急性肺损伤(ALI)是临床常见的危重急症,目前特异性治疗ALI的药物选择性有限.失控性炎症级联反应是该疾病发生发展过程中的重要环节,开发用于防治ALI炎症的药物是一种有效策略.天然产物是抗炎药物的重要来源,具有结构新颖、作用靶点广泛、不良反应小等特点.目前多数已报道的对ALI有防治作用的天然产物及其衍生物只停留在临床前研究阶段,能否真正成药仍然未知.本文作者总结了近年来用于防治ALI的天然产物在结构修饰方面的研究进展,探讨了相关衍生物的构效关系和抗炎作用机制,以期为防治ALI新药的设计和开发提供意见及参考.

目的:构建医院药师岗前规范化培训体系,规范医院药师培训,提升见习药师岗位胜任能力,以达到医院药学工作的基本要求.方法:借鉴国内外现有医院药师规范化培训相关经验,结合浙江大学医学院附属第一医院药学部实际情况,经研究制订初步标准,在实施过程中不断探索完善相关培训标准、培训方案、考核标准及考核方式.结果:初步制订完成《见习药师岗前规范化培训大纲》和《见习药师岗前规范化培训登记手册》,并按培训大纲开展相应培训工作,初步构建该院见习药师岗前规范化培训体系.结论:本研究为该院逐步构建完整的医院药师规范化培训体系打下了基础,也为我国医院药师规范化培训的推广提供了借鉴和参考.

目的 对低剂量地西他滨皮下注射治疗骨髓增生异常综合征的国内外研究进展进行综述.方法 在Pubmed、中国知网、万方等数据资源库检索近年国内外相关文献,阐明地西他滨治疗骨髓增生异常综合征的作用机制,并对低剂量皮下注射的疗效及安全性进行总结与评价.结果 低剂量地西他滨皮下注射能靶向抑制DNA甲基转移酶活性,在发挥抗肿瘤效应同时减轻细胞毒性.与常规静脉给药方案相比,其疗效肯定、作用安全、给药方便、耐受性良好,同时可降低用药剂量、减轻经济负担,提高患者生存质量.结论 低剂量地西他滨皮下注射对不能耐受高剂量化疗与无法接受造血干细胞移植的患者而言或可成为一种较优的治疗选择,具有广阔的应用前景,其联合用药方案值得深入探索研究.

OBJECTIVE:To investigate the role of clinical pharmacists in the treatment of one liver transplantation patient with acute rejection .METHODS:The clinical pharmacists participated into the treatment of one liver transplantation patient with acute rejection .Through analyzing patients ' disease conditions and researching the clinical guide and literature , the clinical pharmacists assisted the clinicians to optimize the treatment regimen of anti-rejection and anti-infection drugs.In order to control the acute rejection , a higher dose of tacrolimus was suggested as a complement to the high-dose corticosteroid by clinical pharmacists .For the culture of sputum showed growth of Acinetobacter baumanii with several times, the adjustment of the anti-infection drugs was advised after analyzing the infections risks by clinical pharmacists:tigecycline with loading dose of 100 mg, maintenance dose of 50 mg, ivgtt, q12 h;cefperazone-sulbactam 2 g, ivgtt, q12 h;sulbactam 1 g, ivgtt, q12 h.The substitution of voriconazole by fluconazole was also advised to decrease the financial burden of the patient .The pharmacy guardianship was kept for the whole treatment process .RESULTS:The suggestions from the clinical pharmacists were adopted .After treatment for 15 days, the acute refection was effectively controlled and the patient was transferred from the liver transplant care unit to the ordinary department without infection symptoms . CONCLUSIONS:The participation of clinical pharmacists in the treatment of liver transplantation patient with acute rejection can optimize the drug therapy , and promote the rational drug use in clinic .