Medication therapy management is a core component in optimizing patients' therapeutic effects and ensuring medication safety. In recent years, with the gradual maturity and wide application of big data technology, machine learning has been playing an increasingly important role in medication therapy management research. It can help healthcare professionals in making rational use of resources, exploring new insights into benefits and risks, and guiding patients to obtain the optimal medication therapy management plans. This paper focused on the current application status of machine learning in the process of medication therapy management, summarized its research achievements in aspects such as adverse drug reaction monitoring, drug-drug interaction prediction, identification of potentially inappropriate medications, optimization of therapeutic drug monitoring, improvement of medication adherence, and support for patient education, and providing references for the research on medication therapy management models.

Medication therapy management for pregnant patients faces severe challenges due to ethical restrictions, individual metabolic differences, and dynamic pharmacokinetic characteristics, making it difficult for traditional methods to meet the demand for precision. Artificial intelligence(AI) provides innovative approaches for medication safety assessment, dose optimization, and personalized medication decisions during pregnancy by integrating multimodal data(such as electronic health records, genomics, real-world evidence) with machine learning, deep learning, and other technologies. This article systematically reviewed the application progress and challenges of AI technology in medication therapy management for pregnant patients, providing theoretical basis for optimizing maternal, and infant safety and clinical decision-making.

Objective To explore the roles of fatty acid binding protein(FABP)4, FABP5, CD36, interleukin(IL)-17 and IL-22 pathways in the recurrence of psoriasis and the targets of the Wuzhong Baidu decoction. Methods A total of 30 SD rats were randomly divided into the blank group, the model group, the Western medicine group(0.023 mg/ mL methotrexate suspension), and the low -, medium -, and high-dose traditional Chinese medicine groups(0.554 g/ mL, 1.107 g/mL, 2.214 g/mL Wugong Baidu decoction concentrated liquid), with 5 rats in each group. The recurrence model was established by using the secondary induction method of imiquimod. The lesion index of each group was compared using the mouse psoriasis area and severity index(MPASI) scoring method. Histopathological changes in the tissues of each group were observed. The distribution of apoptotic cells, collagen fibers, and the mRNA and positive protein levels of various indicators in each group were compared. Results Compared with the model group, the high-dose traditional Chinese medicine group and the Western medicine group significantly improved the skin lesions of rats, reduced the MPASI score(P＜0.05), corrected abnormal keratinization, alleviated cell apoptosis, promoted the synthesis and regular arrangement of collagen fibers, and inhibited the mRNA transcription and protein expression of each index in the pathway(P＜0.05). Conclusion The Wugong Baidu decoction may exert its preventive and therapeutic effects on the recurrence of psoriasis by inhibiting lipid metabolism disorders mediated by FABP4, FABP5 and CD36, and downregulating IL-17 and IL-22, from the perspective of the "lipid metabolism-immune imbalance" linkage.

