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15 August 2026, Volume 23 Issue 8 Previous Issue   

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Volume 23, Issue 8 Table of Contents 2026, 23(8): 0-0.  Abstract ( 16 )   PDF (531KB) ( 15 )   Related Articles | Metrics

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In vitro mutagenic risk of ibutamoren Ye Qian, Kou Xiaoxuan, Niu Qianyi, Song Jie, Li Xiaoyu, Wen Hairuo 2026, 23(8): 841-847.  DOI: 10.19803/j.1672-8629.20260087 Abstract ( 16 )   PDF (1616KB) ( 7 )   Objective To evaluate the in vitro mutagenic risk of ibutamoren using multiple genotoxicity assays. Methods The genotoxic potential of ibutamoren was estimated via computer modeling based on quantitative structure-activity relationships (Dereck and Sarah models) before being validated via bacterial reverse mutation assays, mice lymphoma gene mutation assay, and PIG-A gene mutation assay. Five bacterial strains were tested in the presence or absence of a metabolic activation system that contained ibutamoren. MLA assays were performed using L5178Y cells and ibutamoren under three treatment conditions (+S9/3 h, -S9/3 h, -S9/24 h). The relative proliferation rate (RPD) was calculated for TK6 cells exposed to ibutamoren at different concentrations for 4 hours (+S9) to assess cytotoxicity, and the incidence of mutant cells (CD55-CD59-/CD19+) was detected. Results Ibutamoren was mutagenic to TA98 cells in the absence of S9 and under metabolic activation by rat liver S9, but not to L5178Y cells under any of the three treatment conditions (+S9/3 h, -S9/3 h,-S9/24 h). Compared to the solvent control group, ibutamoren at 150 μg·mL-1 significantly increased PIG-A gene mutation under metabolic activation by 2%S9 (P<0.001) in a dose-dependent manner. Conclusion Benzaldehyde, a metabolite of ibutamoren, can possibly be a contributor to its mutagenicity, but the precise mechanism needs to be investigated. References | Related Articles | Metrics

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An in vivo biological activity detection method for long-acting erythropoietin Liu Xue, Wang Qiaoxu, Wang Han, Qi Lili, Hang Ai, Zhang Jingxian, Feng Zhen 2026, 23(8): 848-851.  DOI: 10.19803/j.1672-8629.20250932 Abstract ( 10 )   PDF (1366KB) ( 7 )   Objective To investigate the pharmacodynamics of long-acting erythropoietin (EPO) in mice and explore a proper method for an in vivo biological activity detection of long-acting EPO. Methods According to the reticulocyte assay method for determining the biological activity of EPO specified in the Chinese Pharmacopoeia, mice were subcutaneously injected with different doses of long-acting EPO or short-acting EPO. The percentage of reticulocytes in the mouse blood was observed for ten consecutive days after administration. A well-conceived dosing regimen and blood sampling schedule were designed to establish an in vivo method for determining the biological activity of long-acting EPO and to conduct the biological activity assay of long-acting EPO. Results According the bio-statistical model using the (3. 3) parallel line method, the in vivo biological activities of three batches of long-acting EPO were 94% (FL% 23%), 94% (FL% 17%) and 92% (FL% 15%) respectively when mice were given low, medium and high doses of 0.2, 0.4 and 0.8 IU per mouse, and day 4 was the optimal blood sampling time, as with short-acting EPO. Conclusion The blood-sampling time for in vivo biological activity assay of long-acting EPO is on day 4. A method should be established based on clinical dosage and product instructions and verified by tests on its applicability. References | Related Articles | Metrics

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Assessment of pollution and probabilistic carcinogenic risk of Pb, Cd and As in Lonicerae Flos Liao Chang, Liu Jialin, Zuo Tiantian, Lin Yongqiang, Cheng Xianlong, Ren Yating, Wang Yanyan, Wang Yannan, Kong Dejuan 2026, 23(8): 852-858.  DOI: 10.19803/j.1672-8629.20260074 Abstract ( 11 )   PDF (1364KB) ( 10 )   Objective To establish a framework for assessment of pollution by heavy metals and harmful elements and the probabilistic carcinogenic risk that is consistent with the usage of traditional Chinese medicine (TCM). Methods The contents of lead (Pb), cadmium (Cd), and arsenic (As) in 41 batches of Lonicerae Flos derived from Lonicera macranthoides were determined via inductively coupled plasma mass spectrometry (ICP-MS). Levels of contamination were assessed using the single-factor pollution index and the Nemerow comprehensive pollution index. The probabilistic carcinogenic risk was also studied based on Monte Carlo simulation combined with the carcinogenic risk (CR) model. Results After correction by the transfer rate, the single-factor pollution indices ranged from 0.00 to 0.52 for Pb, 0.01 to 0.63 for Cd, and 0.00 to 0.11 for As, with Cd being the primary contributing pollutant. The Nemerow comprehensive pollution index ranged from 0.01 to 0.34, indicating an overall pollution level from safe to slight contamination. The probabilistic carcinogenic risk assessment suggested that the carcinogenic risks attributable to Cd and As in Lonicerae Flos warranted attention in both general and high-exposure populations. Conclusion An integrated approach to assessment of contamination and probabilistic carcinogenic risk of heavy metals and harmful elements in Lonicerae Flos derived from Lonicera macranthoides has been established, which is expected to provide technical support for safety evaluation of TCM and for the formulation or revision of relevant regulatory limit standards. References | Related Articles | Metrics

