To evaluate the effectiveness of the plan-do-check-act (PDCA) cycle combined with a drug use pathway in managing the rational use of proton pump inhibitors (PPIs) hospital-wide.

Based on evidence-based medicine, PPI treatment and prophylactic medication pathways were established and implemented through the PDCA cycle. The changes in PPI usage rationality, quarterly average sales amount and its proportion of total drug consumption, medication frequency (DDDs), usage intensity (AUD), medication structure and intravenous usage rate in hospitalized patients were compared before implementation (fourth quarter of 2023) and after implementation (first to third quarters of 2024).

After the implementation of medication pathways, the rationality of PPI use across the hospital significantly improved. The prescription compliance rate increased from 95.17% (571 prescription/600 prescription) to 98.50% (589 prescription /600 prescription), and the order compliance rate rose from 93.33% (140 prescription /150 prescription) to 97.33% (149 prescription /150 prescription). Costs also decreased, with quarterly consumption dropping from 37.82 to 25.98 million yuan, with a reduction of 31.31%, and the cost proportion declining from 0.97% to 0.80%, with a decrease of 17.53%. The reduction in usage intensity was greater than the total volume, with AUD decreasing from 208.48 to 126.28 (with a 39.43% reduction) and DDDs dropping from 153 071.29 to 103 490.17 (with a 32.39% reduction). The medication structure continued to optimize, with the proportion of high-cost PPIs decreasing from 52.35% to 38.28% (with a 26.88% reduction), while the proportion of centralized procurement/essential drugs increased from 40.99% to 42.42% (with a 3.45% rise). The intravenous usage rate declined from 15.51% to 14.67% (with a 5.41% reduction). The intervention effectively achieved the goals of cost control, quality improvement, and compliance.

The PDCA cycle can effectively promote the implementation of drug use pathways and enhance the level of rational drug use.

Sarcopenia-osteoporosis is an age-related syndrome caused by the coexistence of osteoporosis and sarcopenia, and it poses a serious threat to the health of the elderly population. The mitogen-activated protein kinases (MAPKs) signalling pathways, including extracellular signal-regulated kinase 1/2 (ERK1/2), p38 MAPK and c-Jun N-terminal kinase (JNK), regulate the proliferation, differentiation and apoptosis of skeletal muscle and bone tissue, and play a significant role in the development and progression of sarcopenia-osteoporosis. In recent years, various traditional Chinese medicine (TCM) constituents have demonstrated experimental value in modulating the MAPKs signalling pathway and influencing processes related to osteogenesis or muscle atrophy. This article reviews the regulatory effects of the MAPKs signalling pathway in osteogenesis and myogenesis, and summarises research progress on the use of various TCM monomers to intervene in sarcopenia-osteoporosis via this pathway, with the aim of providing new theoretical foundations and therapeutic strategies for the prevention and treatment of sarcopenia-osteoporosis.

Against the backdrop of the comprehensive promotion of the policy of centralized bulk procurement of drugs (referred to as "centralized procurement"), this study aims to systematically review and integrate relevant evidence on the effectiveness, safety, and cost-effectiveness of cephalosporin injectables under centralized procurement as presented in real-world studies, and compare their clinical performance with that of original research drugs/imported generic drugs. The goal is to provide an evidence-based basis for the rational use, clinical evaluation, and policy optimization of selected generic drugs in centralized procurement.

Retrieval of real-world research literature on centralized collection cephalosporin injections published from April 2021 to February 2026, comprehensive analysis was conducted from the dimensions of clinical efficacy, safety, and economy, and QATSM-RWS was used to evaluate the quality of the included studies.

After screening, a total of 17 studies were included. The investigated medications primarily comprised cefuroxime, ceftriaxone, and cefoperazone-sulbactam sodium, covering diverse infectious populations in both adults and children, as well as two key clinical scenarios: perioperative infection prevention and therapeutic anti-infective treatment. The results demonstrated that, in terms of efficacy, most studies indicated comparable overall effectiveness between centrally procured cephalosporin injections and original/imported generic drugs for perioperative infection prevention and therapeutic anti-infective therapy, with only individual studies showing differences in secondary endpoints. Regarding safety, no significant differences were observed between the two groups for perioperative prophylaxis; in therapeutic applications, most studies confirmed equivalent safety profiles across both groups, with only certain safety indicators differing in specific studies. In terms of economy, centrally procured medications significantly reduced treatment-related expenses, demonstrating notable economic advantages.

