Obesity-related heart failure with preserved ejection fraction is one of the representative metabolic-inflammatory phenotype of heart failure （HFpEF）. Its pathophysiology involves chronic low-grade inflammation driven by visceral adiposity， coronary microvascular endothelial dysfunction， excess epicardial adipose tissue， circulatory volume expansion， and impaired exercise capacity. In recent years， major advances of clinical research on obesity-related HEpEF have been achieved with incretin-based therapies， including semaglutide as a glucagon-like peptide-1 receptor agonist （GLP-1 RAs） and tirzepatide as a dual incretin receptor agonist， in this population. Multiple studies have demonstrated that these agents can significantly improve the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score， 6-minute walk distance， body weight， and inflammatory markers， with some studies also suggesting a reduction in the risk of worsening heart failure. This review elaborates on the pathophysiological mechanisms underlying obesity-related HFpEF， core clinical evidence， characteristics of different therapeutic regimens， strategies for combined use with standard treatments， and existing limitations of current clinical data， so as to provide evidence for individualized precision pharmacotherapy of such patients.

The whole-course management of schizophrenia encompasses the acute， consolidation， and maintenance phases. It requires attention not only to early intervention but also to long-term management. Scientific whole-course management can provide a continuous and comprehensive medical services， improve their social function and quality of life， and ultimately achieve the goal of patients' recovery and reintegration into society. This article reviews the latest advances in pharmacological and non-pharmacological treatments in the whole-course management of schizophrenia， providing a theoretical basis in the treatment and rehabilitation management of these patients.

Amyotrophic lateral sclerosis （ALS） is a neurodegenerative disease affecting motor neurons in the brain and spinal cord. Current management centers on disease-modifying therapies combined with multidisciplinary comprehensive care. This article systematically reviews the pharmacotherapeutic landscape of ALS， with a focused analysis of the mechanisms of action， evidence-based data， clinical use， and economic evaluation of the approved drugs in China： riluzole， edaravone， and tofersen. Meanwhile， it sorts out the core research progress of investigational drugs centered on two directions： gene regulation therapy and intervention targeting broad-spectrum pathological mechanisms. The overarching aim is to provide a theoretical foundation and practical guidance for developing individualized and holistic management plans for ALS patients， ultimately aiming to slow disease progression and improve quality of life.

Ziftomenib， an oral menin inhibitor developed by Kura Oncology， US， is indicated for adult patients with relapsed or refractory acute myeloid leukemia （AML） with a susceptible nucleophosmin 1 （NPMI） mutation who have no satisfactory who have altermative treatment options.It received marketing approval from the U.S. Food and Drug Administration （FDA） on November 13， 2025. This review summarizes its mechanism of action， pharmacokinetic characteristics， clinical efficacy and adverse events， so as to offer evidence for rational clinical medication.

Objective To evaluate the application of the novel fully automatic intelligent intravenous compounding robot in pharmacy intravenous admixture Services （PIVAS）， so as to provide practical reference for the intelligent construction of PIVAS. Methods According to the intelligent construction requirements of PIVAS at Peking University Third Hospital， we detected sterility and bacterial endotoxin of finished infusion products. Core quality indicators including drug residue rate and qualified rate of insoluble particles were compared between the robot compounding group （experimental group） and traditional manual compounding group （control group）. Results In terms of residual drug content， the experimental group exhibited a lower residual rate ［1.86% （1.68%， 2.44%）］ compared to the control group ［2.80% （2.46%， 3.19%）］， with the control group showing a statistically significant increase in residual content （Z=-6.085， P<0.001）. For insoluble particles of 10 μm to less than 25 μm： the particle count in the experimental group was 0.5 （0.3， 1.2）， markedly lower than 1.0 （0.63， 2.50） in the control group （Z=-2.596， P=0.009）. At the ≥25 μm size， the experimental group also showed fewer particles ［0.1 （0.0， 0.2）］ compared to the control group ［0.15 （0.10， 0.28）］， and the difference was statistically significant （Z=-2.439， P=0.015）. Both groups comply with relevant standards for bacterial endotoxin and sterility tests. Conclusion The application of the intelligent intravenous drug compounding robot in Pharmacy Intravenous Admixture Services （PIVAS） is superior to traditional manual dispensing in the core quality indicators of finished infusions and provides a feasible solution for the intelligent development of PIVAS.