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Quality evaluation and screening of processing difference markers for Scutellariae Radix based on UPLC fingerprinting combined with multivariate statistical analysis Zheng Binying, Guo Yuchen, Xing Yuhang, Zhang Kaiwen, Guo Zhongyuan, Gong Muxin, Wang Zhimin, Song Yafang, Yang Hong 2026, 23(8): 859-866.  DOI: 10.19803/j.1672-8629.20260334 Abstract ( 15 )   PDF (1762KB) ( 9 )   Objective To establish a more comprehensive quality evaluation system for Scutellariae Radix (SR) and explore the changes in chemical components before and after processing. Methods An ultra-performance liquid chromatography (UPLC) method was developed for simultaneous quantification of seven flavonoids in SR before chemical fingerprinting combined with multivariate statistical analysis was employed to compare samples grown for different years or in different areas, and processed products. Results The analysis found that the contents of the seven flavonoids varied significantly. The overall quality of three-year-old plants was the best, with the baicalin content reaching 171.65 mg·g-1. Through pattern recognition, five chemical components (baicalin, wogonoside, baicalein, oroxin A, and wogonin) were screened as key differential markers for distinguishing raw SR from wine-processed SR. The therapeutic potential of oroxin A warranted more attention. In addition, the established UPLC fingerprint method was highly specific, precise, repeatable and stable, which can be used for accurately distinguishing raw SR from wine-processed SR. Conclusion This study has established a stable and reliable method for simultaneous quantitative analysis of multiple components in SR, identified the key determinants of its quality, and screened out processing-related differential markers. References | Supplementary Material | Related Articles | Metrics

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HPLC fingerprint for Jiuwei Qianghuo pills and quality evaluation Liu Jingjing, Liu Shusen, Li Siqi, Xu Beilei, Liu Jing 2026, 23(8): 867-874.  DOI: 10.19803/j.1672-8629.20260240 Abstract ( 11 )   PDF (4556KB) ( 8 )   Objective To analyze the potential index components of Jiuwei Qianghuo pills and investigate inter-manufacturer quality differences in order to provide a reference for quality evaluation. Methods The HPLC fingerprint of Jiuwei Qianghuo pills was established, and similarity was calculated using the similarity evaluation system for chromatographic fingerprints of traditional Chinese medicine. Common peaks were identified by HPLC-MS via comparisons with reference substances and literature retrieval while their botanical origins were traced by comparing single medicinal materials with the whole formulation. Network pharmacology was employed to construct a component-target network and perform pathway enrichment analysis to identify key components. Results A total of 18 common peaks were identified in the fingerprint and attributed to their respective medicinal sources: peaks 1, 17, and 18 to Atractylodis Rhizoma, peaks 2, 5, and 7 to Saposhnikoviae Radix, peaks 3, 8, and 14 to Notopterygii Rhizoma et Radix, peaks 6, 9, 10, and 11 to Scutellariae Radix, peaks 13 and 16 to Angelicae Dahuricae Radix, peak 4 to Rehmanniae Radix, peak 12 to Glycyrrhizae Radix et Rhizoma, and peak 15 to Chuanxiong Rhizoma. The similarity of fingerprints for 8 batches of samples ranged from 0.883 to 0.971, indicating considerable quality variations between manufacturers. A total of 632 intersection targets were obtained between components and diseases, with the pills primarily acting against wind chill or common colds through the PI3K-Akt signaling pathway, the MAPK signaling pathway, among others. Five key targets and seven key active components were identified, suggesting that the therapeutic effects of Jiuwei Qianghuo pills were mediated through multiple components, targets, and pathways. Conclusion The established HPLC fingerprint is stable and reliable. Combined with network pharmacology to predict potential active ingredients, targets, and pathways, this study provides a reference for elucidating the pharmacodynamic material basis and quality control of Jiuwei Qianghuo pills. References | Supplementary Material | Related Articles | Metrics