Objective To explore the effects and mechanism of Liqi Jieyu formula on the behavioral changes and the regulation of the hypothalamic-pituitary-adrenal(HPA) axis function in a rat model of post-stroke depression(PSD). Methods A total of 45 SD rats were selected and randomly divided into the normal group, the model group, the positive control group, the high-dose group and the low-dose group. The PSD animal model was established by embolizing the middle cerebral artery combined with chronic unpredictable mild stress, and the treatment was administered continuously for 21 days. Before the establishment of the model, body weight and behavioral assessments were conducted on the rats at days 7, 14, and 21. Hematoxylin eosin(HE) staining was used to observe the structure changes in the hippocampal tissue. The levels of adrenocorticotropic hormone(ACTH) and corticosterone were measured by enzyme-linked immunosorbent assay. Western blotting was used to analyze the protein expression levels of hippocampal glucocorticoid receptor(GR) and hypothalamic corticotropin-releasing hormone(CRH). Results Compared with the model group, the body weights of the positive control group, the high-dose group and the low-dose group all increased significantly(P＜0.05). D21, the immobility time in the model group was significantly longer than that in the normal group(P＜0.01), while the positive control group, high-dose group, and low-dose group were significantly shorter than those in the model group(P＜0.01). D21, the consumption levels in the positive control group, the high-dose group, and the low-dose group were all significantly higher than those in the model group(P＜0.01). D21, the scores for vertical and horizontal movements in the positive control group, the high and low dose groups were all significantly higher than those in the model group(P＜ 0.05). The HE staining results indicated that the pathological damage in the cerebral cortex was significantly improved in all treatment groups compared to the model group. The main effects of the serum ACTH(F＝8.911, P＜0.01) and corticosterone(F＝23.51, P＜0.01) levels in each group were significant. The serum ACTH and corticosterone levels in the positive control group and the high-dose group were significantly lower than those in the model group(P＜0.01). Western blotting results showed that compared with the model group, the expression of CRH decreased and GR increased in all treatment group. Conclusion Liqi Jieyu formula can effectively alleviate the depressive-like behavior of PSD rats, and its effect is closely related to the regulation of HPA axis function. The mechanism involves reducing serum ACTH and corticosterone and the protein expression of CRH, increasing the expression of GR in the hippocampus, modulating HPA axis function, thereby ameliorating symptoms in PSD model rats.

Objective To analyze the current applications of machine learning in sepsis diagnosis, treatment and management, and to analysis the research landscape and emerging trends. Methods A systematic literature search was conducted in the PubMed database for studies published between 2020 and 2025, using terms related to "machine learning" and "sepsis". Results A total of 82 peer-reviewed articles were included in the analysis. The study designs encompassed a range of methodologies, including prospective and retrospective approaches, with retrospective studies comprising 90% of the cohort. Notably, 23 studies(28.0%) explored the integration of bioinformatics with machine learning algorithms to identify sepsis-associated biomarkers. However, 63 studies(80.8%) were assessed as having a high overall risk of bias. While significant progress has been made in the areas of early warning systems and prognostic evaluation, there remains a substantial gap in the development of personalized and precision-based therapeutic decision-making tools. Conclusion Future research should prioritize the integration of multimodal data, the development of interpretable models, and clinical translation to enhance the accuracy and efficiency of sepsis diagnosis and treatment.

Objective To investigate the lipid-lowering effect of sacubitril valsartan combined with rosuvastatin on patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI) and its impact on the cardiovascular outcomes. Methods A total of 121 ACS patients admitted to Shanghai Jing'an district Zhabei central hospital from January 2021 to December 2024 were selected as the research subjects. They were divided into the case group(61 cases) and the control group(60 cases) according to the treatment methods. Both groups underwent PCI and received aspirin combined with clopidogrel. The control group was given rosuvastatin, while the case group was given sacubitril valsartan combined with rosuvastatin. Both groups were treated for 2 months. The clinical efficacy, lipid levels, myocardial injury conditions, cardiac function, and the occurrence of adverse cardiovascular events were compared between the two groups. Results After treatment, the total clinical effective rate of the case group was higher than that of the control group(91.80% vs. 75.00%, P＜0.05). After treatment, the total cholesterol, triglycerides, low-density lipoprotein cholesterol, N-terminal pro-B-type natriuretic peptide, creatine kinase-MB, and cardiac troponin I levels, as well as the left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and interventricular septal thickness, were all lower than those before treatment in both groups(P＜0.05), and those of the case group were lower than those of the control group(P＜0.05), the high-density lipoprotein cholesterol levels of both groups were higher than those before treatment, and the case group was higher than the control group(P＜0.05). The incidence of adverse cardiovascular events in the case group was lower than that in the control group(4.92% vs. 16.67%, P＜0.05). Conclusion Sacubitril valsartan combined with rosuvastatin can effectively regulate lipid indicators in ACS patients after PCI and has a positive effect on the long-term cardiovascular outcome.

