BACKGROUND:Recent studies have shown that drug-induced liver injury may be related to the immune response activated by drugs. A cytosolic dsDNA inflammasome called absent in melanoma 2 (AIM2) was found to be associated with aseptic inflammation. The present study aimed to explore the effects of on the liver injury and inflammation in methotrexate (Mtx)-induced rats. METHODS:Sprague Dawley (SD) rats were selected and classified into 4 groups randomly, includes control group, Mtx group, Mtx-Xiaochaihu decoction (XCHD) group and Mtx-magnesium isoglycyrrhizinate (MgIG) group. Light microscopy was used to examine histological specimens after hematoxylin-eosin (HE) staining. The AST levels in liver tissue and blood serum ALT in the rats were assessed with enzyme linked immunosorbent assay (ELISA). Then AIM2 expression and inflammatory factors, including caspase-1, IL-18, and IL-1β, in the liver biopsy specimens of rats were detected by immunohistochemistry. Furthermore, the correlation between inflammatory and AIM2 expression factors was comprehensively analyzed. RESULTS:Functional and structural hepatotoxicity can be caused by the exposure to Mtx, which was supported by the improved biochemical marker levels and the worse histopathological changes in liver tissue. Compared with the Mtx group, the levels of liver enzymes ALT and AST, histological deterioration in the liver tissues were effectively decreased by XCHD and MgIG treatment, respectively. In addition, the expression of AIM2, caspase-1 and IL-1β was observably higher in the Mtx group, which was apparently inhibited in the Mtx-XCHD and Mtx-MgIG groups. There was no obvious change in IL-18 expression among four groups. AIM2 expression were positively associated with the severity of liver inflammation and had a higher relevance with caspase-1 expression. CONCLUSIONS:AIM2 inflammasome in hepatocytes has a significant effect on the development of Mtx-induced liver injury, which can be ameliorated by both XCHD and MgIG treatment. The latent mechanism and potential signal pathway require further study.

目的:探讨基于绩效考核的适合本院院情的处方点评模式及其效果.方法:通过改进处方点评制度和流程,建立奖惩制度,采用回顾性分析方法,比较改进前后处方的合格率、医生接受率等指标变化.结果:采用新的处方点评模式之后,本院2015年下半年处方合格率(72.95％)和医生接受率(95.08％)均高于2015年上半年(59.67％,71.49％),差异有统计学意义(P＜0.05).结论:该模式具有可行性和操作性,最大限度地对门诊不合理用药进行主动干预,切实提高医院合理用药水平,同时增加临床接受度和认可度.

目的:从原发性高血压(HPN)与慢性心力衰竭(CCF)的双视角,利用Cochrane方法系统评价缬沙坦与卡托普利的疗效,为临床药物选择提供循证证据.方法:计算机检索PubMed、EMbase、Web of Science、Cochrane Library、 CBM、CNKI、维普和万方等数据库,检索时限均为从建库至2013年6月.由2名评价者按照纳入与排除标准以及Cochrane协作网推荐的方法独立筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 4.2软件进行Meta分析.结果:HPN有效性部分纳入13个研究,1 222例患者,CCF有效性部分纳入9个研究,852例患者.与卡托普利比较,缬沙坦治疗HPN和CCF的效果总体上优于卡托普利.在治疗HPN方面,缬沙坦降低收缩压效果优于卡托普利[WMD=-1.88(95％CI,-3.84 ～0.08),P=0.05];在治疗CCF方面,缬沙坦提高左心室射血分数(LVEF)效果优于卡托普利[WMD=-3.15 (95％ CI,0.79 ～5.52),P＜0.01].安全性部分纳入17个研究,合并分析结果显示缬沙坦治疗HPN和CCF的不良反应发生率低于卡托普利[OR =0.23(95％ CI,0.16 ～0.32),P＜0.01].结论:基于现有临床循证医学证据,缬沙坦治疗原发性高血压与慢性心力衰竭的有效性和安全性均优于卡托普利,是临床治疗高血压及慢性心力衰竭较好的用药选择.

目的:阐述自动发药系统在门诊药房工作中发挥的作用,并结合实际情况对系统的改进与优化进行简介.方法:通过在实际应用中提出问题,实时改进,完善自动发药系统.结果:改进后明显缩短了配方距离,减少了配方时间,为用药服务增加了时间.结论:自动发药系统可提高门诊药房工作效率,减少纠纷,使药师得以为患者提供更为优质的药学服务.

Objective:To introduce the application and practice of information technology in the pharmacy management of our hos-pital in order to provide reference for fine hospital management. Methods: The difficulties and application experience of information technology in the practice of hospital storeroom, pharmacy and medication management were summarized and analyzed. Results: The introduction of information and automation technology was beneficial to the improvement of work efficiency, prevention of medication er-rors, reduction of the incidence of clinical irrational drug use and improvement of patient treatment service quality. Conclusion:Imple-menting information-based pharmacy management is not only a new idea and method in hospital pharmacy development, but also the in-evitable tendency of the times.