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Contents of alkaloids in Arecae Semen grown in different areas and harvested at different times by HPLC Zhu Tao, Bach Thitham, Ling Jie, Zan Ke, Zhang Ronglin, Lin Queyue 2026, 23(8): 875-879.  DOI: 10.19803/j.1672-8629.20260239 Abstract ( 11 )   PDF (1404KB) ( 8 )   Objective To determine the optimal origin and harvest time of Arecae Semen by analyzing the contents of four alkaloids in Arecae Semen of different origins and harvested at different times. Methods A high-performance liquid chromatography (HPLC) method was adopted to determine the contents of four alkaloids, namely guvacoline, arecoline, guvacine, and arecaidine, in Arecae Semen grown in China, Indonesia, Myanmar and Vietnam and harvested at different times. The separation was performed on a Waters XBridge BEH Amide column (4.6 mm×250 mm, 5 μm) with a mobile phase consisting of acetonitrile (A) and 0.2% phosphoric acid (containing 0.2% triethylamine) (B) under gradient elution (0-20 min, 19%A; 20-25 min, 19%→23%A). The detection wavelength was set at 210 nm, the flow rate was 1 mL·min-1, and the column temperature was maintained at 30°C. Results There were significant differences in contents of alkaloids in Arecae Semen of different origins. The contents of alkaloids in Arecae Semen from Hainan and Guangdong were much higher than those of other origins while the content of arecaidine in Vietnamese samples was relatively high. Furthermore, the contents of arecoline and guvacoline were higher in mature samples, whereas the content of arecaidine was higher in immature samples. Conclusion There are significant differences in contents of alkaloids in Arecae Semen collected from different areas and harvested at different times. This study is expected to provide data for finding better production areas and harvesting periods. References | Related Articles | Metrics

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A bioactivity assay method for quality control of Zhike Pipa granules based on antioxidant effects Qu Shuiqing, Chen Sini, Li Ruiyun, Cao Chunran, Li Zheng, Cai Tong, Li Wendong 2026, 23(8): 880-886.  DOI: 10.19803/j.1672-8629.20250888 Abstract ( 11 )   PDF (1676KB) ( 8 )   Objective To establish a novel bioactivity-based quality control method for Zhike Pipa granules based on clinical efficacy and the potential role of antioxidant stress activity. Methods The antioxidant activity of Zhike Pipa granules was evaluated using four bioactivity indicators: superoxide anion scavenging capacity, hydroxyl radical scavenging capacity, DPPH radical scavenging capacity, and total antioxidant capacity. The indicator with the optimal linearity and sensitivity was selected for methodological validation before the selected method was used to evaluate the bioactivity of samples of Zhike Pipa granules from different manufacturers to compare their quality. The spectrum-effect relationship between chemical components and antioxidant activity was established via Pearson correlation analysis, gray relational analysis (GRA), and orthogonal partial least squares analysis (OPLS), and the potent pharmaceutical ingredients responsible for ZPG’s antioxidant effect were screened. Results Compared with the other three indicators, the DPPH radical scavenging capacity of Zhike Pipa granules showed excellent linearity within the range of concentrations, were highly sensitive, and met methodological requirements for repeatability and stability. Using this indicator, the quality of Zhike Pipa granules from 18 manufacturers was evaluated. The DPPH scavenging capacity was found to vary widely. Spectrum-effect relationship analysis showed that chlorogenic acid, neo-chlorogenic acid, cryptochlorogenic acid, hyperoside, and isoquercitrin were significantly correlated with the DPPH free radical scavenging rate in at least two methods, which were regarded as the leading contributors to the antioxidant activity of ZPG. Conclusion This study has established a bioactivity-based quality control method for Zhike Pipa granules using the DPPH radical scavenging capacity as a key parameter. This method can lead to favorable linearity, a high sensitivity, and satisfactory repeatability and stability. Results of bioactivity screening indicate that chlorogenic acid, neo-chlorogenic acid, cryptochlorogenic acid, hyperoside, and isoquercitrin are the key active ingredients responsible for ZPG’s antioxidant effect. This study is expected to provide some reference for quality control of ZPG based on clinical efficacy. References | Related Articles | Metrics

