Rivaroxaban， a novel oral factor Xa inhibitor， is well established in the treatment and prevention of venous thromboembolism （VTE） in adults. With the rising incidence of VTE among pediatric patients， the clinical demand for anticoagulation therapy in this population has grown substantially. However， there are significant differences between children and adults in coagulation system maturity， hepatic and renal function， and the activity of drug-metabolizing enzymes， make it difficult to directly extrapolate adult dosing regimens. Therefore， conducting population pharmacokinetic （PopPK） studies among Chinese children holds significant clinical value in clarifying the drug metabolism characteristics of children at different developmental stages and guiding precise anticoagulation therapy. Currently， PopPK studies of rivaroxaban in pediatric individuals with VTE remain limited both domestically and internationally. This review summarizes progress of PopPK studies of rivaroxaban in pediatric VTE， identifies key factors influencing pharmacokinetic heterogeneity， and discusses potential directions for model optimization， with the aim of offering a reliable reference for individualized anticoagulation therapy and precision clinical management in pediatric VTE patients.

Metabolic dysfunction-associated steatotic liver disease （MASLD） is one of the most prevalent chronic liver diseases globally， closely associated with metabolic disorders such as obesity and type 2 diabetes mellitus. Currently， there are still limitations in therapeutic options for MASLD， and new treatment strategies are urgently needed. Glucagon-ike peptide-1 receptor agonists （GLP-1RAs） have emerged as a research focus in MASLD management due to their multiple effects in weight regulation， glycolipid metabolism improvement， and anti-inflammatory/anti-fibrotic effects. This review systematically delineates the mechanisms by which GLP-1RAs ameliorate MASLD， including reducing body weight and regulating food intake， improving insulin resistance and glycolipid metabolism， inhibiting hepatic inflammation and fibrosis， and modulating gut microbiota via the gut-liver axis. Furthermore， it summarizes clinical evidence supporting the efficacy of both single-target GLP-1RAs and glucose-dependent insulinotropic polypeptide （GIP）/GLP-1 dual receptor agonists in treating MASLD， discusses their potential clinical applications and future research directions.

Mazdutide is a dual glucagon （GCG） and glucagon-like peptide-1 （GLP-1） receptor agonist， and it is a new drug for lowering blood sugar and reducing weight independently developed by a Chinese pharmaceutical company. This article reviews the basic information， mechanism of action， pharmacokinetic characteristics， clinical efficacy and safety of mazdutide， aiming to provide a reference for its rational application in clinical practice.

Objective To investigate the effects of retention enema with Zengye Chengqi Decoction on gastrointestinal function and systemic inflammatory response in patients with acute upper gastrointestinal bleeding （AUGIB） after shock resuscitation. Methods Patients with AUGIB admitted to Yuncheng Central Hospital affiliated to Shanxi Medical University from June 2022 to September 2025 who had achieved shock resuscitation were randomly divided into a control group and an observation group. Both groups received conventional western medical treatment， while the observation group additionally underwent retention enema with Zengye Chengqi Decoction. The time to achieve target enteral nutrition calorie goal was compared between the two groups. Gastric residual volume （GRV） and antral motility index （MI） were measured on days 1， 3， and 5， and serum levels of C-reactive protein （CRP）， procalcitonin， and interleukin-6 （IL-6） were detected. Traditional Chinese Medicine （TCM） syndrome scores were assessed on days 1 and 6. Safety indicators such as rebleeding， diarrhea， abdominal pain/abdominal distension， liver and kidney function abnormalities， and allergic reactions were recorded. Results A total of 74 patients in the control group and 72 in the observation group were included in the final analysis. On days 3 and 5， the MI in the observation group was （1.82±0.56） and （2.76±0.75）， respectively， both significantly higher than those in the control group ［（1.35±0.38） and （1.94±0.61）， respectively］. The GRV in the observation group was （140.5±50.3） mL and （118.6±39.1） mL on days 3 and 5， both significantly lower than those in the control group ［（163.9±52.4） mL and （148.2±41.6） mL， respectively］. The time to achieve target enteral nutrition in the observation group was （3.3±1.5） days， which was shorter than that in the control group ［（4.3±2.2） days］ （all P<0.01）. The distribution of TCM syndrome score grades showed a statistically significant difference between the two groups， with a total effective rate of 84.7% in the observation group， higher than 66.2% in the control group （P<0.01）. On days 3 and 5， the IL-6 levels in the observation group were （97.3±37.7） pg/mL and （62.1±24.1） pg/mL， respectively， both significantly lower than the corresponding levels in the control group ［（116.0±42.6） pg/mL and （93.9±36.4） pg/mL， respectively］. On day 5， the CRP level in the observation group was （16.7±7.9） mg/L， significantly lower than that in the control group ［（20.3±8.5） mg/L］ （all P<0.01）. The incidence of diarrhea in the observation group was 16.7%， which was higher than 5.4% in the control group （P<0.05）. Conclusions Retention enema with Zengye Chengqi Decoction can safely and effectively promote gastrointestinal function recovery and alleviate systemic inflammatory response in patients recovering from hemorrhagic shock due to AUGIB.