Overall, centrally procured cephalosporin injections are basically consistent with original drugs/imported generic drugs in terms of clinical effectiveness and safety, while also offering superior cost-effectiveness, which can reduce patients’ medical burden. Limited by factors such as the limited coverage of included research varieties, mostly single-center studies, and small sample sizes, relevant research evidence still needs to be improved. Large-sample, multi-center clinical studies need to be conducted in the future to further consolidate the evidence-based basis.

To compare the clinical efficacy of daratumumab injection combined with lenalidomide capsules and dexamethasone injection in the treatment of multiple myeloma (MM).

Patients with MM were divided into control group and treatment group according to the treatment method. Patients in the control group received the bortezomib for injection, lenalidomide capsules and dexamethasone injection (VRd) regimen; patients in the treatment group received the daratumumab injection, lenalidomide capsules and dexamethasone injection (DRd) regimen. The VRd regimen: Within each 28-day cycle, bortezomib for injection at 1.3 mg·m^-2, lenalidomide capsules at 25 mg·d^-1 and dexamethasone injection at 20 mg·d^-1 were administered according to the standard protocol. The DRd regimen: Based on lenalidomide capsules and dexamethasone injection , daratumumab injection at 16 mg·kg^-1 was added (once weekly in cycles 1-2, once every 2 weeks in cycles 3-6, and once every 4 weeks thereafter). Efficacy was evaluated after 3 cycles of treatment in both groups. Clinical efficacy, MM-related biomarkers and adverse reactions were compared between the two groups.

The study enrolled 88 patients, with 45 cases in the control group and 43 cases in the treatment group. Post-treatment evaluation revealed objective response rates (ORR) of 77.78% (35 cases/45 cases) and 90.70% (39 cases/43 cases) for the control and treatment groups, respectively, demonstrating no statistically significant intergroup difference (P>0.05). After treatment, the levels of hemoglobin of control group and treatment group were (102.85±15.87) and (109.71±16.24) g·L^-1, respectivley; the levels of β2-microglobulin (β2-MG) were (4.29±1.12) and (3.67±1.03) mg·L^-1, respectivley; the levels of lactate dehydrogenase (LDH) were (167.29±30.92) and (152.32±29.67) U·L^-1, respectivley; the levels of monoclonal protein (M protein) were (17.42±3.87) and (15.39±3.42) g·L^-1, respectivley; bone marrow plasma cells were (10.25±2.13)% and (8.92±2.06)%, respectivley; cluster of differentiation 3 positive (CD3⁺) were (62.45±8.74)% and (67.06±9.12)%, respectivley; CD4⁺ levels were (34.26±5.12)% and (37.68±5.33)%, respectivley; CD4⁺/CD8⁺ ratios were 1.16±0.24 and 1.28±0.22, respectivley. Compared the control group with treatment group, the differences of above indexes were all statistically significant (all P<0.05). The total incidence of peripheral neuropathy of control group and treatment group were 22.22% (10 cases/45 cases) and 2.33% (1 case/43 cases), respectivley; myelosuppression were 15.56% (7 cases/45 cases) and 37.21% (16 cases/43 cases), respectivley; infection were15.56% (7 cases/45 cases) and 34.88% (15 cases/43 cases), respectivley, all with statistically significant differences (P<0.05, P<0.01).

While ensuring clinical efficacy, the DRd regimen exerts more significant effects in improving immune function, levels of MM-related biomarkers, and quality of life, and significantly reduces the incidence of peripheral neuropathy. However, it is associated with increased risks of myelosuppression and infection.

To explore the effect of the Mst1/Nrf2 pathway on myocardial autophagy function in type 2 diabetic mice, and to verify whether Mst1 gene knockout and Nrf2 activation can improve diabetic cardiomyopathy (DCM) by regulating autophagy.