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Determination of meropenem concentrations in human plasma using 2-dimensional liquid chromatography Ding Rui, Chen Yongyan, Han Wenchao, Zhang Hanjuan 2026, 23(8): 887-891.  DOI: 10.19803/j.1672-8629.20250498 Abstract ( 10 )   PDF (1307KB) ( 7 )   Objective To establish a fully automated 2-dimensional liquid chromatography with ultraviolet detection (2D-LC/UV) method for determining the concentration of meropenem in plasma from critically ill patients and to apply it in clinical practice. Methods A 2D-LC/UV system was adopted. Plasma samples were processed with a protein precipitant. Online solid-phase extraction was performed on a one-dimensional column-Aston SNCB (4.6 mm×50 mm, 5 μm)-for preliminary enrichment and separation of meropenem before the target analyte was transferred to a two-dimensional column-Aston SNBR (4.6 mm×200 mm, 5 μm)- for further separation and detection. The mobile phases for the one-dimensional and two-dimensional columns were meropenem-1D and BPI-1 alkaline, respectively, at a flow rate of 1.0 mL·min-1. The column temperature was 40℃, and the detection wavelength was 310 nm. The external standard method was used for quantification. Results Meropenem showed good linearity at concentrations ranging from 1.837 5 to 147 μg·mL-1, with a correlation coefficient (R²) of 0.999 98. The relative recoveries for the low-, medium-, and high-concentration (1.5、20.0、80.0 μg·mL-1) quality controls (QCs) exceeded 95%, and both intra- and inter-day precision (RSD%) was below 5%. Conclusion This method proves to be capable of accurate and efficient automated analysis while streamlining the pretreatment process and reducing costs. Furthermore, it is sensitive enough for high-throughput monitoring of steady-state trough concentrations of meropenem. References | Related Articles | Metrics

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Multicenter case analysis of thyroid dysfunction associated with immune checkpoint inhibitors Lyu Xinge, Liu Aijia, Wu Yi, Pan Chen, Wang Yuting, Cui Xiangli 2026, 23(8): 892-897.  DOI: 10.19803/j.1672-8629.20260414 Abstract ( 11 )   PDF (1289KB) ( 7 )   Objective To analyze cases of immune checkpoint inhibitors-related thyroid dysfunction (ICIs-TD) from both multicenter and literature sources in order to provide a reference for early clinical identification and optimization of management strategies. Methods Patients with malignancies who developed thyroid dysfunction following ICIs therapy were retrospectively enrolled from six hospitals between August 2024 and July 2025. CNKI, Wanfang, VIP, PubMed, Web of Science, Scopus, Embase, and Cochrane Library were searched for literature related to ICIs-TD that was published as of October 2025. Clinical characteristics were summarized and statistically analyzed. Results A total of 70 patients with ICIs-TD were enrolled from six hospitals, including 47 cases of hypothyroidism, 17 cases of hyperthyroidism, and 6 cases of thyroiditis. A total of 238 articles involving 265 cases of ICIs-TD were included in literature review, comprising 127 cases of hypothyroidism, 53 cases of hyperthyroidism, and 85 cases of thyroiditis. Hypothyroidism was the dominating condition, and most patients received programmed cell death-1 (PD-1) inhibitors. More than 60% of the patients developed ICIs-TD within 4 months of ICIs therapy. The median time to onset was 97 (66.5, 133.5) days in the multicenter cohort and 63 (42, 105) days in literature, respectively. The symptoms were generally mild, with more than half of the patients continuing ICIs. Management strategies included thyroid hormone replacement or symptomatic treatment with β-blockers, and the overall prognosis was favorable. Conclusion Regular monitoring of thyroid function and antibodies during ICIs therapy is recommended, especially in high-risk populations, in order to facilitate early detection of thyroid injury. Frequent interruption of immunotherapy should be avoided to support individualized precision management. References | Related Articles | Metrics

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Pharmacovigilance for general anesthetics Sa Rina, Shi Yanlei, Ma Yuanyuan, Ma Yanping, Pan Xinbo, Liang Xi, Ge Bin, Lu Jinjing, Zhang Bing 2026, 23(8): 898-903.  DOI: 10.19803/j.1672-8629.20250750 Abstract ( 19 )   PDF (1365KB) ( 12 )   Objective To explore ways to use general anesthetics safely and establish a perioperative pharmacovigilance system so as to improve the quality of anesthesia and ensure surgical safety. Methods By reviewing the latest literature, the priorities of pharmacovigilance concerning commonly used general anesthetics were summarized, and a full-cycle strategy for pharmacovigilance was constructed that involved “pre-anesthesia assessment of risks-individualized regimens-perioperative real-time monitoring- management of postoperative recovery”. Measures to strengthen pharmacovigilance for surgical anesthesia were recommended. Results This strategy for full-cycle pharmacovigilance identified the major risks posed by anesthetics. Through institutionalized management, this strategy could do much to reduce the risk of drug-related adverse events and enhance the precision of perioperative management. Conclusion A strategy for full-cycle pharmacovigilance and a localized pathway for implementation have been established, which is expected to provide a valuable reference for optimizing the management of general anesthetics in medical institutions and for boosting the construction of safety systems for anesthesia. References | Related Articles | Metrics