Objective To investigate the clinical efficacy of Tianyi formula on acute ischemic stroke(AIS) patients with Qi deficiency and blood stasis syndrome and its effect on lipid peroxidation levels. Methods A total of 70 patients with AIS and Qi deficiency and blood stasis syndrome who were admitted to the Fujian Provincial People Hospital(Affiliated to Fujian University of Traditional Chinese Medicine) from March 2024 to March 2025 were selected. Patients were randomly divided into a control group and a treatment group, and each group was 35 cases. The control group received conventional treatment, while the treatment group additionally received Tianyi formula. Clinical efficacy, National Institute of Health stroke scale(NIHSS), modified barthel index(MBI), modified Rankin scale(mRS), changes in the Qi deficiency and blood stasis syndrome score, and serum lipid peroxidation indicators were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was higher than that of the control group(88.57 vs 74.29%, P＜0.05). Both groups showed reduced NIHSS scores, mRS scores, and Qi deficiency and blood stasis syndrome scores, and serum ROS, MDA, LPO, and 4-HNE levels, with the treatment group exhibited lower scores than the control group(P＜0.05). After treatment, MBI scores, serum GSH, and GPX-4 levels increased in both groups, with the treatment group showed higher levels than the control group(P＜0.05). Conclusion Tianyi formula demonstrated definite efficacy in treating AIS patients with Qi deficiency and blood stasis syndrome. It can significantly reduce the extent of neurological deficits, improve patients' activities of daily living, alleviate oxidative stress and lipid peroxidation levels, enhance antioxidant capacity, and exhibit clinical safety.

Objective To analyze the efficacy of Xiyanping combined with montelukast sodium in treating pediatric acute bronchitis(ATB), and its effects on inflammatory cytokines, cellular immune function, and airway remodeling m ediators. Methods A total of 122 children with ATB who were diagnosed and treated at our hospital from March 2022 to March 2024 were enrolled, and all of them received conventional treatment. They were divided into a control group(Xiyanping injection) and a study group(Xiyanping injection combined with montelukast sodium) according to block randomization method, with 61 cases in each group. The therapeutic efficacy, pro-inflammatory cytokines, cellular immune function, airway remodeling indicators, and the occurrence of adverse reactions in the two groups were compared. Results After treatment, the total clinical effective rate in the study group was significantly higher than that in the control group(97.80% vs. 67.21%, P＜0.05). Levels of procalcitonin, interleukin(IL)-6, IL-8, and high-sensitivity C-reactive protein decreased significantly in both groups compared to pre-treatment(P＜0.05), and the study group was lower than the control group(P＜0.05). Levels of CD4＋ and CD4＋/CD8＋ ratio, natural killer cells in both groups increased significantly(P＜0.05), while CD8＋ levels decreased significantly(P＜0.05), and the improvements in the study group were significantly greater than those in the control group(P＜0.05). Levels of tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase 9 in both groups decreased significantly compared to pre-treatment(P＜0.05), and the study group was lower than the control group(P＜0.05). The total incidence of adverse reactions in the study group was lower than in the control group(8.20% vs. 4.92%), but the difference was not statistically significant(P＞0.05). Conclusion Xiyanping combined with montelukast sodium can enhance clinical efficacy, alleviate inflammatory reactions, improve immune function, and reduce the expression of airway remodeling in children with ATB.

