To enhance the transparency and reporting quality of systematic reviews， the reporting guidelines for systematic reviews and meta-analyses（PRISMA ）working group released the PRISMA 2009， which primarily focused on direct comparisons between two interventions. With the growing need for comprehensive evaluations of multiple interventions in clinical research， network meta-analysis （NMA） has been widely adopted. Consequently， the PRISMA working group introduced the PRISMA-NMA extension in 2015， based on PRISMA 2009， to address the reporting standards for NMA. PRISMA 2020 has updated and revised PRISMA 2009. there is no corresponding update for NMA reporting guidelines.This article integrates PRISMA 2020 and PRISMA-NMA and analyzes the NMA reporting standards by practical study example the quality， aiming to support the standardized writing， review， and publication of NMA studies， and improve the quality and credibility.

Diabetic peripheral neuropathy（DPN）is a prevalent complication that seriously impairs the quality of patients' life. This article reviews the latest research progress in the epidemiology， pathogenesis， diagnostic classification and treatment strategies of DPN. Studies have shown that DPN is associated with the downregulation of Na⁺/K⁺-ATPase expression， mitochondrial dysfunction， DNA damage， and elevated inflammatory cytokines in DPN pathogenesis in addition to classic pathogenesis， additional contributors include gut microbiota dysbiosis， amino acid metabolism dysregulation， and Schwann cell （SC） dysfunction. Intraepidermal nerve fiber density and emerging high-resolution neuroimaging techniques can be used as new diagnostic tools. Some new antidiabetic drugs have shown neuroprotective effects， and the third generation of new calcium channel modulators such as Mirogabalin and Cilgabalin show a good prospect in the efficacy and safety of diabetic peripheral neuropathic pain （DPNP）. In the future， the prognosis of patients can be further improved through early diagnosis， precise treatment and the development of new drugs.

Lifitegrast is a novel small molecule integrin inhibitor that inhibits T-cell-mediated inflammation in dry eye disease （DED） by blocking the conformational activation of lymphocyte function-associated antigen-1 （LFA-1） and its binding to intercellular adhesion molecule-1 （ICAM-1）. Lifitegrast ophthalmic solution were first approved in the United States in 2016 and was included in the American Academy of Ophthalmology （AAO） dry eye treatment practice guidelines in 2018.In December 2023， it was included in the list of the “Third Batch of Encouraged Generic Drugs” released by the National Health Commission and five other departments. In June 2025， lifitegrast ophthalmic solution were approved for listing in China. This article systematically reviews the domestic and international research data on lifitegrast ophthalmic solution from different perspectives such as pharmacology， pharmacokinetics， clinical efficacy， and safety， in order to provide a reference for the safe and rational use of the drug in clinical practice.

Lemborexant is a dual orexin receptor antagonist that was approved by the FDA on December 20， 2019， and subsequently approved in China on May 20， 2025. It is used for the treatment of adults insomnia characterized by difficulty falling asleep and/or maintaining sleep. Clinical studies have demonstrated that lemborexant is effective in both short-term and long-term treatment of adult insomnia patients. Moreover， it exhibits superior safety compared to traditional hypnotic drugs， particularly in addressing potential safety concerns such as next-day residual effects， rebound insomnia， withdrawal reactions， drug dependence， and drug abuse. This article reviews the progress in pharmaceutical characteristics， key clinical studies， and special safety studies of lemborexant.

Objective To explore the differences in postoperative analgesic effects and adverse events between butorphanol and remifentanil in elderly patients after hip fracture surgery admitted to the ICU. Methods This retrospective observational study enrolled patients admitted to the ICU at Beijing Jishuitan Hospital between December 2022 and April 2023. The patients were divided into the butorphanol and remifentanil groups based on their analgesic history. Numeric rating scale （NRS） scores and respiratory and hemodynamic conditions before （T₀）， and 1 h （T₁）， 4 h （T₄）， 8 h （T₈）， and 12 h （T₁₂） after the administration of analgesics were collected. The adverse events were also recorded. Results A total of 144 cases， with 74 and 70 in the butorphanol and remifentanil groups， respectively， were included. In both study groups， the drug was administered through continuous infusion. No statistically significant difference in NRS scores was observed between the two groups at baseline （T₀） ［（3.66±0.69） vs. （3.76±1.17）， P=0.678］， T₁ ［（0.58±0.92） vs. （0.54±0.88）， P=0.862］ and T₄ ［（0.09±0.30） vs. （0.10±0.46）， P=0.434］. At T₈ and T₁₂， NRS scores had declined to 0 in both groups. A one-way repeated measures ANOVA revealed that the NRS scores of the two groups showed a decreasing trend over time， but there were no statistically significant difference between-group or time×group interaction in both group （P_time<0.001， P_group=0.818， P_time×group=0.909）. The butorphanol group exhibited significantly higher arterial partial pressure of carbon dioxide （P_group=0.032）， systolic pressure （P_group=0.024）， and mean arterial pressure （P_group=0.028） compared to the remifentanil group. Conclusion Continuous intravenous infusion of butorphanol or remifentanil might yield comparable postoperative analgesic effects for elderly patients in the ICU after hip fracture surgery. Butorphanol may exert a more pronounced effect on the respiratory system， whereas remifentanil has a slightly greater influence on hemodynamics， but a smaller effect on hemodynamic.