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691 cases of adverse drug reactions caused by new antineoplastic drugs Li Jianping, Du Ning, Tang Min, Zhou Ziyuan, Zuo Jing 2026, 23(8): 904-908.  DOI: 10.19803/j.1672-8629.20260055 Abstract ( 15 )   PDF (1289KB) ( 11 )   Objective To study the patterns and characteristics of adverse drug reactions (ADRs) related to new antineoplastic drugs, and provide a reference for clinical medication. Methods A total of 691 cases of ADRs caused by new antineoplastic drugs were collected in a cancer hospital between October 2020 and October 2025. Data on gender, age, types of drugs, systems-organs involved in ADRs, clinical manifestations, off-label medication, grading and outcomes of ADRs and correlations was analyzed via the Microsoft Excel. Results Among the 691 cases, 374 (54.12%) were males and 317 (45.88%) females, and the average age was (57.02±12.34) years. There were 397 (57.45%) cases of serious ADRs and 32 (4.63%) cases of new ADRs. A total of 70 new antineoplastic drugs were involved. Immune checkpoint inhibitors were responsible for 271 cases (35.61%),and tislelizumab was the leading cause (72 cases). There were 121 cases involved in off-label medication and 20 systems-organs involved. The most frequently affected systems were blood and the lymphatic system (48.59%). Most of these ADRs were mitigated (78.00%). Conclusion Data on pharmacovigilance concerning new antineoplastic drugs remains lacking. ADRs associated with these agents can involve multiple systems-organs. Therefore, it is recommended that patients undergo baseline and dynamic monitoring. Off-label medications pose a risk to safety. Multidisciplinary collaboration and ethical review should be enforced to reconcile the conflict between delayed generation of evidence and pressing clinical needs. References | Related Articles | Metrics

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214 cases of adverse drug reactions caused by inosine injection Bai Liqin, Nie Hongke, Yang Shuting, Jiang Xiaofeng 2026, 23(8): 909-913.  DOI: 10.19803/j.1672-8629.20260111 Abstract ( 15 )   PDF (1196KB) ( 11 )   Objective To analyze the characteristics of adverse drug reactions (ADRs) induced by inosine injection and provide references for safe medications. Methods A total of 214 cases of ADRs induced by inosine injection collected in 2004-2025 were retrieved from the Adverse Drug Reaction Monitoring System of Yunnan Province. Statistical analysis was conducted of the patients’ gender, age, systems-organs involved and clinical manifestations, indications for medication, combined medications, and onset time of ADRs. Results The male-to-female ratio was 0.57:1. Most of the adverse reactions caused by inosine for injection occurred in patients over 65 years old. The primary diseases were indications that were not recorded in package inserts in 57 patients (26.64%). Combined medications included electrolyte/acid-base balance/ nutrition agents, enzymes and other biochemical agents (113 cases, 52.80%). Adverse reactions usually started within 30 minutes of medication. ADRs primarily involved the skin and appendages, the whole body, sites of injection and the gastrointestinal system. The new serious clinical manifestations were rigors, hyperpyrexia, dyspnea, palpitations, anaphylactoid reaction, purpura, anaphylactic shock and hypersensitivity. Conclusion Clinicians should be alert to ADRs caused by inosine for injection in clinical practice, standardize clinical medications, and prevent such serious adverse reactions as anaphylaxis. References | Related Articles | Metrics

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Clinical characteristics of 105 cases of drug poisoning Xiao Yue, Chen Huilin, Liu Huiying, Liu Yingjie, Hu Yiyun, Xu Shixi 2026, 23(8): 914-918.  DOI: 10.19803/j.1672-8629.20260017 Abstract ( 16 )   PDF (1365KB) ( 12 )   Objective To explore the epidemiology, distribution of drug types, causes of poisoning, and factors influencing the prognosis of patients with drug poisoning in order to provide evidence for developing strategies for targeted prevention and clinical management. Methods The clinical data of 105 patients with drug poisoning admitted to The First People’s Hospital of Chenzhou City between December 31, 2023 and December 31, 2024 was retrieved. Descriptive analysis, the chi-square test, and multivariable logistic regression analysis were used to analyze the patients’ gender, age, types of drugs, causes of poisoning, clinical interventions, and prognosis. Results Among the 105 patients, 36 (34.28%) were male and 69 (65.72%) were female, with an average age of (21±14) years. The proportion of adolescents ages 18 and younger was the highest (64.76%). The most commonly-used drug was antipsychotics (27.62%). Self-poisoning by medication was the leading cause of poisoning (67.62%), particularly among adolescents aged 13-18 (94.00%), with the female suicide rate by drug ingestion (78.26%) significantly higher than that of males (47.22%). Logistic regression analysis indicated that the length of hospital stay, age, gender, history of mental illness, categories of intoxicating agents, therapeutic drug monitoring, gastric lavage, and blood purification were not independent risk factors for prognosis(cured or not) (all P>0.05). Conclusion In this region, adolescent females represent the primary population affected by drug poisoning, with self-poisoning by medication being the primary cause. Antipsychotic drugs are the primary category of toxic substances. Prevention efforts should prioritize mental health of adolescents and the regulation of antipsychotic drugs for future prevention and control efforts. References | Related Articles | Metrics