Objective To observe the effect of subanesthetic dose of esketamine on postoperative pain and early delayed neurocognitive recovery （DNR） in elderly patients at plateau areas. Methods Elderly patients at plateau areas who underwent laparoscopic radical resection of gastrointestinal tumors under general anesthesia were randomly divided into the observation group （esketamine was infused at a rate of 0.2 mg/（kg·h） from 10 minutes before anesthesia induction until 10 minutes before the end of the surgery） and the control group （constant-rate infusion of normal saline）. Record the visual analog scale （VAS） and the incidence rates of DNR on 1st， 3rd and 7th days after surgery， frequency of self-administered analgesia and dosage of dezocine postoperatively， as well as the serum concentrations of C-reactive protein （CRP）， interleukin-10 （IL-10）， and S100 calcium-binding protein β （S100β） were measured before anesthesia and at 1st， 3rd and 7th days after surgery. Results A total of 67 patients were enrolled， 33 cases in the control group and 34 cases in the observation group. The VAS scores of the observation group on the 1st and 3rd days postoperative were significantly lower than those of the control group ［3.0 （2.5， 4.0） points vs 4.0 （2.5， 5.0） points， 2.0 （2.0， 3.0） points vs 3.0 （2.0， 4.0） points， all P<0.05］. The frequency of self-administered analgesia and dosage of dezocine in the observation group were lower than those of the control group ［1.0 （1.0， 2.0） times vs 2.0 （1.0， 3.0） times， 5.0 （0.0， 5.0） mg vs 5.0 （5.0， 7.5） mg， all P<0.05］. The serum CRP concentrations on the 1st， 3rd and 7th days after surgery in the observation group were lower than that of the control group ［（42.3±12.3） mg/L vs （53.9±16.4） mg/L， （55.9±14.9） mg/L vs （82.1±20.7） mg/L， （52.4±16.0） mg/L vs （61.3±17.6） mg/L， all P<0.05］. The serum IL-10 concentration on the 1st day after surgery in the observation group was higher than that of the control group ［（33.4±5.8） pg/mL vs （28.9±5.8） pg/mL， P<0.05］. The frequency of self-administered analgesia and the dose of dezocine was positively correlated with serum CRP concentrations on the 1st， 3rd and 7th days after surgery. Conclusion For older patients in plateau regions， administration of 0.2 mg/（kg·h） esketamine during general anesthesia can reduce inflammatory responses and optimize postoperative analgesia.

Objective To evaluate the efficacy and safety of tocilizumab in the treatment of thyroid eye disease （TED）. Methods A retrospective analysis was conducted on TED patients who received tocilizumab treatment at Beijing Tongren Hospital from January 2023 to August 2025. Changes in thyroid-stimulating hormone receptor antibody （TRAb） and clinical activity score （CAS） before and after treatment were compared to evaluate efficacy. Changes in laboratory parameters and adverse events before and after treatment were collected to assess drug safety. Results A total of 199 patients were admitted. Among them， 74 （37.19%） were male and 125 （62.81%） were female， with a mean age of 49.31±11.52 years. Efficacy： after treatment， the median TRAb level was 1.86 （IQR：1.09， 4.44） U/L， which was significantly lower than the baseline 4.53 （IQR：1.97， 14.00） U/L （P<0.001）. The CAS significantly dropped from a baseline of 3.00±0.97 to 1.61±0.61 （P<0.001）. Subgroup analysis revealed that patients with higher baseline CAS achieved greater improvement. Safety： white blood cells and neutrophils decreased significantly after treatment （P<0.001）； alanine transaminase， aspartate aminotransferase， and creatinine increased （P<0.001）； fibrinogen decreased significantly （P<0.001）； among lipid parameters， only high-density lipoprotein cholesterol increased （P<0.001）. Serious adverse events were rare. Conclusion As a second-line treatment for TED， the efficacy of tocilizumab is definitely significant. Its safety is generally manageable， but attention should be paid to its adverse reactions.