The experimental animals were randomly divided into the following 4 groups, with 8 animals in each group: Control group (6 C57BL/6N mice, standard diet), DCM group (6 C57BL/6N mice), DCM+Mst1^-/- group (6 Mst1 gene knockout mice), high-sugar and high-fat diet, DCM+Mst1^-/-+Nrf2 group (6 diabetic mice with Mst1 gene knockout intervened by Tert-butylhydroquinone(tBHQ)(50 mg/kg/day)(PHR3512, Sigma-Aldrich). Cardiac function was detected by blood pressure, and autophagy was analyzed by Western blot.

The 4w systolic blood pressures of the control group, the high glucose control group, the high glucose Mst1 knockout group, and the high glucose Mst1^-/-±Nrf2 group were (103.6±1.43), (117.23±9.80), (111±7.43) and (109.21±3.22) mmHg, respectively, and the 8w systolic blood pressures were (99.09±1.46), (135.78±5.98), (123.57±8.90) and (119.97±6.97) mmHg, respectively. the 12w systolic blood pressures were (106.67±2.32), (138.90±2.00), (126.68±2.98) and (120.63±3.12) mmHg, respectively. The diastolic blood pressures at 4w were (79.50±1.12), (99.24±3.89), (85.03±1.89) and (82.90±3.22) mmHg, respectively. The diastolic blood pressures at 8w were (76.35±2.12), (106.78±5.98), (94.80±3.90) and (88.90±2.90) mmHg, respectively. The diastolic blood pressure at 12w were (78.79±1.70), (101.32±2.13), (93.62±3.98) and (89.02±1.92) mmHg, respectively. The 4-week mean arterial pressures were (87.51±0.41), (117.23±9.80), (85.56±1.46) and (83.91±2.23) mmHg, respectively. The 8-week mean arterial pressures were (84.24±2.41), (116.46±5.68), (104.80±3.91) and (98.90±2.90) mmHg, respectively. the 12-week mean arterial pressures were (86.09±1.74), (101.32±2.13), (103.60±3.37) and (99.02±1.55) mmHg, respectively. Compared with the mice in the Control group, the systolic blood pressure, diastolic blood pressure and mean arterial pressure of the mice in the DCM group, DCM+Mst1^-/- group and DCM+Mst1^-/-+Nrf2 group were significantly increased (P<0.000 01).

Improved cardiac diastolic function in mice with Mst1/Nrf2 activation. This effect is achieved by reducing the expression of p62 protein, further emphasizing that the Mst1/Nrf2 axis exerts its protective function by regulating autophagy-related proteins.

This study aimed to reassess the antibiotic treatment regimen for invasive community-associated methicillin-resistant Staphylococcus aureus(CA-MRSA) infections at a tertiary children’s hospital.

A retrospective analysis was conducted on cases of invasive clindamycin-resistant MRSA infections in children without underlying diseases between 2021 and 2025. A total of 34 children met the inclusion criteria, with the most common types of diagnosis being osteomyelitis (17 cases) and deep abscess (7 cases).

The median duration of intravenous (IV) antibiotic therapy was 11.5 days (interquartile range [IQR], 6-42 days), and the total treatment duration (IV + oral) was 32 days (IQR, 23-42 days). Overall, 50% of the children were subsequently switched to oral antibiotic therapy. The definitive antibiotics used for treatment included vancomycin (15 cases), TMP-SMX (trimethoprim-sulfamethoxazole, 9 cases), linezolid (7 cases), ceftaroline (2 cases), and doxycycline (1 case). The cure rates of different definitive antibiotic treatment regimens were similar: 73.3% in the vancomycin group, 88.9% in the TMP-SMX group, 50% in the ceftaroline group, and 100% in both the linezolid group and the doxycycline group. Three children died from MRSA infection, among whom 2 were treated with vancomycin and 1 with ceftaroline.

Vancomycin is the most commonly used drug for the treatment of invasive clindamycin-resistant CA-MRSA infections in children. However, in specific cases, TMP-SMX and linezolid may be considered as oral alternative options during the completion phase of treatment. Further research is still needed in the future to optimize the treatment regimen for such infections.