=1.244， 95%CI： 1.061-1.459， P<0.05； monthly income 3001-6000 yuan： OR=1.266，95%CI： 1.060-1.512，P<0.05）. Conclusion This study indicates that the concern of drug instructions by children aged 8-18 in China is closely related to the child's gender， educational level， maternal education， number of hospital visits， family location in the last 3 months， long-term medication use of co-residents， and per capita monthly household income level. There is a need for government and relevant departments to establish and promote children's medication instructions guidance strategies according to relevant factors， so as to strengthen safe medication guidance and improve children's medication safety.

Objective To analyze the utilization of antiepileptic drugs among adolescents in 70 hospitals across 6 cities （Beijing， Chengdu， Guangzhou， Hangzhou， Shanghai and Zhengzhou） in China from 2016 to 2022， and to provide references for clinical medication practice. Methods Prescription data of epileptic patients from the Chinese Pharmaceutical Association Prescription Analysis Project were randomly selected. Statistical analysis were performed on the number of adolescent patients， drug costs， variety of drugs， defined daily doses （DDDs）， defined daily dose cost （DDDc）， and the ratio of drug consumption expenditure ranking （B） to DDDs ranking （A）. Results A total of 54 689 prescriptions for adolescent epilepsy patients were included， with more males than female patients. The number of adolescent patient visits showed a year-on-year decreasing trend. Oxcarbazepine and levetiracetam ranked the highest in DDDs. The average DDDc of oxcarbazepine， carbamazepine， and levetiracetam over the 7 years showed little difference. From 2020 to 2022， the usage frequency of lacosamide and zonisamide increased significantly， and the usage frequency of perampanel in 2022 increased by 169.67% compared to 2021. Conclusion From 2016 to 2022， conventional antiepileptic drugs for adolescents in the 6 cities conform to recommended guidelines； however， rational use of certain antiepileptic drugs in adolescents still requires attention.

Objective To characterize the adverse drug reactions （ADRs） and identify the risk factors associated with estradiol/estradiol-dydrogesterone used for endometrial regeneration after transcervical adhesiolysis. Methods A retrospective analysis was conducted on patients who underwent transcervical adhesiolysis at the First People’s Hospital of Yuhang District， Hangzhou City， Zhejiang Province， between 2021 and 2024 and who subsequently received estradiol/estradiol-dydrogesterone for endometrial repair and experienced ADRs. General clinical data， medication use， ADR profiles， and patient outcomes were collected； the occurrence patterns of mastalgia， dysmenorrhea， irregular vaginal bleeding， headache/migraine， and gastrointestinal discomfort were analyzed. Multivariable logistic regression was employed to identify factors influencing ADR development. Results After excluding ineligible cases， 317 patients were enrolled； 209 （65.93%） experienced two or more ADRs， with a total of 548 ADR occurrences. Mastalgia was the most frequent event （231 cases， 72.87%）， followed by dysmenorrhea， irregular vaginal bleeding， headache/migraine， and gastrointestinal discomfort. Most ADRs were grade 1-2 in severity； no grade 5 ADRs occurred， and most resolved favorably. Multivariate logistic regression showed that the dose of estradiol/estradiol-dydrogesterone was an independent risk factor for mastalgia （OR=3.243， 95%CI：1.660-6.334）， dysmenorrhea （OR=2.435， 95%CI：1.457-4.068）， irregular vaginal bleeding （OR=1.906， 95%CI：1.047-3.470）， and headache/migraine （OR=6.583， 95%CI：2.750-15.760） （all P<0.05）. Concomitant use of other medications was an independent risk factor for irregular vaginal bleeding （OR=2.698， 95%CI：1.424-5.112） and gastrointestinal discomfort （OR=3.244， 95%CI：1.282-8.204） （all P<0.05）. Conclusion Following transcervical adhesiolysis， ADRs related to estradiol/estradiol-dydrogesterone for endometrial regeneration predominantly involve the reproductive system and the breast； most are grade 1-2 in severity and resolve satisfactorily. The dose of estradiol/estradiol-dydrogesterone and concomitant medication are the principal factors influencing ADR occurrence.