Objective To evaluate the clinical efficacy of iron sucrose injection combined with recombinant human erythropoietin （rhEPO） in the treatment of renal anemia， and its improvement effect on iron metabolism. Methods A total of 120 patients with renal anemia were enrolled from April 2023 to October 2024 and randomly divided into observation group and control group， with 60 patients in each group. The observation group received iron sucrose injection combined with rhEPO， while the control group received rhEPO alone for 12 weeks. Parameters related to anemia， iron metabolism， nutritional status， and inflammatory markers were compared before and after treatment. The functional assessment of chronic illness therapy-fatigue （FACIT-F） scale was used to assess fatigue and weakness， and the kidney disease quality of life short form （KDQOL-SF） was used to evaluate quality of life. Any adverse reactions during the treatment period were recorded. Results After treatment， the levels of hemoglobin （Hb）， hematocrit （HCT）， red blood cell （RBC） and serum ferritin in both groups were significantly higher than before treatment （P<0.05）， with greater increases observed in the observation group ［Hb：（111.45±11.39）g/L vs （103.29±8.71）g/L， P<0.001； HCT：（34.29%±5.07%） vs （30.50%±4.97%）， P<0.001； serum ferritin： （185.42±54.27）ng/mL vs （159.79±52.34）ng/mL， P=0.010］. The highest Hb level during treatment in the observation group was significantly higher than that in the control group［（114.57±10.34） g/L， vs （104.72±10.26） g/L， P<0.001］. The proportion of patients reaching the target Hb level was higher in the observation group （91.67% vs 76.67%， P=0.024）， and the time to reach the highest Hb level was shorter［ （8.29±2.41）weeks vs （10.17±3.63） weeks， P=0.001）. After treatment， high-sensitivity C-reactive protein， white blood cell， and fasting blood glucose levels were significantly decreased in both groups compared to pre-treatment level， with more pronounced reductions in the observation group （P<0.05）. Scores on FACIT-F scales， as well as kidney and dialysis related quality of life and general health quality of life， were significantly improved in both groups， with more marked improvements in the observation group （P<0.05）. No serious adverse reactions were reported in either group during treatment. Conclusion Iron sucrose injection combined with rhEPO significantly improves Hb levels， iron metabolism， and anemia-related symptoms in patients with renal anemia. It also alleviates fatigue and enhances quality of life， making it a valuable treatment option for clinical practice.

Objective To analyze the factors influencing the serum trough concentration and target attainment rate of meropenem in hospitalized patients， thus to provide references for the formulation of initial treatment dosage in clinical practice. Methods A retrospective study was conducted， including patients who received meropenem and underwent therapeutic drug monitoring （TDM） from May 2023 to August 2024. Basic information， disease status， medication use， and laboratory test results were collected. Factors influencing the serum drug concentration and target attainment rate were analyzed. Results A total of 116 patients were included， including 75 males and 41 females. Among the 116 patients， the median serum trough concentration of meropenem was 2.31 （1.41， 7.65） μg/mL. Using the serum trough concentration greater than 4 times the minimum inhibitory concentration （MIC） of meropenem or 4 mg/L as the standard， the target attainment rate was 29.31%. The age of patients in the standard group was higher than that in the non standard group， and their levels of Charlson Comorbidity Index， serum creatinine were also higher than those in the non standard group，and the creatinine clearance rate was lower than that in the non compliant group. Binary logistic regression analysis of the target attainment rate revealed that pulmonary infection （OR=3.466， 95%CI： 1.289-9.317， P=0.014）， intracranial infection （OR=0.250， 95%CI： 0.063-0.992， P=0.049）， and creatinine clearance rate （OR=0.988， 95%CI： 0.978-0.998， P=0.023） had significant effects （P<0.05）. Multiple linear regression analysis of the serum trough concentration showed that for every 1 μmol/L increase in serum creatinine， the serum trough concentration increased by 0.080 μg/mL （B=0.080， 95%CI： 0.018-0.143， P=0.012）， which was statistically significant （P<0.05）. Conclusion In clinical practice， regimen may have a lower target attainment rate. TDM should be performed and the dosing regimen should be adjusted in a timely manner based on clinical symptoms and creatinine levels infection， or abnormal creatinine levels.