Objective To investigate the efficacy of olanzapine combined with fluoxetine in the treatment of bipolar disorder （BD） during acute depressive episodes. Methods Patients with bipolar disorder （BD） in the acute depressive episode phase， admitted to Xuzhou Eastern Hospital Affiliated to Xuzhou Medical University from January 2020 to December 2024， were selected. They were randomly divided into an observation group and a control group using the random number table method. The control group was treated with fluoxetine， while the observation group received the combination of fluoxetine and olanzapine. The effective rate， related symptoms ［Hamilton Depression Rating Scale （HAMD） and Positive and Negative Syndrome Scale （PANSS）］， dysfunctional attitudes ［Dysfunctional Attitude Scale （DAS）］， cognitive function ［MATRICS Consensus Cognitive Battery （MCCB）］， adverse reactions， and manic switch rate were compared between the two groups. Results A total of 280 BD patients were included， with 140 cases in each of the observation and the control groups. after the treatment， the PANSS and HAMD scores of the observation group were significantly lower than those of the control group （P<0.05）. Additionally， the dysfunctional attitude score of the observation group was significantly lower than that of the control group （P<0.05）. Furthermore， working memory， Trail Making Test （TMT）， and processing speed time of the observation group was significantly lower than those of the control group （P<0.05）. The overall efficacy rate of the observation group was significantly higher than that of the control group （93.57% vs 80.71%， P<0.05）. There was no significant difference in the total incidence of adverse reactions and the rate of switch to mania between the two groups （P>0.05）. Conclusion The combination of olanzapine and fluoxetine has superior efficacy in treating BD during the acute depressive episode phase. This regimen can improve BD-related symptoms and functional impairments， enhance cognitive function， and exhibite a favorable safety profile.

Objective To evaluate the safety and efficacy of lanthanum carbonate， sevelamer， and sucroferric oxyhydroxide in treating patients with chronic kidney disease stage 3-5 complicated with hyperphosphatemia. Methods We searched Chinese and English databases from inception to June 1， 2025， for randomized controlled trials. A total of 11 studies were included for meta-analysis. Results Three drugs had similar efficacy in reducing blood phosphorus levels. For specific indicators， sevelamer was more effective than lanthanum carbonate in reducing the level of calcitriol （MD=-4.20， 95%CI：-8.21~-0.19， P<0.05）； sucroferric oxyhydroxide was superior to sevelamer in increasing serum ferritin （MD=66.39， 95%CI：31.18~101.61） and transferrin saturation （MD=4.58， 95%CI：0.81~8.36）. In terms of safety， the incidence of gastrointestinal adverse reactions differed， with the order being sucroferric oxyhydroxide>sevelamer>lanthanum carbonate， but there was no statistically significant difference in the overall incidence of adverse events. Conclusion The clinical efficacy of the three drugs is similar， with sucroferric oxyhydroxide having more gastrointestinal adverse reactions and lanthanum carbonate having the best tolerance.

