Latest ArticlesTo analyze the rationality and effectiveness of hepatoprotective drugs in clinical practice and explore the evidence-based basis for off-label use, as well as the clinical value of prophylactic use and combination therapies.
Clinical data of 732 hospitalized patients treated with hepatoprotective drugs from January 2023 to December 2024 were collected. Rationality was evaluated based on drug labels, domestic and international guidelines, and expert consensus. Effectiveness was assessed by comparing liver function indicators before and after treatment.
A total of 732 patients were included. Rational use of hepatoprotective drugs was observed in 592 cases (80.87%), while 140 cases (19.12%) were categorized as irrational use. Rational use was subcategorized into label-compliant use (252 cases, 34.43%) and off-label use (340 cases, 46.45%). Off-label use cases were further classified as guideline-supported (91 cases, 12.43%) and consensus-supported (249 cases, 34.02%). Irrational use primarily included non-indicated prescriptions (58 cases, 7.92%), prophylactic use (43 cases, 5.87%), and redundant combinations (20 cases, 2.73%). Significant reduction in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) levels was observed after treatment (all P<0.001). The effective rate was significantly higher in the label-compliant group than in the inappropriate-use group (72.62% vs 53.57%, P<0.05). No statistically significant differences were found among monotherapy, dual therapy, and triple-or-more therapy groups (62.54% vs 69.31% vs 62.79%, P>0.05).
Clinical application of hepatoprotective drugs should strictly adhere to instructions and authoritative guidelines, and avoid non-indicated prescriptions or combination therapy. This study provides a reference for rational clinical medication use and clinical pharmacist interventions.
To evaluate the cost-effectiveness of imipenem/cilastatin/relebactam (IMI/REL) in patients with hospital-acquired bacterial pneumonia (HABP) and ventilator-associated pneumonia (VAP), using piperacillin/tazobactam (PIP/TAZ) as a comparator, and to assess its economic viability within the Chinese healthcare system.
From the perspective of the Chinese healthcare system, a hybrid decision tree-Markov model was constructed to simulate the long-term health outcomes of IMI/REL and PIP/TAZ from the mean age of disease onset until death. Efficacy and safety data were derived from a Phase Ⅲ clinical trial (NCT03583333), while cost and utility parameters were obtained based on literature reviews and expert interviews. Cost-utility analysis was performed, and one-way and probabilistic sensitivity analyses were conducted to validate the robustness of the results. The unit price of IMI/REL was set at 1 240 yuan per vial based on publicly available sales prices, and which both base-case and scenario analyses were conducted.
The base-case analysis showed that the total treatment cost in the IMI/REL group was 164 275.71 yuan with a quality-adjusted life year (QALY) of 4.32, while the total cost in the PIP/TAZ group was 143 946 yuan with a QALY of 4.13. The incremental cost-utility ratio (ICER) was 104 991.37 yuan per QALY, which was lower than the threshold of three times China's per capita gross domestic product (GDP). The scenario analysis indicated that under the assumption of partial survival among uncured patients, the cost-effectiveness conclusion of IMI/REL remained robust.
Under the currently available price setting, IMI/REL demonstrates favorable cost-effectiveness compared with PIP/TAZ, providing a reference for optimizing treatment strategies and informing medical insurance payment policies for HABP/VAP in China.
To investigate the relationship between potentially inappropriate medication (PIM) and falls among the elderly in the medical-nursing integration community, and to provide a basis for fall prevention in the elderly.
A retrospective study was conducted. General information of the participants was collected, including basic information, disease conditions, medication use, various assessment records, and records of fall events. PIM screening was performed using the criteria of potentially inappropriate medications for older adults in China (2017). Statistical analyses were performed using R 4.3.0. Depending on the data type, t-tests, non-parametric rank sum test, or chi-square test was used, and logistic regression was used to analyze the relationship between various risk factors and falls.
A total of 1 153 elderly individuals from the medical-nursing integration community were enralled and divided into two groups based on the presence of falls between January 2022 and June 2024: the fall group (n=290) and the non-fall group (n=863). Multivariate Logistic regression analysis showed that increased age, the presence of pain, anxiety and depression, and an increased number of psychotropic PIMs, endocrine PIMs, and NSAID PIMs were independent risk factors for falls (P<0.05), whereas a higher education level was a protective factor against falls (P<0.05).
An increased number of endocrine PIMs, NSAID PIMs, and psychotropic PIMs is closely associated with falls in the elderly. Clinicians should promote rational drug use, reduce the types and numbers of PIMs, and thus lower the risk of falls in this population.
Central nervous system (CNS) diseases have become a major global public health challenge. With the extension of human lifespan and the intensification of population aging, the incidence of these diseases has shown a significant upward trend, yet their clinical treatment still faces critical technological bottlenecks. The presence of the blood-brain barrier (BBB) hinders the delivery of over 98% of small-molecule drugs and nearly all macromolecular drugs into the brain, rendering conventional drug administration methods unable to achieve effective therapeutic concentrations. In recent years, brain-targeted nano-drug delivery systems based on nanotechnology have demonstrated breakthrough potential: nanocarriers can improve the efficiency of drug crossing the BBB through size effects; surface functional modifications enable precise drug delivery to the brain. This article describes the composition and function of the BBB, the types of nanocarriers, and brain-targeting strategies via functional group modifications, aiming to provide theoretical foundations and technical references for developing safe and efficient brain-targeted nano-drug delivery systems.