Objective To investigate the effect of dual antiplatelet therapy （DAPT） on ocular indicators in patients with diabetic retinopathy （DR）-related vitreous hemorrhage （VH）. Methods A retrospective study was conducted on patients who were diagnosed with both DR-related VH and coronary heart disease （CHD） and received DAPT at Beijing Tongren Hospital， Capital Medical University， from January 2021 to December 2025. Clinical characteristics， DAPT regimens， and follow-up results of ocular indicators were collected. Results A total of 23 patients were enrolled， including 14 males （60.9%） and 9 females （39.1%）， with an average age of 56.43±10.15 years old （range： 31-69 years old）. Among them， 18 patients （78.3%） were treated with aspirin combined with clopidogrel， and 5 patients （21.7%） were treated with aspirin combined with ticagrelor. There was a statistically significant difference in the VH grade of the left eye after treatment between the two groups， suggesting that aspirin combined with clopidogrel may reduce the risk of DR-related VH progression compared with aspirin combined with ticagrelor. Conclusion For patients with both DR-related VH and CHD requiring DAPT， the ocular safety profiles of the two antiplatelet regimens may differ. Aspirin plus clopidogrel may be associated with a lower risk of aggravated vitreous hemorrhage.

Objective To analyze the medication adjustment strategies and symptom outcomes of stepped therapy in children with allergic rhinitis （AR），and to evaluate their impact on symptom control rate， quality of life， and safety. Methods Children with allergic rhinitis （AR） who visited the Department of Otorhinolaryngology at Shanghai Children's Medical Center from January to December 2024 were selected as the study subjects. They were divided into four stepped levels according to disease severity and symptom duration： mild intermittent （Level 1）， mild persistent （Level 2）， moderate-to-severe intermittent （Level 3）， and moderate-to-severe persistent （Level 4）. Corresponding initial treatments were implemented based on the level， and medications were adjusted according to symptom control status. Follow-up lasted for 6 months. Data collected included initial drug selection， number and methods of treatment adjustments， Pediatric Rhinoconjunctivitis Quality of Life Questionnaire （PRQLQ） scores， adverse reactions， and symptom control rates for each level. Results Among the 600 enrolled children， 128 were classified as Level 1， 156 as Level 2， 182 as Level 3， and 134 as Level 4. The symptom control rate after initial treatment decreased with increasing severity level （P<0.05）. After medication adjustments， the overall symptom control rate reached 89.67%， with the rate in Level 4 increasing to 78.36% （P<0.05）. The number of adjustments in Levels 3 and 4 was significantly higher than that in Levels 1 and 2 （P<0.05）， and the main adjustment strategies were treatment escalation and combination therapy. After 6 months of treatment， the PRQLQ scores decreased significantly （P<0.05）. The overall incidence of adverse reactions was 5.33%， primarily local irritation， with no severe adverse reactions reported. No statistically significant difference was observed among the four levels （P>0.05）. Conclusion Initial stepped treatment based on disease severity， followed by dynamic adjustment according to symptom control， can effectively improve symptom outcomes， increase the control rate， and has good safety. It is worthy of clinical promotion and application.

Objective To analyze the clinical manifestations and intervention effects of malignant arrhythmia induced by glucocorticoid withdrawal. Methods Clinical data of patients with GWS-related malignant arrhythmia （February 2019-June 2024） were retrospectively analyzed. Features of glucocorticoid use/withdrawal， malignant arrhythmia types， and intervention outcomes were summarized. Results A total of 6 patients were included， 4 had Sheehan syndrome （long-term hormone replacement） and 2 were elderly critically ill patients （receiving therapeutic glucocorticoids）. The main withdrawal cause was self-discontinuation （4 patients， 66.7%）. Time from withdrawal to arrhythmia onset was 2 days to over 2 years. There were 2 cases of 2 days and 3 cases of elderly patients. The onset time of Sheehan syndrome was more than 2 months. Malignant arrhythmia was mainly polymorphic ventricular tachycardia （including torsades de pointes，5 patients，83.3%）， all with QT prolongation （552-760 ms）； all cases were refractory to conventional antiarrhythmics. Glucocorticoid supplementation （4 cases combined with thyroid hormone replacement） achieved 100% cardioversion； only 1 ventricular fibrillation patient had residual brain injury. Conclusion For malignant arrhythmia induced by glucocorticoid withdrawal， elderly critically ill patients present with an “immediate” onset （≤2 days）， while Sheehan syndrome patients present with a “delayed” onset （≥25 days）. Clinically， avoid sudden glucocorticoid withdrawal should be avoided；for cases of unexplained malignant arrhythmias， it is essential to first investigate the history of hormone withdrawal and initiate hormone intervention as early as possible.