Objective Based on the FDA Adverse Event Reporting System （FAERS） Database of the US Food and Drug Administration， this study compared the adverse event signals of eculizumab combined with tacrolimus and the two drugs used alone， aiming to provide a reference for clinical combination therapy. Methods We extracted relevant adverse event reports recorded from October 2017 to December 2025 and removed duplicate records to establish three cohorts： eculizumab monotherapy group， tacrolimus monotherapy group， and combination group. Four disproportionate signal detection algorithms were adopted： reporting odds ratio （ROR）， proportional reporting ratio （PRR）， Bayesian confidence propagation neural network （BCPNN）， and multi-item gamma Poisson shrinker （MGPS）. New signals and the time-to-onset of adverse events were further analyzed. Results A total of 67 553 reports were included， comprising 25 756 in the eculizumab monotherapy group， 41 354 in the tacrolimus monotherapy group， and 443 in the combination therapy group. The combination group was predominantly female （54.4%） and consisted mainly of patients aged 18-64 years （56.7%）， with the highest proportion of reports originating from the United States （25.3%）. Compared to eculizumab alone， the most frequently reported signal in the combination group was thrombotic microangiopathy （n=59）， while chronic respiratory diseases and diffuse large B-cell lymphoma showed the strongest signals （ROR=160.05）. Compared to tacrolimus alone， fatigue was the most commonly reported adverse event in the combination group （n=31）， with John Cunningham virus positivity， pharyngeal edema， and secondary hypertension showing the most significant signals （ROR=132.23）. After comparison with the drug labels， 26 new signals were identified， primarily involving various laboratory tests， injuries， toxicities， procedural complications， and conditions related to pregnancy， puerperium， and perinatal periods. The median time to onset for the three groups was 274， 246， and 251 days， respectively， with no statistically significant differences （P=0.076）. Weibull distribution analysis revealed that the shape parameters and their upper 95% confidence intervals for all three groups were less than 1. Conclusion The prominent disproportionate adverse event signals of eculizumab combined with tacrolimus mainly cover renal and urinary disorders， infectious and invasive diseases， as well as hematopoietic and lymphatic system disorders.Clinicians should enhance monitoring for these risks and remain vigilant regarding both early and delayed adverse events.

Objective To investigate the clinical efficacy of the combination therapy of reduced glutathione and octreotide in treating acute pancreatitis （AP）. Methods AP patients were randomized into two groups using a random number table method： the control group （treated with octreotide alone） and the observation group （treated with octreotide combined with reduced glutathione）. After 7 days of treatment， the clinical efficacy， clinical performance evaluation， serum inflammatory factors， pancreatic enzyme levels， oxidative stress indicators， intestinal mucosal barrier function indicators， APACHE Ⅱ score， BISAP score， and adverse reactions were compared between the two groups at baseline and after treatment. Results A total of 100 patients were included， with 50 cases in each group. The total effective rate of clinical treatment for AP patients in the observation group was significantly higher than that in the control group （94.00% vs 78.00%， P<0.05）， and there was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. After treatment the total antioxidant capacity （T-AOC） of both groups was significantly higher than at baseline （P<0.05）， and the increase in the research group was more significant than that in the control group （P<0.05）. After treatment， the clinical performance evaluation （disappearance time of abdominal pain， bloating， recovery time of upper abdominal pain， etc.）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， C-reactive protein （CRP）， tumor necrosis factor-α （TNF-α）， serum lipase （LPS）， amylase （AMY）， malondialdehyde （MDA）， diamine oxidase （DAO）， endotoxin， D-lactate （D-LA）， APACHE Ⅱ score， and BISAP score of both groups were significantly reduced compared to those at baseline （P<0.05）， with greater reductions observed in the observation group （P<0.05）. Conclusion The combination therapy of reduced glutathione and octreotide can inhibit the inflammatory response of patients with acute pancreatitis， restore pancreatic function， regulate intestinal barrier indicators， improve clinical efficacy， and promote rapid recovery.