Objective To systematically evaluate the incidence of adverse reactions associated with finerenone in the treatment of diabetic nephropathy， providing evidence-based support for its clinical application and risk management strategies. Methods PubMed， Web of Science， The Cochrane Library， Embase， CNKI， Wanfang Data base， VIP.com， and Chinese Biomedical Literature Database were searched for studies on finerenone for the treatment of diabetic nephropathy from database inception to January 2025. The quality of the included studies was assessed with reference to the methodological evaluation criteria for non-randomized controlled trials， and RevMan5.4 software was used to conduct statistical analyses of the primary outcome measures ［total drug-related adverse reactions， serious adverse reactions， estimated glomerular filtration rate （eGFR） decline ≥40%， and hyperkalemia］ and secondary outcome measures （trial discontinuation due to adverse reactions， trial discontinuation due to serious adverse reactions， acute kidney injury， nasopharyngitis， diarrhea， urinary tract infection， constipation， dizziness， and arthralgia）. Results A total of 8 clinical trials involving 10 704 patients were included. The overall incidence of adverse reactions was 18% （95%CI： 10%-26%）： 9% （95%CI： -0.06%-24%） for treatment duration <3 months， 22% （95%CI： 19%-25%） for 3-12 months， and 20% （95%CI： 15%-26%） for >12 months. The incidence of serious adverse reactions was 10.7% （95%CI： 5.6%-19.3%）： 4.7% （95%CI： 1%-17.3%） for <3 months，4.7% （95%CI： 3.8%-6.5%） for 3-12 months， and 24.2% （95%CI： 13%-40.8%） for >12 months. The incidence of eGFR decline ≥40% was 7.4% （95%CI： 4.7%-13.7%）： 2% （95%CI： 1%-3%） for <3 months， 4.7% （95%CI： 1%-32.8%） for 3-12 months， and 12.2% （95%CI： 6.5%-21.8%） for >12 months. The incidence of hyperkalemia was 5.6% （95%CI： 2.9%-9.1%）： 3.8% （95%CI： 2%-10.7%） for <3 months， 4.7% （95%CI： 2.9%-6.5%） for 3-12 months， and 7.4% （95%CI： 3.8%-15.9%） for >12 months. The incidence of secondary outcomes was <10%. Conclusion Finerenone demonstrates a favorable safety profile； however， the relatively high incidence of eGFR decline ≥40% and hyperkalemia with treatment durations exceeding 12 months remains a potential risk.

Objective To explore the risk of allergic reactions induced by methylprednisolone based on the FDA Adverse Event Reporting System （FAERS） database， so as to provide a reference for clinical medication safety. Methods Adverse drug reaction （ADR） reports related to methylprednisolone-induced allergy， with methylprednisolone as the primary suspected drug， were retrieved from the FAERS database （2004—2024）. The reporting odds ratio （ROR） method was employed for risk signal mining， and a descriptive analysis of the identified adverse events was conducted. Results A total of 2752 reports of methylprednisolone-related allergic reactions were included， with a predominance of female patients （59.23%） and a high proportion of individuals aged 18-64 （50.55%）. The main manifestations of methylprednisolone-related allergies included dyspnea， pruritus， rash， erythema， and urticaria. The narrow ROR was 7.01 （95%CI： 6.38-7.71）， and the broad ROR was 1.73 （95%CI： 1.65-1.81）. Compared with oral administration， intravenous administration of methylprednisolone was associated with an increased risk of allergic reactions. 6.46% of the cases resulted in death. Conclusion Methylprednisolone may induce allergic reactions. Therefore， clinical monitoring should be strengthened during its use， and attention should be paid to potential cross-allergic reactions with other glucocorticoids.

This study systematically reviewed official websites and policy documents of drug regulatory authorities in the United States， Japan， Australia， and the European Union. The background， legislative context， technical requirements， and application methods of patient medicine information （PMI） in Untied States， drug guide for patients in Japan， consumer medicine information （CMI） in Australia， and package leaflet （PL） in European Union were analyzed. The research found that these countries and regions have generally established patient-centered patient drug information （PDI） systems characterized by unified formats and simple， easy-to-understand language. Based on international experience， China can develop our own PDI system by improving the regulatory framework， establishing standard specifications， and optimizing accessible pathways， enhancing medication safety and the accessibility of health information.

A 44-year-old female patient with type 2 diabetes mellitus was initiated on semaglutide injection for suboptimal glycemic control. Following a rapid titration from 0.25 mg to 1.00 mg over a three-week period， the patient developed severe gastrointestinal adverse effects， which subsequently led to acute kidney injury. This event was assessed as an adverse drug reaction attributable to semaglutide. Renal function recovered to normal after drug discontinuation and appropriate supportive care. Caution is advised when prescribing semaglutide injection，paying attention to individuals reactions to ensure clinical medication safety.

This article reports a case of hypophosphatemia induced by multiple infusions of ferric carboxymaltose in a patient with iron deficiency anemia. A 53-year-old female patient， who had received regular treatment for iron deficiency anemia， presented to Peking Union Medical College Hospital and was administered a single dose of ferric carboxymaltose injection （1000 mg diluted in 100 mL of normal saline， administered via intravenous infusion over no less than 15 min）. On day 6th after administration， laboratory tests revealed biochemical abnormalities， including decreased serum phosphate， increased urinary phosphorus， elevated parathyroid hormone， and decreased total 25-hydroxyl vitamin D. A diagnosis of ferric carboxymaltose-associated hypophosphatemia was considered. Furthermore， ultrasound revealed the presence of renal calculi， and the patient reported menorrhagia and prolonged menstruation following drug administration. After replacement therapy with iron sucrose recommended by clinical pharmacist， the patient's relevant biochemical parameters gradually returned to normal levels. This case report aims to remind clinicians to closely monitor biochemical indicators such as serum phosphate in patients with iron deficiency anemia after infusion of ferric carboxymaltose and enhance clinicians' awareness of recognizing and reporting this adverse reaction.