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Determinants of blood concentrations and target attainment rates of sodium valproate Yang Hang, Liu Ting, Zhao Yan, Wang Xiuli 2026, 23(8): 919-925.  DOI: 10.19803/j.1672-8629.20260322 Abstract ( 12 )   PDF (1529KB) ( 11 )   Objective To analyze the blood concentrations of sodium valproate in inpatients at a hospital and explore the determinants of blood concentrations and therapeutic target attainment so as to provide references for rational use of sodium valproate. Methods This study was a retrospective study. The concentrations of sodium valproate in patients hospitalized at the First Affiliated Hospital of Henan Polytechnic University between October 20, 2021 and March 26, 2026 were analyzed. All the samples were detected via fluorescent immunochromatographic assay and a total of 137 valid cases were collected. The therapeutic target attainment rate of blood concentrations and the incidence of adverse drug reactions (ADRs) in these patients were calculated while the effects of gender, age, liver function, smoking history, drinking history, comorbidities, dosage forms, daily dose, and concomitant medications on blood concentrations and the target attainment rate were explored. Results The mean blood concentration of sodium valproate among the 137 inpatients was (60.38±36.80) μg·mL-1, and the target attainment rate was 44.52%. The incidence of ADRs was 13.87%. Notably, the incidence of ADRs was significantly higher among patients with blood concentrations above 100 μg·mL-1 and those treated with injection. Multiple linear regression analysis showed that daily dose, injection, concomitant carbapenems and hepatic enzyme inducers were independent factors influencing blood concentrations, with statistically significant difference (P<0.05). Binary logistic regression analysis suggested that liver function was an independent influencing factor of the target attainment rate of blood concentrations (OR=8.349, 95%CI: 1.752-39.772, P=0.008). Conclusion Clinicians should closely monitor patients’ liver function, daily dose, and dosage forms, as well as concomitant use of carbapenems and hepatic enzyme inducers when administering sodium valproate. Monitoring blood concentrations of sodium valproate can provide references for its rational clinical administration. References | Related Articles | Metrics

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Contributors to sinus bradycardia caused by amisulpride Zhu Lifang, Wang Lingjun, Li Huanfen, Chen Yongxin, Huang Supei, Wang Jinbao, Guo Fei 2026, 23(8): 926-930.  DOI: 10.19803/j.1672-8629.20250580 Abstract ( 9 )   PDF (1379KB) ( 8 )   Objective To explore the incidence and determinants of sinus bradycardia caused by amisulpride and provide a reference for rational medication. Methods The medical records of inpatients taking amisulpride between January 15, 2024 and January 15, 2025 were retrieved from the hospital information system. The effects of gender, age, BMI, medical history, daily dose, concomitant medications, basal heart rate and baseline blood potassium levels on the occurrence of sinus bradycardia were investigated. At the same time, the incidence and the dosage when sinus bradycardia occurred were calculated. Single factor analysis and multivariate logistic regression were used to analyze the contributors. Results A total of 215 inpatients were included in this study, 72 of whom had sinus bradycardia, and 16 were complicated with arrhythmia, so the incidence rate was 33.49%. According to the Naranjo scale, 15 of these cases were probably related to amisulpride and 57 were possibly related. Thirty-nine of these patients were treated with amisulpride at doses of over 800 mg·d-1, 24 at doses that ranged from 400 mg·d-1 and 800 mg·d-1, and 9 at doses of less than 400 mg·d-1. Single factor analysis showed that there were statistically significant differences in basal heart rate, types of combined drugs and combinations with clozapine (all P<0.05). The results of multiple logistic regression analysis suggested that basal heart rate and clozapine were significantly associated with sinus bradycardia caused by amisulpride (all P<0.05). Conclusion Patients should undergo electrocardiogram examinations before using amisulpride. High doses of amisulpride are more likely to cause sinus bradycardia. In case of slow basal heart rate, patients ought to be given other antipsychotic drugs. The dose or type of drugs should be adjusted along with changes in the electrocardiogram to ensure safe and effective medication. References | Related Articles | Metrics