Objective To develop a machine learning prediction model based on pretreatment routine clinical variables for grade ≥2 immune-related adverse events （irAEs） associated with programmed cell death protein 1 （PD-1） inhibitors in patients with non-small cell lung cancer （NSCLC）. Methods Patients with NSCLC who received PD-1 inhibitor therapy from January 2021 to June 2025 were enrolled. The primary outcome was the occurrence of grade ≥2 irAEs， according to the Common Terminology Criteria for Adverse Events version 5.0 （CTCAE 5.0）， from the first administration of PD-1 inhibitor to 90 days after the last administration. Variable dimension reduction was performed using preliminary univariate screening combined with least absolute shrinkage and selection operator （LASSO） regression， and 10 clinically available variables were retained. Regularized logistic regression， random forest， XGBoost， and LightGBM model were trained and compared. The optimal model was selected according to the area under the receiver operating characteristic curve （AUC）， and its performance was evaluated in the validation set. Results A total of 197 patients were included， with 138 patients in the training set and 59 in the validation set. Grade ≥2 irAEs occurred in 71 patients （36.0%）， including 23 patients （11.7%） with grade ≥3 irAEs. The final variables included in the model were age， Eastern Cooperative Oncology Group performance status （ECOG PS）， history of interstitial lung disease， baseline glucocorticoid use， baseline proton pump inhibitor （PPI） use， neutrophil-to-lymphocyte ratio （NLR）， lymphocyte count， albumin， C-reactive protein （CRP）， and D-dimer. LightGBM showed the best performance， with a cross-validation AUC of 0.812 in the training set and an AUC of 0.779 （95%CI： 0.648-0.910） and a PR-AUC of 0.699 in the validation set. At the threshold of 0.372， the sensitivity， specificity， and Brier score were 71.4%， 73.7%， and 0.176， respectively. SHAP analysis showed that baseline glucocorticoid use， history of interstitial lung disease， age， baseline PPI use， and NLR contributed substantially to the model. Conclusion The LightGBM model constructed using selected routine clinical variables shows moderate predictive performance for grade ≥2 irAEs associated with PD-1 inhibitors in patients with NSCLC， and may provide a reference for pretreatment risk stratification and adjustment of follow-up monitoring intensity.

Objective To compare the differences between the 2024 and 2026 editions of the Regulations for the Implementation of the drug Administration law of the People's Republic of China （hereinafter referred to as the Regulations） and explore innovative pathways to hospital pharmaceutical affairs management. Methods A comparative study was conducted between the 2024 and 2026 editions of the Regulations， involving item-by-item matching and comparative analysis of the overall framework structure， core themes of the provisions， and clauses related to the responsibilities of health administrative departments. Revisions， additions， deletions， and adjustments were standardized with annotations， systematically reviewing and compared the content differences and institutional evolution characteristics between the two editions. Results Compared to the 2024 edition， the 2026 edition underwent significant modifications in chapter setup and provisions， exhibiting three key features： （1） the introduction of specialized clauses matching the functions of health administrative authorities for the first time； （2） further enhancement of the completeness and coverage of full-lifecycle supervision of medicines； （3） a focused emphasis on special medication needs for special groups and specific scenarios. Conclusion The 2026 edition of the Regulations demonstrates innovative breakthroughs in the design of hospital pharmaceutical affairs management， covering daily operations， pharmaceutical care， hospital-enterprise collaboration， and risk control. It reflects the legal requirements of the three-medical coordination mechanism and provides a innovative pathway in hospital pharmaceutical affairs management.

Objective To analyze the utilization status of topical anti-glaucoma drugs in the tertiary hospital in Beijing from 2022 to 2025. Methods Prescription data from the hospital management information system （HIS） of the tertiary hospital in Beijing between 2022 and 2025 were retrieved. Statistical analysis was performed on indicators including total consumption value， proportion of consumption value， defined daily doses （DDDs）， defined daily dose cost （DDC）， and the ranking ratio （B/A）. Results The total consumption value of anti-glaucoma drugs increased annually， with prostaglandin analogues accounting formore than 54% of the total. The top four drugs by DDDs were brinzolamide/timolol， latanoprost， brimonidine， and tafluprost. The DDDs for all anti-glaucoma drugs in the outpatient pharmacy were significantly higher than those in the inpatient pharmacy. The B/A ratio for topical anti-glaucoma drugs primarily ranged from 0.3 to 4.0. Conclusion The usage trends of anti-glaucoma medications in this hospital align with recommendations from domestic and international guidelines. Prostaglandin analogues remain the dominant category， while the DDDs of fixed-dose combination preparations （e.g.， brinzolamide/timolol） continues to increase， reflecting the increasingly optimized of medication structure.