Targeted nano-drug delivery systems (NDDS) have provided a new strategy for the precise therapy of tumor. NDDS, as novel modes of drug delivery, are capable of penetrating various biological barriers to deliver therapeutic agents precisely to tumor sites. By leveraging their unique size effect, controlled release, stimulation response, ease of modification and functionalization, these systems enhance drug stability and solubility, improve bioavailability, and reduce systemic toxicity and side effects. Consequently, they enable targeted drug delivery and theranostics, offering promising solutions to overcome the therapeutic limitations of conventional chemotherapeutic agents. This paper summarizes the advantages of NDDS, the classification, principles and targeted design strategies of nano-carriers, focuses on the types of commonly used targeting ligands and their mechanisms of action, analyzes the current developments and challenges in scalable production, in vivo transport, biocompatibility and clinical translation, and looks forward to the prospects of future applications, with the aim of providing references for the further development and clinical applications.
Vaccination against influenza serves as a critical measure for disease prevention, significantly mitigating the socio-economic impacts of influenza epidemics. This study conducted a comprehensive analysis of global influenza vaccine-related patents retrieved from the PatSnap global patent database, examining multiple dimensions including patent application trends, geographical distribution, patent classifications, and rankings of key applicants. Furthermore, it investigated the technological focal points in existing patents and analyzed the patent portfolios of major applicants, with the aim of providing strategic recommendations for domestic influenza vaccine R&D and patent deployment. Statistical analysis revealed a phased growth pattern in influenza vaccine patent applications, with China and the United States dominating both technology origination and target markets. While multinational corporations like GlaxoSmithKline lead in industrial applications, China's applicants primarily consist of universities and research institutions, demonstrating lower industrialization rates. The study proposes three strategic initiatives: enhancing international collaboration for universal vaccine development, strengthening quality supervision systems, and prioritizing intellectual property protection for next-generation vaccine technologies such as nucleic acid vaccines. These recommendations aim to bolster the global competitiveness of China's influenza vaccine industry.
As a specialized agency of the United Nations, the World Health Organization (WHO) is dedicated to promoting the effective regulation of medical products across countries, ensuring that medicines, vaccines, and medical devices can sustain the normal functioning of national health systems and enable individuals from different countries to access high-quality health support. Since 2014, WHO has launched the regulatory systems strengthening (RSS) program for medical products, adopting a series of initiatives to develop a comprehensive framework that guides countries in enhancing their medical product regulatory capacities and provides crucial support for the coordinated improvement of regulatory capabilities on a global scale. This paper focuses on explaining the core initiatives under the RSS program, including the quality management system (QMS), good regulatory practices (GRP), good reliance practices (GRelP), and global competency framework (GCF), which is expected to provide references and insights to accelerate the modernization of drug administration and enhance the international competitiveness of the pharmaceutical industry in China.
Calcitonin gene-related peptide (CGRP) is a neuropeptide with potent vasodilatory effect, closely associated with migraine attacks. CGRP and its receptor (CGRP-R) are currently the most promising targets for the treatment and prevention of migraine. The migraine treatment drugs for CGRP mainly include CGRP-R antagonists and CGRP monoclonal antibodies. By blocking the binding of CGRP to its receptor, CGRP-R antagonists can have a similar effect on migraine as triptans, with a lower incidence of adverse reactions. They are more effective and safe new drugs for treating migraine. The author used the incoPat database to search and count the patent applications of small molecule CGRP/CGRP-R antagonists, analyzed the overall trend of patent applications, geographical distribution, applications of important applicants, the distribution of technical fields of patent applications, and the core patents of key varieties, and tried to reflect the patent application status of small molecule CGRP/CGRP-R antagonists, reveal their development trend, and give relevant suggestions. It provides a reference for domestic pharmaceutical companies and research institutions.
Based on the new drug research and development (R&D) cooperation data of different stages from 2015 to 2021, this study explored the heterogeneity in the composition of entities and spatial structure across different stages of new drug research and development by using social network analysis, negative binomial models and other methods. It identified various types of collaborations in new drug research and development and further discussed the main factors driving such collaborations in China. The main results are as follows: firstly, there are differences in actor composition across various stages of new drug R&D. Universities and research institutions are key actors in the pre-clinical trial phase, whereas enterprises play a dominant role during the clinical trial phase. Secondly, overall, the topological structure of China's new drug R&D collaboration network has evolved from a "dual-core" driven pattern to a "dual-core+multi-polar" driven pattern. The "dual-core" refers to Beijing and Shanghai, while the "multi-polar" nodes include cities such as Suzhou, Guangzhou, Chengdu, and Nanjing. Moreover, the spatial configuration of the collaboration network differs significantly between the pre-clinical and clinical trial phases. Thirdly, in the pre-clinical trial phase, urban R&D collaborations tend to shift from internal to external partnerships, whereas the direction of this shift is reversed during the clinical trial phase. Fourthly, geographical proximity plays a significant role in all stages of new drug R&D collaboration, while factors such as technological and institutional proximity exhibit certain phase-specific and stage-dependent variations.
This paper aims to further give full play to the important role of drug traceability codes in maintaining drug safety and public interests, and overcome the problem of information asymmetry in the field of medical insurance funds. By listing the interest subjects in the supervision of medical insurance funds, analyzing the manifestations of information asymmetry among multiple subjects, and with the help of the theory of information asymmetry, dissecting the problems in aspects such as information disclosure, acquisition, transmission and feedback in supervision. Based on a full understanding of the collection mechanism of drug traceability codes, as well as their existing advantages and disadvantages, and drawing on beneficial practices abroad, we explore new paths for them to empower the supervision of medical insurance funds. The construction of the drug traceability code system in our country is at a critical stage, with problems such as inaccurate information, difficult interpretation and poor sharing. Therefore, it is suggested that the drug traceability code be optimized from the four modules of information disclosure, update, sharing and release, the medical insurance fund settlement system be improved, the training of underwriting personnel be strengthened, the responsibility for fraud and deception in medical insurance be seriously pursued in accordance with the law, the construction of the talent team be improved and the public be encouraged to participate in supervision.