Objective To explore the efficacy and safety of combination of apatinib in the conversion therapy for unresectable advanced gastric cancer. Methods According to the inclusion and exclusion criteria， the Cochrane Library， SinoMed， and other Chinese and international databases， as well as the Chinese Clinical Trial Registry and ClinicalTrials.gov were systematically searched for relevant studies from the inception to October 30， 2024. collect relevant clinical research date， document screening， quality evaluction and bias risk assessment. A meta-analysis of single-group rates was conducted by STATA18.0 software. Results Five high-quality studies involving 192 patients were enrolled in this meta-analysis （MINORS score≥11）. In terms of tumor response， the pooled objective response rate （ORR）， conversion surgery rate and R0 resection rate were 71%（95%CI：55%-85%），67%（95% CI：60%-74%），86%（95%CI：66%-98%），respectively. In overall survival （OS）， the patients who underwent the conversion surgery had a superior 1-year overall survival rate compared with those who did not （RR=1.53， 95%CI：1.18-1.98， P=0.00）. In terms of safety， no adverse events （AEs） （≥Grade Ⅲ） were observed. Conclusion In summary， this meta-analysis demonstrated that the apatinib combination has promising efficacy and safety in the conversion therapy for patients with unresectable advanced gastric cancer.

Objective To compare the early efficacy of bortezomib combined with cyclophosphamide or dexamethasone （VCD） and bortezomib combined with lenalidomide or dexamethasone （VRD） for patients with newly diagnosed multiple myeloma （NDMM） who are not suitable for transplantation， and to provide basis for the selection of clinical treatment. Methods A total of 60 NDMM patients from December 2019 to November 2024 were selected， divided into the VCD group and the VRD group. The early efficacy included complete response （CR）， better partial response （VGPR）， overall response rate （ORR） and adverse events rate. Logistic regression was used to evaluate the influencing factors of VGPR achievement. The progression free survival （PFS） and overall survival （OS） were compared between the two groups. Results After 4 cycles of treatment， achieve （VGPR+CR） rate of VCD group and VRD group were 40.00% （16.7%+23.3%） and 46.67%（26.7%+20.0%）， respectively， and the ORR rate of VCD group and VRD group were 73.33% and 76.67%， and with no significant difference between the two groups. There was no significant difference in grade 3 and above adverse events between the two groups during treatment. ISS Ⅲ （OR： 2.059， 95%CI： 1.129-3.768， P=0.020） and high-risk cytogenetic risk （OR： 2.312， 95%CI： 1.247-4.305， P=0.008） were independent risk factors for VGPR. Up to March 25， 2025， the median PFS of VCD group was 52.20 months and that of VRD group was 50.00 months. The median OS of the two groups had not yet reached. There was no significant difference in cumulative PFS （χ²=2.163， P=0.141） and OS （χ²=0.823， P=0.367） between the two groups. Conclusion The short-term efficacy and safety of VCD and VRD regimens in NDMM patients who are not suitable for transplantation are equivalent. ISS stage Ⅲ and high-risk cytogenetics significantly affect the early efficacy. Clinical treatment options should be optimized according to the individual risk characteristics of patients.