Objective To compare the respiratory pathogen spectrum， antimicrobial resistance characteristics， and their association with short-term outcomes between hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated by pneumonia and those with AECOPD alone. Methods AECOPD patients from June 2023 to June 2025 were consecutively enrolled and divided into an AECOPD group and a CP-AECOPD group. Baseline datas were collected. The pathogen composition， resistance phenotypes， and short-term outcomes were compared between the two groups. Results A total of 352 hospitalized AECOPD patients were included， with 200 in the AECOPD group and 152 in the CP-AECOPD group. Patients in the CP-AECOPD group were older， had worse lung function， and exhibited significantly higher inflammatory marker levels. In terms of pathogens， the CP-AECOPD group showed higher rates of overall pathogen detection （77.63% vs. 54.00%）， bacterial positivity （42.11% vs. 27.00%）， and mixed bacterial-viral infections （23.68% vs. 12.00%） compared to the AECOPD group. Both groups were predominantly infected with Gram-negative bacteria （Klebsiella pneumoniae and Acinetobacter baumannii）， but the CP-AECOPD group had a significantly higher rate of multidrug resistance （MDR） （66.00% vs. 43.59%）. Clinical outcomes were worse in the CP-AECOPD group， including higher ICU admission rates （27.63% vs. 14.00%）， mechanical ventilation rates （25.00% vs. 11.00%）， longer average hospital stays （12.80±5.60 days vs. 9.60±4.30 days）， and higher 28-day mortality rates （9.21% vs. 3.00%）. Subgroup analysis further showed that among patients with CP-AECOPD， the ICU occupancy rate （28.13% and 44.44%， respectively）， mechanical ventilation rate （25.00% and 44.44%， respectively）， average length of stay （12.45 days and 15.83 days， respectively） and 28-day mortality （12.50% and 11.11%， respectively） of patients with bacterial infection and mixed infection were significantly higher than those of other subgroups. Conclusion The pathogen spectrum， drug resistance and short-term outcome of CP-AECOPD and simple AECOPD were significantly different. Gram-negative bacteria were dominant， and the multi drug resistance rate of CP-AECOPD was higher， and the risk of ICU admission and death was greater.

Objective To evaluate the clinical efficacy and safety of sodium thiosulfate in the treatment of calcific uremic calciphylaxis （CUA）， in order to provide reference for the treatment of CUA. Methods A retrospective observational study was conducted， including patients with calciphylaxis who were admitted to the Department of Nephrology， Beijing Chuiyangliu Hospital from January 2019 to July 2025. The clinical efficacy and safety of sodium thiosulfate in treating CUA patients were observed. Results A total of 23 patients were included. During the treatment period， no statistically significant differences were observed in hemoglobin， alanine aminotransferase， albumin， corrected calcium， alkaline phosphatase， serum phosphorus， or parathyroid hormone at any time point. In terms of clinical efficacy， 8 cases showed marked improvement （34.8%）， 11 cases were effective （47.8%）， and 4 cases were ineffective （17.4%）. The overall effective rate was 82.6%. The Visual Analogue Scale （VAS） pain score of the 23 patients significantly decreased from 9 （7， 10） at baseline to 3 （3， 5） at 2 weeks， 1 （0， 2） at 4 weeks， and 0 （0， 0） at 12 weeks （P<0.001）. One patient （4.3%） experienced nausea and vomiting， which resolved with symptomatic treatment. No severe allergic reactions or hypotensive events occurred. Conclusion Sodium thiosulfate can significantly relieve pain and promote wound healing in CUA patients with a favorable safety profile. This treatment strategy warrants further clinical application.

