Drug-related problems (DRPs) are common among surgical patients, especially older patients with polypharmacy and underlying diseases. DRPs can potentially lead to morbidity, mortality, and increased treatment costs. The enhanced recovery after surgery (ERAS) system has shown great advantages in managing surgical patients. Medication therapy management for surgical patients (established as “surgical pharmacy” by Guangdong Province Pharmaceutical Association (GDPA)) is an important part of the ERAS system. Improper medication therapy management can lead to serious consequences and even death. In order to reduce DRPs further, and promote the rapid recovery of surgical patients, the need for pharmacists in the ERAS program is even more pressing. However, the medication therapy management services of surgical pharmacy and how surgical pharmacists should participate in ERAS programs are still unclear worldwide. Therefore, this article reviews the main perioperative medical management strategies and precautions from several aspects, including antimicrobial agents, antithrombotic agents, pain medication, nutritional therapy, blood glucose monitoring, blood pressure treatment, fluid management, treatment of nausea and vomiting, and management of postoperative delirium. Additionally, the way surgical pharmacists participate in perioperative medication management, and the relevant medication pathways are explored for optimizing medication therapy management services within the ERAS programs. This study will greatly assist surgical pharmacists’ work, contributing to surgeons accepting that pharmacists have an important role in the multidisciplinary team, benefitting medical workers in treating, counseling, and advocating for their patients, and further improving the effectiveness, safety and economy of medication therapy for patients and promoting patient recovery.

ANXA1 is a calcium-dependent phospholipid-binding protein and is frequently associated with inflammation, cell proliferation and apoptosis. However, the relationship between ANXA1 and the prognosis...

Chronic inflammation of white adipose tissue is a key link between obesity and the associated metabolic syndrome. Transient receptor potential melastatin-like 7 (TRPM7) is known to be related to inflammation; however, the role of TRPM7 in adipocyte phenotype and function in obesity remains unclear. Here, we observe that the activation of adipocyte TRPM7 plays an essential role in pro-inflammatory responses. Adult male mice are used in our experiments. Adipocyte-specific deficiency in TRPM7 attenuates the pro-inflammatory phenotype, improves glucose homeostasis, and suppresses weight gain in mice fed a high-fat diet. Mechanistically, the pro-inflammatory effect of TRPM7 is dependent on Ca²⁺ signaling. Ca²⁺ influx initiated by TRPM7 enhances transforming growth factor-β activated kinase 1 activation via the co-regulation of calcium/calmodulin-dependent protein kinase II and tumor necrosis factor receptor-associated factor 6, leading to exacerbated nuclear factor kappa B signaling. Additionally, obese mice treated with TRPM7 inhibitor are protected against obesity and insulin resistance. Our results demonstrate TRPM7 as a factor in the development of adipose inflammation that regulates insulin sensitivity in obesity.

Background: Immune checkpoint inhibitor-associated myocarditis (ICI-associated myocarditis) is a rare but fatal immune-related adverse event. Early identification of high-risk patients remains challenging. This study aimed to identify risk factors and develop models for predicting both the occurrence and severity of ICI-associated myocarditis. Methods: This retrospective unmatched case-control study stratified patients receiving ICIs into ICI-associated myocarditis (stratified into mild and severe subgroups) and controls. Comparative analysis of baseline and onset-phase data was performed, with logistic regression used to identify risk factors for the development of ICI-associated myocarditis and the severe myocarditis. Results: In this cohort of 196 patients (98 myocarditis cases vs. 98 controls), a two-tiered risk stratification was established. Patients with myocarditis were further stratified into mild (n=71) and severe (n=27) subgroups. For predicting the occurrence of ICI-associated myocarditis, a baseline model incorporating elevated eosinophil ratio, reduced lymphocyte ratio, and elevated myoglobin demonstrated an area under the ROC curve (AUC) of 0.699 (95% CI, 0.626-0.772, P < 0.001). Upon onset, for predicting severe myocarditis, a model combining electrocardiographic abnormalities (T-wave changes, bundle branch blocks) and marked CK elevation (>10× ULN) achieved a higher AUC of 0.769 (95% CI, 0.655-0.882, P < 0.0001). Severe cases presented significantly earlier than mild cases (33 vs . 63 days, P = 0.043) and had higher rates of symptoms and concurrent immune-related adverse events. Conclusion: A baseline profile of elevated eosinophil ratio, reduced lymphocyte ratio, and elevated myoglobin collectively may help identify patients at risk for ICI-associated myocarditis. At myocarditis onset, a combination of specific electrocardiographic abnormalities and marked CK elevation may predict severe cases. These findings suggest a two-stage approach for early risk stratification and targeted management.