Objective To evaluate the effects of indacaterol/glycopyrronium on lung function and St. George's Respiratory Questionnaire （SGRQ） scores in patients with stable chronic obstructive pulmonary disease （COPD）. Method A total of 160 patients with stable COPD （April 2022 to April 2024） in Huzhou First People's Hospital were randomly assigned to either the treatment group （n=80） receiving indacaterol/glycopyrronium inhalation powder （one inhalation once daily） or the control group （n=80） receiving salmeterol/fluticasone inhalation powder （one inhalation twice daily） for 3 months. Outcomes included clinical efficacy， lung function， serum inflammatory markers， psychological resilience （Connor-Davidson Resilience Scale， CD-RISC）， and quality of life. Results During the treatment， 5 cases fell off in the control group， 3 cases fell off in the treatment group， 75 cases in the final control group， and 77 cases in the treatment group completed the study. In the treatment group， 53 cases were significantly effective， 16 cases were effective， the total effective rate was 89.61%. In the control group， 40 cases were significantly effective， 18 cases were effective， the total effective rate was 77.33%. After treatment， forced expiratoty volume insecend （FEV1）， forced vital capacity （FVC）， FEV1/FVC， and FEV1% in both groups increased compared to before treatment， while tumor necrosis factor-α （TNF-α）， IL-6， C-reactive protein （CRP）， and procalcitonin （PCT） decreased. Elasticity score， intensity score， optimism score， and Connor-Davidson Resilience Scale （CD-RISC） total score all increased compared to before treatment. Symptom score， activity score， impact score， and St.George's Respiratoty Questunnaive （SGRQ） total score all decreased compared to before treatment， and the above indicators in the treatment group improved more significantly than those in the control group. Conclusion The treatment of stable COPD indacaterol/glycopyrronium significantly enhances lung function， reduces systemic inflammation， improves clinical efficacy， increases psychological resilience， and elevates quality of life in stable COPD patients compared to salmeterol/fluticasone.

Objective To conduct a post-marketing re-evaluation of the clinical safety of azulfidine tablets based on literature analysis， providing references for safe clinical use. Methods Literature on adverse drug reactions （ADRs） related to azulfidine tablets published between 2021 and 2024 was retrieved from CNKI， Wanfang Database， VIP Database， China Biomedical Literature Database， and PubMed. Descriptive analysis was employed to analyze ADR characteristics. Results A total of 14 studies were included （8 clinical studies/safety monitoring reports and 6 case reports）， involving 276 patients. ADRs affected 12 organs/systems and manifested as 45 different clinical symptoms， with a total of 378 occurrences. The most common ADRs were gastrointestinal disorders （132 occurrences， 34.9%）， characterized by nausea， diarrhoea， vomiting， followed by abnormal laboratory test results （94 occurrences， 24.9%）， including elevated alanine aminotransferase， elevated aspartate aminotransferase， and decreased leukocyte counts； and neurological disorders （64 occurrences， 16.9%）， characterized by dizziness and headache. The management of ADRs was recorded in 78 patients， with most cases improved or recovered. Severe ADRs （grade ≥3） were observed in 6 patients， presenting as elevated transaminases， dyspnoea. Conclusion The clinical manifestations of ADRs associated with azvudine are diverse， with significant impacts on the digestive and nervous system. It is recommended to continuously expand the monitoring population， particularly among the elderly， to enhance the safe use of azvudine.

Objective To evaluate the impact of the pharmaceutical care charging policy on pharmaceutical care practice for respiratory inpatients， clinical pharmacist involvement， and pharmacy management indicators. Methods Retrospective analysis was conducted on pharmaceutical care records of patients who received charging-based pharmaceutical care in the general ward of the Department of Respiratory and Critical Care Medicine at Beijing Chaoyang Hospital after the policy implementation （September 2024 to February 2025）， including care content， major monitored medications， types of interventional recommendations， and acceptance rate of pharmacists’ suggestions. Using the pre-policy period （September 2023 to February 2024） as the control， changes in clinical pharmacist involvement （monthly average pharmaceutical care cases， acceptance rate of interventional suggestions） and pharmacy management indicators （antibiotic drug use intensity， average medication cost per hospitalization） were analyzed. Results A total of 100 patients were included， collected 111 pharmaceutical care cases records with a monthly average of 18.5 pharmaceutical care cases. After implementing the pharmaceutical care charging policy， pharmaceutical care volume significantly increased （18.5 vs 10.5 monthly cases， P<0.01）， and the acceptance rate of interventional suggestions rose from 61.90% （52/84） to 93.68% （163/174） （P<0.001）. Further analysis showed that antibiotic use intensity per case and average medication cost per hospitalization significantly clecreased （P<0.05）. Conclusion Implementation of the pharmaceutical care fee policy significantly increases pharmaceutical care volume of respiratory inpatients， enhances clinical pharmacist involvement， and improves pharmacy management effectiveness.