Objective To investigate the association between peripheral neuropathy （PN） and serum levels of interleukin-6 （IL-6） and microRNA-146a （miR-146a） in patients with acquired immunodeficiency syndrome （AIDS） following antiviral therapy. Methods This prospective study enrolled AIDS patients who were admitted to Wuyi County Center for Disease Control and Prevention from July 2022 to January 2025. Participants were divided into the PN group and the non-PN group based on whether peripheral neuropathy （PN） developed after antiretroviral therapy （ART）. The study compared serum IL-6 and miR-146a levels， as well as nerve conduction velocities ［including median motor nerve conduction velocity （MMCV）， peroneal motor nerve conduction velocity （PMCV）］， and sensory nerve conduction velocity ［median sensory nerve conduction velocity （MSCV） and peroneal superficial sensory nerve conduction velocity （PSCV）］ between the two groups. Pearson correlation was used to evaluate relationships among these parameters； multivariate logistic regression was performed to identify independent factors for PN； receiver operating characteristic （ROC） curves analyzed the predictive value of IL-6 and miR‑146a. Results Among 269 AIDS patients， 94 （34.94%） developed PN. In the PN group， serum IL-6 levels were significantly higher， while miR-146a levels and nerve conduction velocities were significantly lower than those in the non-PN group （all P < 0.05）. IL-6 was negatively correlated with nerve conduction velocity， while miR-146a was positively correlated （all P<0.05）. Multivariate logistic regression analysis revealed that IL-6， WHO stage， and viral load were independent risk factors for PN， while miR-146a， PMCV， and PSCV were independent protective factors （all P<0.05）. ROC analysis showed that the AUC for predicting PN using the combination of IL-6 and miR-146a reached 0.965， which was significantly superior to that of individual indicators （all P<0.001）. Conclusion Elevated serum IL-6 levels and decreased miR-146a are strongly associated with PN in AIDS patients after antiviral therapy； combined detection of these markers may serve as a potential molecular biomarker for early warning of PN.

Objective To conduct a multidimensional comprehensive quantitative evaluation of insulin icodec injection for the treatment of type 2 diabetes mellitus （T2DM） from five aspects （effectiveness， safety， pharmaceutical properties， economy， and other characteristics）， thereby providing a reference for clinical medication and drug selection by medical institutions. Methods A systematic search was performed in Chinese and English databases including PubMed， Web of Science， the Cochrane Library， CNKI， VIP （Chinese Sci-Tech Journal Database）， and Wanfang Database. Retrieved studies were screened and their quality was assessed to evaluate the efficacy and safety of insulin icodec injection in treating T2DM. The pharmaceutical properties， economic characteristics， and other attributes of insulin icodec injection were obtained by reviewing the drug label and searching the National Medical Products Administration （NMPA） website and the Sunshine Procurement Platform. A multidimensional comprehensive quantitative evaluation was then conducted using the Rapid Guide for Drug Evaluation and Selection in Chinese Medical Institutions （3^rd Edition）. Results A total of eight randomized controlled trials （RCTs） were included， and the overall quality of the studies was satisfactory. In patients with T2DM， insulin Icodec injection was non-inferior to commonly used insulins （such as insulin glargine and insulin degludec） in terms of improving glycated hemoglobin （HbA1c） levels and reducing the time to reach average blood glucose targets. It did not increase the incidence of hypoglycemia or other safety risks. Given its once-weekly injection regimen， insulin icodec injection is particularly suitable for patients with poor clinical adherence to insulin therapy. According to the quantitative evaluation rules of the Rapid Guide （3rdEdition）， the total score of insulin icodec injection was 68.36， consisting of 19 points for effectiveness， 18 points for safety， 19 points for pharmaceutical properties， 7.36 points for economy， and 5 points for other characteristics. Conclusion Insulin icodec injection is non-inferior to commonly used insulins in treating T2DM and does not increase the risk of adverse events. The multidimensional quantitative evaluation results indicate that insulin icodec injection has high clinical application value.