Objective To explore the therapeutic effect of acarbose combined with liraglutide in the treatment of early diabetic nephropathy(DN) and its influence on urinary microalbumin-to-creatinine ratio (UACR), serum creatinine(Scr), and estimated glomerular filtration rate(eGFR). Methods Patients with early DN admitted to Linquan county people's hospital from April 2022 to April 2025 were selected as the research subjects. Patients were divided into the experimental group(n＝54) and the control group(n＝52). The experimental group received treatment with acarbose combined with liraglutide, and the control group received treatment with liraglutide. Both groups received 8 weeks of treatment. The primary outcome was the overall effective rate, the secondary outcomes included the levels of UACR, Scr and eGFR before and after treatment, the improvement in blood glucose and blood lipids, and the incidence of adverse reactions. Results After treatment, the total effective rate of the experimental group was higher than that of the control group(79.63% vs. 59.62%, P＜0.05). After treatment, the UACR, Scr, fasting plasma glucose, 2-hour postprandial plasma glucose,glycosylated hemoglobin, total cholesterol, triglycerides, and low-density cholesterol levels in the experimental group were lower than those in the control group(P＜0.05), and the eGFR level was higher than that in the control group(P＜0.05). The incidence of adverse reactions in the experimental group was lower than that in the control group(9.26% vs. 11.54%), but there was no significant difference(P＞0.05). Conclusion Acarbose combined with liraglutide can improve the clinical efficacy of DN, further improve UACR, Scr, and eGFR levels, lower blood glucose and lipid levels, and does not increase the risk of adverse events.

Objective To analyze the efficacy of levocarnitine combined with benazepril for patients with essential hypertension(EH) and heart failure(HF), and its effects on exercise endurance and cardiovascular protection. Methods A total of 160 patients with EH and HF treated in our hospital from January 2022 to December 2024 were included. They were divided into the observation group and the control group by simple random sorting method, with 80 cases in each group. All patients received conventional treatment, and the control group was treated with benazepril, while the observation group was treated with levocarnitine as an adjunct to benazepril. The clinical efficacy, exercise endurance, cardiac function indicators, blood pressure, cardiovascular events, and safety were compared between the two groups. Results After treatment, the total clinical effective rate of the observation group was higher than that of the control group(78.75% vs. 63.75%, P＜0.05). After treatment, the peak oxygen consumption, maximum exercise duration, and six-minute walking test distance in both groups improved compared to pre-treatment(P＜0.05), and the observation group was higher than the control group(P＜0.05. After treatment, the left ventricular ejection fraction in both groups increased compared to pre-treatment(P＜0.05), and the observation group was higher than the control group(P＜0.05), the left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and heart rate in both groups decreased compared to pre-treatment(P＜0.05), and the observation group was lower than the control group(P＜0.05). After treatment, the diastolic and systolic blood pressures in both groups decreased compared to pre-treatment(P＜0.05), and the observation group was lower than the control group(P＜0.05). During treatment, the total incidence of cardiovascular events in the observation group was lower than that in the control group(7.50% vs. 18.75%, P＜0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups during treatment(P＞0.05). Conclusion Levocarnitine combined with benazepril is effective in treating EH with HF, and can further improve the exercise endurance and cardiac function of patients and protect the cardiovascular system.

Objective To investigate the application of external fumigation and washing sitz bath combined with Qingre Jiedu formula and modified intersphincteric surgery in the treatment of high complex anal fistula. Methods A total of 86 patients with high-level complex anal fistulas admitted to Haian City Hospital of Traditional Chinese Medicine from January 2021 to January 2025 were included. The patients were randomly divided into groups at a 1:1 ratio using a computer-generated random number sequence. The random sequence was generated by independent statisticians and was distributed in a hidden manner through sequential numbering, opaque, and sealed envelopes. After enrollment, they were sequentially divided into the experimental group and the control group according to the order of enrollment, with 43 cases in each group. The control group received modified intersphincteric surgery treatment, while the experimental group additionally treated with external fumigation and washing sitz bath and Qingre Jiedu formula. The total effective rate, wound healing time, wound exudate volume, edema score, pain condition, anorectal dynamics, growth factor level, anal function, and the incidence of adverse reaction between the two groups were compared. Results The total effective rate of the experimental group was higher than that of the control group(χ2＝4.440，P＝0.035). The wounds healing time in the experimental group was shorter than that in the control group(t＝9.156，P＜0.05). At 7 days, 14 days and 1 month after the operation, the wounds exudate volume in the experimental group were significantly lower than those in the control group(t＝3.439、8.850、15.072，P＜0.05). At 3 and 7 days after the operation, the edema score of the experimental group were significantly lower than those of the control group(t＝2.303、2.945，P＜0.05). At 3, 7, 14 days after the operation and 1 month later, the visual analogue pain score of the experimental group were significantly lower than those of the control group(t＝8.232、11.104、13.751、10.267，P＜0.05). Three months after the operation, the rectal compliance, rectal resting pressure, maximum rectal tolerance volume, epidermal growth factor, transforming growth factor β1, and vascular endothelial growth factor levels in the experimental group were all higher than those in the control group, while the rectal resting pressure and the scores of each item in the Wexner scale were lower than those in the control group(P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P ＞0.05). Conclusion External fumigation and washing sitz bath combined with Qingre Jiedu formula and modified intersphincteric surgery demonstrates significant efficacy in treating high complex anal fistula, promoting wound healing, reducing exudate and edema, alleviating pain, improving anorectal dynamics and growth factor levels, and enhancing anal function, with high safety.