Objective To evaluate the situation of off-label use of traditional Chinese medicine （TCM） injections in children in a tertiary hospital. Methods The medical orders of traditional Chinese medicine injection for hospitalized children in the First Affiliated Hospital of Henan Medical University from 2021 to 2023 were retrospectively analyzed， and the situation of off-label use was analyzed and evidence-based evaluation was conducted. Results A total of 1024 children with TCM injection were collected， 4495 medical orders for intravenous infusion during hospitalization were collected， 1038 of which were for TCM injection， and there were 296 cases of off-label medication orders， accounting for 6.58% of medical orders for intravenous infusion during hospitalization and 28.52% of medical orders for TCM injection， involving 17 kinds of TCM injections. The types of drug use include ultra contraindication population， ultra indication population， ultra applicable population， etc. A total of 22 items of off-label drug use were involved in 17 kinds of traditional Chinese medicine injections， of which 12 items were effectiveness grade Ⅱb， and 10 items were effectiveness grade Ⅲ. There were 5 recommendations at level Ⅱb and 17 recommendations at level Ⅲ. The evidence level of off-label drug use was C for 12 items and no evidence for 10 items. Conclusion The off-label use of TCM injection in children is common in this hospital， and the evidence level of evidence-based medicine is generally low. It is recommended to optimize the management process of off-label drug use and carry out active monitoring of adverse events or adverse reactions to ensure drug safety.

Anticoagulation therapy is a fundamental pharmacological intervention for thrombotic disorders， yet its associated safety risks present a significant challenge in clinical practice. Clinical pharmacists at home and abroad have continuously promoted the rational use of anticoagulants and carried out numerous explorations on anticoagulation pharmaceutical care. This paper introduces the Core Elements of Anticoagulation Stewardship Programs （ASP） developed in the United States together with its supporting documents， and elaborates on the inspirations for Chinese pharmacists to carry out anticoagulation pharmaceutical care. The core elements theory of anticoagulation stewardship provides scientific， effective and operable guidance for medical institutions to build standardized systematic anticoagulation management models for inpatients. Pharmacists can utilize tools such as the checklist and gap analysis to objectively assess current service models， identify areas for improvement， and facilitate the transition from fragmented services to a comprehensive， high-quality anticoagulation stewardship system.

Driven by the increasing demand for chronic disease management and the in-depth specialized development of pharmaceutical care， ward-based clinical pharmacists in the department of endocrinology are confronted with the dual challenges of improving the efficiency and quality of medication therapy management. Taking type 2 diabetes mellitus （T2DM） as the research subject， this study constructed a hierarchical plus closed-loop pharmaceutical care model for ward-based clinical pharmacists. The hierarchical management stratifies patients based on disease severity， medication-related risks， blood glucose levels and medication adherence. The closed-loop system covers the full spectrum of care including admission assessment， in-hospital pharmaceutical management， discharge medication education and community follow-up， thereby forming a continuous and integrated service chain. Ward-based clinical pharmacists carried out standardized work including medication order review， medication reconciliation， medication adherence evaluation， formulation of clinical pathways for medication therapy. After the implementation of the ward-based clinical pharmacist service model， compared with the period before implementation， the total medical cost， average drug cost per admission， length of hospital stay， drug proportion and antimicrobial use density decreased significantly， and the awareness of adverse drug reaction （ADR） monitoring was notably enhanced.

The clinical pharmacist provided comprehensive medication management for breast cancer patients with advanced maternal age pregnancy. The treatment regimen consisted of liposomal doxorubicin combined with cyclophosphamide， followed by sequential albumin-bound paclitaxel. The patient's adverse reactions and fetal status were closely monitored throughout the treatment. At 37⁺³ weeks of gestation， the patient delivered a healthy live female infant， and no abnormalities were observed in the offspring during a 4-year follow-up. Through this holistic management approach， the clinical pharmacist ensured the safe use of chemotherapy drugs during pregnancy， safeguarded the health of both mother and child.

This case report describes a patient with systemic lupus erythematosus and severe infection who developed liver injury complicated by hypofibrinogenemia following tigecycline therapy. Based on the Naranjo adverse drug reaction probability scale， the adverse reaction was considered likely to be associated with tigecycline. Following discontinuation of tigecycline and symptomatic treatment， the patient's liver function gradually improved， and the fibrinogen level returned to normal. This report summarizes the occurrence， management and outcome of this adverse reaction， aiming to provide a reference for the identification， treatment， and pharmaceutical care of tigecycline-related adverse reactions.