Objective To evaluate the clinical efficacy， safety， and prognostic factors of polymyxin B in treating children with Gram-negative bacterial pulmonary infection after neurosurgery procedures. Methods A retrospective analysis was conducted on pediatric patients meeting inclusion criteria from January 2021 to January 2024. Efficacy endpoints （clinical response rate， microbial clearance rate， 28-day mortality） and adverse reactions were observed. Univariate and multivariate logistic regression analyses were conducted to identify prognostic factors.Patients were stratified into three groups based on trough concentrations： <0.50 μg/mL， 0.50-<2.00 μg/mL， and ≥2.00 μg/mL， to evaluate the relationship between trough concentrations and treatment efficacy/safety. Results A total of 100 pediatric patients were selected. The total effective rate was 85.00% （85/100）， the microbial clearance rate was 85.71% （60/70）， and the 28-day mortality rate was 12.00% （12/100）； The effective rate of Acinetobacter baumannii infection （80.77%） was significantly lower than that of other pathogen groups； The incidence of adverse reactions was 23.00% （23/100）， with nephrotoxicity being the most common （8 cases）. The group with blood drug concentration≥2.00 μg/mL had an increased risk of nephrotoxicity； multivariate logistic regression analysis revealed that the clinical pulmonary infection score （CPIS） （OR=4.243， 95%CI： 1.368-13.160， P=0.012）， procalcitonin （PCT） （OR=3.215， 95%CI： 1.158-8.928， P=0.025）， duration of mechanical ventilation （OR=4.895， 95%CI： 1.705-14.050， P=0.003）， blood drug concentration <0.50 μg/mL （OR=3.360， 95%CI： 1.221-9.245， P=0.019）， and concomitant medication use （OR=2.818，95%CI： 1.596-4.040， P<0.001） were all independent risk factors for poor prognosis. Conclusion Polymyxin B has a definite effective in treating pulmonary infections in children after neurosurgical procedures. CPIS， PCT levels， duration of mechanical ventilation， and low drug concentrations are important factors influencing prognosis.

Objective To investigate the clinical efficacy and safety of doxycycline sequential sitafloxacin in the treatment of genital chlamydial infection， in order to providing references for rational clinical medication. Methods Patients with refractory or complex genital chlamydial infection who were admitted to Hunan Provincial Maternal and Child Health Hospital from June 2022 to June 2025 were included. They were divided into the moxifloxacin group （doxycycline followed by moxifloxacin） and the sitafloxacin group （doxycycline followed by sitafloxacin） by random number table method. Clinical efficacy， pathogen eradication rate， symptom improvement （Chlamydia trachomatis clearance rate and time to symptom relief）， adverse reactions， and reinfection rate were compared between the two groups. Results A total of 108 patients with genital chlamydial infection were included in this study and divided into the moxifloxacin group and the sitafloxacin group， with 54 cases in each group. The clinical efficacy in the sitafloxacin group （98.15%） was significantly higher than that in the moxifloxacin group （88.89%） （P<0.05）. There were no statistically significant differences in the clearance rate of Chlamydia trachomatis and symptom improvement time between the two groups at 1， 2， and 3 weeks after treatment （P>0.05）. The incidence of adverse reactions in the sitafloxacin group （5.56%） was significantly lower than that in the moxifloxacin group （20.37%） （P<0.05）. There were no statistically significant differences in reinfection rate between sitafloxacin group （3.70%） and moxifloxacin group （9.26%） （P>0.05）. Conclusion Doxycycline sequential sitafloxacin is effective in treating genital chlamydial infection. Compared with doxycycline sequential moxifloxacin treatment， this strategy has better clinical efficacy and higher safety， and is worthy of promot and application.

This article reports a case of a 32-year-old female patient with refractory adult-onset Still's disease （AOSD） who developed multiple skin lesions on the neck， upper limbs， abdomen， and thighs following administration of tocilizumab for injection. The presentation progressed to diffuse dark erythema with epidermal necrosis， scattered bullae （some ruptured， leaving denuded areas）， and erosions of the oral mucosa， lips， vulva， and conjunctivae. Nikolsky's sign was positive. After excluding other potential drug culprits and pathological causes， the condition was attributed to tocilizumab， resulting in a diagnosis of severe bullous drug eruption. The adverse drug reaction （ADR） causality assessment was evaluated as 'probable'. Tocilizumab was discontinued， and treatment with glucocorticoids and intravenous immunoglobulin （IVIG） was initiated， leading to significant improvement in symptoms and relevant laboratory parameters. This article reviews the occurrence and management of this severe bullous drug eruption to serve as a reference for physicians and pharmacists in the identification， diagnosis， treatment， and pharmaceutical care of such reactions associated with this drug.

Cefoperazone-sulbactam is a compound preparation composed of third-generation cephalosporin and β-lactamase inhibitors. It has good antibacterial effects.This article reports on a 59-year-old male patient who underwent subdural drilling drainage for chronic subdural hematoma. After the operation， he developed hypostatic pneumonia in the lower lobes of both lungs. After receiving cefoperazone-sulbactam， he developed Stevens-Johnson syndrome. The diagnosis and treatment process of this adverse reaction are described. The article also discusses the association， risk factors， treatment， and prognosis of Stevens-Johnson syndrome caused by cefoperazone sodium and sulbactam sodium.