Objective To explore the genotype characteristics and drug treatment efficacy for patients with chronic hepatitis C virus （HCV） infection， providing a basis for clinical medication. Methods HCV-infected patients treated in Hebei Petro China Central Hospital from September 2020 to September 2022 were selected. The genotypes of HCV-infected patients were detected， and the efficacy of anti-HCV treatments was analyzed. Results A total of 120 patients were included. The predominant HCV genotypes were 1b and 2a， accounting for 63.3% and 29.2%， respectively. The proportion of male patients with HCV genotype 1b and 2a was higher， accocunting for 56.7% and 80.0% respectively. The proportion of female patients with HCV genotype 1b was 43.42%， significantly higher than that of patients with genotype 2a （20.00%， P<0.05）. There was no statistically significant difference in age distribution between patients with HCV genotype 1b and genotype 2a （P>0.05）. The direct-acting antiviral （DAA） regimen was the primary treatment， accounting for 90.00% of cases. The sustained virological response （SVR） rate of the DAA regimen was 98.1%， significantly higher than that of the pegylated interferon plus ribavirin （PR） regimen （P<0.05）. No significant difference in SVR were observed between different DAA regimens （P>0.05）. After DAA treatment， the levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and γ-glutamyl transpeptidase （γ-GT） were 78.39， 60.30， and 30.40 U/L， respectively， all were significantly lower than pre-treatment levels （P<0.05）. Conclusion The predominant HCV genotypes in this study were 1b and 2a， suggesting a potential association with gender. The DAA regimen was the main treatment modality and demonstrated excellent therapeutic efficacy， making it suitable for clinical application.

With the implementation of the “internet+” strategy， the field of pharmaceutical services in China has undergone an important transformation from the traditional window-based mode to an internet-based service model. This study takes the practice of internet-based traditional Chinese medicine （TCM） pharmaceutical services in Beijing hospital of traditional Chinese medicine as the research object. It elaborates on the innovative practices in several areas， including online medication consultation， internet-based pharmaceutical clinics， internet-based medication instruction services， intelligent review of TCM prescriptions， and home delivery of medicines. This research systematically analyzes the current status and existing problems of the integrated TCM pharmaceutical service model that combines “online and offline” services. It also explores optimization pathways based on typical case studies. The study proposes to promote the optimization of TCM pharmaceutical service models through optimizing the quality standard system， applying big data in TCM， and cultivating composite talents in TCM. It aims to provide references and insights for the updating and transformation of TCM pharmaceutical service models in TÇM medical institutions.

Objective To establish a pharmaceutical intervention mode for the stress ulcer prophylaxis （SUP） in ICU according to the latest ICU-SUP guidelines and evaluate the effect of the intervention mode on rational drug use for SUP in critically ill patients. Methods Patients admitted to the ICU of Xuanwu Hospital from 2022 to 2023 were selected. They were divided into the control group （from January to December 2022） and the intervention group （from January to December 2023） based on the date of ICU admission. The effectiveness of pharmacological intervention for preventing stress ulcers promoted by clinical pharmacists was evaluated. Results A total of 459 patients were included， with 239 （2469 patient-days） in the intervention group and 220 （2353 patient-days） in the control group. After the intervention， the rate of rational drug use patient-days increased by 15.0%， the proportion of medication overuse patient-days decreased by 7.2%， and the proportion of insufficient medication patient-days decreased by 4.5%. The incidence of occult bleeding significantly decreased， while the incidences of pneumonia， Clostridium difficile infection， and the length of ICU stay did not show significant changes （P> 0.05）. Conclusion The ICU-SUP pharmacological intervention mode has achieved preliminary effect in the SUP process and has reduced the incidence of bleeding.

This article reports a case of a 40-year-old female patient with lung adenocarcinoma who developed mild bilateral lower limb edema during long-term alectinib therapy. Due to disease progression， treatment was switched to lorlatinib and the patient experienced severe systemic edema accompanied by tension blisters， particularly pronounced in the lower body. Based on the clinical course， lorlatinib was considered the primary cause of the aggravated adverse reaction， though a delayed cumulative effect of alectinib could not be entirely excluded. After immediate discontinuation of lorlatinib and symptomatic management， the patient's systemic edema gradually resolved.