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Two cases of hematemesis caused by polyethylene glycol electrolytes powder (Ⅱ) during bowel preparation Zhang Yumao, Liu Junbo, Luo Qianjiang, Tan Binying, Deng Bin, Xing Weiqing, Li Yuzhen 2026, 23(8): 931-933.  DOI: 10.19803/j.1672-8629.20260120 Abstract ( 17 )   PDF (1254KB) ( 11 )   Objective To analyze the clinical characteristics of hematemesis induced by polyethylene glycol electrolytes powder (Ⅱ) for bowel preparation, explore the possible mechanisms and risk factors, and provide references for safe clinical medication. Methods Two cases of hematemesis due to severe vomiting after administration were retrospectively analyzed. Based on a literature review, the mechanisms, causality, potential triggers, and preventive measures were explored. Results Correlation analysis showed that hematemesis was associated with polyethylene glycol electrolytes powder (Ⅱ) in these two patients. Symptoms improved after drug discontinuation, acid suppression and symptomatic treatment with favorable prognosis. Conclusion Despite its safety, polyethylene glycol electrolytes powder may cause severe vomiting, hematemesis or even Mallory-Weiss Syndrome. Physicians should evaluate risk factors beforehand and control administration speed to prevent severe vomiting and ensure safe medication. References | Related Articles | Metrics

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Two cases of acute systemic pain caused by sacituzumab tirumotecan for injection in cancer patients Gao Chaozheng, Zhao Yifan, Su Li, Li Ping 2026, 23(8): 934-937.  DOI: 10.19803/j.1672-8629.20250700 Abstract ( 11 )   PDF (1197KB) ( 7 )   Objective To explore such adverse drug reactions (ADRs) as acute pain caused by sacituzumab tirumotecan for injection and to evaluate its clinical manifestations, potential mechanisms, and management strategies. Methods A retrospective analysis was conducted of two cancer patients who developed acute pain following treatment. Data on patients’ demographics, time to ADR onset, pain manifestations, and interventions was collected. Potential mechanisms were analyzed with reference to the literature. Results Both patients developed acute pain within 4 hours of intravenous infusion. Symptoms were gradually resolved after symptomatic treatment and drug discontinuation. Literature suggested that as a TROP-2-targeted antibody-drug conjugate (ADC), sacituzumab tirumotecan for injection might caused pain through such mechanisms as inflammatory mediator release or the “bystander effect”. Conclusion Sacituzumab tirumotecan for injection may cause acute pain. Clinicians should be vigilant about this risk, and close monitoring and prompt interventions during treatment are recommended. References | Related Articles | Metrics

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One case of sequential delayed-to-immediate hypersensitivity reaction caused by sacituzumab tirumotecan for injection Xie Huali, Guan Bixi, Zhuo Yubo, He Jieli, Chen Zhe 2026, 23(8): 938-940.  DOI: 10.19803/j.1672-8629.20250854 Abstract ( 13 )   PDF (1271KB) ( 8 )   Objective To analyze one case of sequential hypersensitivity reactions (HSRs) caused by sacituzumab tirumotecan for injection (sac-TMT) and provide a reference for safe clinical use. Methods One case of sequential HSRs in a patient with advanced breast cancer treated with sac-TMT was analyzed. Clinical manifestations, laboratory findings, and treatment regimens were analyzed with reference to literature. Results Delayed rash, pruritus, and fever occurred 4 days after the first dose, which was consistent with type Ⅳ HSR. During the second infusion, anaphylactic shock (typeⅠHSR) occurred 13 minutes after initiation and was classified as Brown grade 3. Total immunoglobulin E and interleukin-6 levels were elevated. Causality was determined as “probable”. After drug withdrawal and emergency treatment, the patient recovered. Sac-TMT was permanently discontinued. Conclusion Sac-TMT can induce sequential HSRs progressing from typeⅣ to typeⅠupon re-exposure, suggesting immunogenicity risks. For patients with risk factors for HSRs or a history of HSRs, comprehensive pre-treatment assessment and emergency preparedness are recommended in accordance with clinical guidelines and prescribing information. References | Related Articles | Metrics

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One case of euglycemic diabetic ketoacidosis caused by ertugliflozin tablets combined with polyethylene glycol loxenatide injection Sun Qian, Yu Ying 2026, 23(8): 941-943.  DOI: 10.19803/j.1672-8629.20250913 Abstract ( 10 )   PDF (1242KB) ( 8 )   Objective To analyze the risks and mechanism of euglycemic diabetic ketoacidosis (euDKA) induced by the combination of ertugliflozin tablets and polyethylene glycol loxenatide injection in order to contribute to the safety of clinical medications. Methods The treatment process of a patient who developed euDKA after using the aforementioned drug combination was analyzed while the mechanism and risk factors were investigated based on literature. Results The patient’s condition improved after discontinuation of suspected drugs and symptomatic treatment. Conclusion The combination of ertugliflozin tablets and polyethylene glycol loxenatide injection may induce euDKA. Clinicians should assess the condition of an individual patient, offer pharmaceutical care and provide related information to ensure safe medications. References | Related Articles | Metrics