Chimeric antigen receptor T cell therapy(CAR-T cell therapy) is a revolutionary cell-based immunotherapy technique that has initiated innovative exploration and clinical practice in pediatric medicine, bringing therapeutic hope to children with refractory and severe diseases. However, it may be accompanied by adverse reactions, which remains a key issue to be focused on in current research and clinical application. This paper comprehensively reviewed the latest research progress of CAR-T cell therapy at home and abroad, systematically summarized the application status of this therapy in pediatric hematological malignancies, solid tumors, and autoimmune diseases, and conducted in-depth analysis of its mechanism, providing a reference for clinical practice.

Juvenile idiopathic arthritis(JIA) is a common connective tissue disease in children, mainly characterized by chronic arthritis and often accompanied by systemic damage. The main therapeutic goals of JIA are to suppress symptoms and improve the quality of life of children. Conventional synthetic disease-modifying anti-rheumatic drugs, glucocorticoids, and nonsteroidal anti-inflammatory drugs are important components of JIA treatment, but long-term use is often associated with many adverse reactions. Since the 21st century, biological agents and small molecule targeted drugs have greatly improved the prognosis of children with JIA through precise regulation of immune responses. This article systematically reviewed the development history of JIA treatment regimens and the future research directions have been prospectively discussed, aiming to provide reference for clinical practice.

Objective To systematically evaluate the current status, operational challenges, and service demands of pharmaceutical care clinics in maternal and child healthcare(MCH) institutions in Beijing, aiming to provide evidencebased references for optimizing pharmaceutical services for pregnant and lactating women and promoting the highquality development in this specialized field. Methods A cross-sectional study was conducted using a questionnaire survey in 15 specialized MCH hospitals in Beijing. The survey investigated aspects including drivers and barriers to establishment, operational models, service scope, human resource allocation, and developmental bottlenecks. Results Among the 15 surveyed institutions, 8(53.3%) had established pharmaceutical care clinics, mostly after 2021 and driven by national policies. The primary barrier for institutions without such clinics, was a shortage of qualified specialized pharmacists(71.4%). Services in established clinics were highly focused on medication safety counseling during pregnancy and lactation. Significant systemic bottlenecks were identified at the operational level: the lack of a unified national fee schedule for pharmaceutical services(4.8 points) and low pricing standards(4.7 points) were considered the primary challenges. The absence of a standardized training and certification system for specialized pharmacists(4.6 points) and a scarcity of senior, multi-skilled pharmacists(4.5 points) constrained team development. Internally, hospital management also included the difficulties such as heavy workloads and the lack of scientific performance evaluation and incentive mechanisms(both 4.6 points). Conclusion Pharmaceutical care clinics in Beijing's MCH institutions are in a preliminary, policy-driven stage of development, characterized by clear patient demand but uneven progress and prominent bottlenecks. It is imperative to establish a standardized training and certification system for specialized pharmacists, develop a rational pricing and health insurance reimbursement mechanism, and optimize internal operational management to foster professional, standardized, and sustainable development.