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One case of rash caused by chiglitazar sodium tablets Lin Liping, Chen Yan, Jia Xueling 2026, 23(8): 944-947.  DOI: 10.19803/j.1672-8629.20250774 Abstract ( 16 )   PDF (1160KB) ( 10 )   Objective To investigate the clinical characteristics and potential immunologic mechanisms associated with rashes induced by chiglitazar sodium tablets in order to provide a reference for safe medication. Methods The clinical data of a patient who had developed a rash following the administration of chiglitazar sodium was retrospectively analyzed. Causality was evaluated using the Naranjo Adverse Drug Reaction Probability Scale, and related literature was reviewed to explore possible immune mechanisms and treatment strategies. Results The patient presented with a rash the day chiglitazar sodium tablets were administrated, which progressed to a generalized rash across the body within six days. Symptoms were resolved within 48 hours of drug discontinuation. The Naranjo score was 6, indicating a “probable” association with the drug. Literature suggested that this type of rash might be linked to immune mechanisms. Treatment involved drug discontinuation, and the prognosis was favorable following symptomatic management. Conclusion Chiglitazar sodium tablets carry the risk of inducing rashes, so enhanced clinical monitoring and early identification are recommended. Upon the onset of a rash, immediate discontinuation of the drug and prompt intervention are essential to safe medication. References | Related Articles | Metrics

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Progress in vaccine development during the endgame of the Global Polio Eradication Initiative Quan Yaru, Zhang Su, Chen Guoqing 2026, 23(8): 948-953.  DOI: 10.19803/j.1672-8629.20260303 Abstract ( 13 )   PDF (1430KB) ( 7 )   In the endgame of the Global Polio Eradication Initiative (GPEI), the research and development of poliovirus vaccines is shifting from empirical attenuation to molecular rational design to address two key safety concerns: the risk of circulating vaccine-derived poliovirus (cVDPV) outbreaks triggered by conventional oral poliovirus vaccines (OPVs), and the biosafety risk associated with live virus used in conventional inactivated poliovirus vaccine (IPV) production. This article reviews the research progress in novel oral poliovirus vaccines (nOPV), S19-inactivated poliovirus vaccine (S19-IPV), and virus-like particle (VLP) vaccines. It is recommended that multi-technology synergy be adopted to advance technical upgrades from genetic modification to zero-live-virus production, thereby establishing a robust immune barrier free of derivative risks and achieving complete polio eradication. References | Related Articles | Metrics

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Research progress in the integrated mechanism of traditional Chinese medicine against gastric ulcer by regulating multiple signaling pathways and intestinal flora Zhang Xuqiang, Dong Shoutang, Wang Huaibin, Gong Xiaomin, Li Weijun, Yang Hongqin 2026, 23(8): 954-959.  DOI: 10.19803/j.1672-8629.20260280 Abstract ( 15 )   PDF (1342KB) ( 10 )   Objective To review the integrative mechanisms by which Traditional Chinese Medicine combats gastric ulcer by regulating multiple signaling pathways and gut microbiota and inducing synergistic interactions between these two systems so as to provide data for clinical research. Methods Related databases were searched for studies published in recent years on the regulation of signaling pathways related to gastric ulcer and to the modulation of gut microbiota structure and function mediated by Traditional Chinese Medicine. The included studies were analyzed by focusing on the mechanisms underlying inflammatory responses and gastric mucosal repair. Results By regulating multiple signaling pathways, Traditional Chinese Medicine can not only alleviate inflammation and promote the proliferation and repair of gastric mucosal epithelial cells, but also modulate gut microbiota composition, restore microbial homeostasis, and enhance mucosal barrier function. Bidirectional interactions were observed between signaling pathways and gut microbiota, forming an integrated network that contributed to synergistic mucosal repair. Conclusion Traditional Chinese Medicine can be used to treat gastric ulcer through integrative mechanisms involving multiple targets, multiple pathways, and gut microbiota regulation. This study is expected to offer new lines of thought for future research. References | Related Articles | Metrics

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MHRA warns of angioedema risk caused by angiotensin-converting enzyme inhibitors (ACEI) 2026, 23(8): 960-960.  DOI: 10.19803/j.1672-8629.20269908 Abstract ( 1 )   PDF (647KB) ( 1 )   Related Articles | Metrics