目的 探讨长链非编码RNA PITPNA-AS1在卵巢癌中的作用及其可能的分子机制.方法 采用荧光实时定量聚合酶链式反应(qPCR)技术检测卵巢癌组织和对应的癌旁组织、卵巢癌细胞系和正常卵巢上皮细胞系中PITPNA-AS1的表达水平.将PITPNA-AS1表达最少的细胞系分为对照组和实验组,分别转染阴性对照质粒或PITPNA-AS1质粒.细胞计数实验(CCK-8)法和Transwell法检测细胞的增殖活性和侵袭能力.生物信息学方法预测和双荧光素酶活性报告基因实验验证PITPNA-AS1作用的分子机制.qPCR和Western blot检测PITPNA-AS1相互作用的基因表达.结果 PITPNA-AS1在卵巢癌组织中表达低于癌旁组织(P<0.01).PITPNA-AS1在卵巢癌细胞系中的表达水平均低于正常卵巢上皮细胞(P<0.05),OVCAR-3细胞表达最少(P<0.01).与对照组比较,过表达PITPNA-AS1能抑制OVCAR-3细胞的增殖活力(P<0.05)和侵袭能力(P<0.01).PITPNA-AS1与miR-92a-3p存在靶向关系(P<0.01),miR-92a-3p与转录因子21(TCF21)存在靶向关系(P<0.01).过表达PITPNA-AS1导致OVCAR-3细胞中miR-92a-3p的表达下降(P<0.01),TCF21基因的表达增加(P<0.01).结论 PITPNA-AS1在卵巢癌组织和细胞系中低表达,PITPNA-AS1可靶向调控miR-92a-3p/TCF21抑制卵巢癌OVCAR-3细胞的增殖和侵袭.

笔者通过参与1例接受糖皮质激素治疗后导致糖尿病的诊疗过程,分析其用药方案,了解疾病特点,为临床诊疗提供参考.同时通过为患者提供药学监护和用药教育,体现了临床药师在临床实际诊疗中的价值.

目的:考察山萘酚对人卵巢癌SKOV-3细胞生长、凋亡的影响及作用机制.方法:采用CCK-8法检测山萘酚对SK-OV-3细胞增殖的影响;流式细胞术和AnnexinV-FITC/PI凋亡试剂盒检测SKOV-3细胞的凋亡情况;RT-PCR检测NICDmRNA的表达;Western Blot方法检测Notch1蛋白的表达.结果:山萘酚对卵巢癌SKOV-3细胞有显著的增殖抑制作用,且呈一定的剂量依赖性;凋亡检测结果表明,山萘酚能够促进卵巢癌SKOV-3细胞凋亡的发生;RT-PCR结果显示山萘酚干预组(80 μmol· L-)NICD mRNA的表达水平明显降低(P＜0.05),Western Blot结果显示山萘酚干预组(80 μmol· L-1)Notch1蛋白表达水平显著降低(P＜0.05).结论:山萘酚能明显抑制卵巢癌SKOV-3细胞的体外增殖,诱导细胞凋亡其机制可能是通过干预Notch1的表达.

目的 探讨临床药师在伴有重度骨质疏松的肾病综合征患者药物治疗方案确定中发挥的作用.方法 临床药师对微小病变型肾病患者免疫抑制方案和糖皮质激素性骨质疏松(GIOP)防治方案进行用药调整建议,并对患者实施用药教育,以期在病情控制良好的情况下,减少患者骨折风险.结果 医师采纳调整方案,患者用药期间病情好转,且未发生不良反应.结论 临床药师结合患者病情及用药特点,灵活运用治疗指南,全程监护患者用药效果,提高医师及患者的安全用药意识,在治疗中发挥了积极作用.

OBJECTIVE To evaluate the teaching effect on clinical pharmacotherapy,and discuss to develop the cooperative teaching model for undergraduate students of clinical pharmacy by universities and hospitals.METHODS The course was given by the clinical pharmacists in hospital in English to overseas students of Huazhong University of Science and Technology.The teaching content and effect was investigated through survey and literature research.RESULTS The chapters of the course are comprehensive,while the time of teaching is relatively limited.The contents more emphasized on basic concepts,while the practical ability training was slipped.CONCLUSION Based on the hospital pharmacy practice,the clinical pharmacists should focus on building capacities on pharmaceutical servicesthrongh multiple teaching forms and assessments.

Osimertinib is a third generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI).It is an antineoplastic drug approved for the treatment of EGFR T790M mutation positive for locally advanced or metastatic non small cell lung cancer (NSCLC).It is significantly efficiency,well tolerated,with side effects more likely to be accepted compared with the first and second generation of EGFR-TKL For persons received other EGFR-TKIs which become resistant,osimertinib would bring a new choice for them.On March 22,2017,CFDA accelerated the approval of the Astrazeneca application of the imported mesylate osimertinib tablets.In this paper,we review the osimertinib in terms of mechanism of action,market experience,clinical trial,pharmacokinetics,safety and tolerability,to provide a reference for clinical application.

Objective:To discuss the rational administration mode of warfarin through participating in one patient ’ s therapy with coagulation dysfunction of clinical pharmacist .Methods:Clinical pharmacists participated in the adjustment of warfarin and performed pharmaceutical care for the patient with renal injury induced by warfarin .Results:The individualized administration of warfarin for the patient was determined , and the conditions and compliance of the patient in the drug use were both improved .Conclusion:The partici-pation of clinical pharmacists in individualized drug treatment is beneficial to the effective enhancement of drug treatment in clinics and the important role played by clinical pharmacist .

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：评价糖皮质激素与环磷酰胺联合应用治疗肾病综合征的疗效。方法回顾性分析我院2014年6月～2016年6月间收治的82例肾病综合征确诊病例资料，所有患者均给予甲泼尼龙联合环磷酰胺治疗，观察患者治疗前后肾功能相关指标变化情况。结果本组患者治疗后的24Upro、BUN、Scr、ALB以及尿量水平均较治疗前有明显改善，经统计学检验表明具有统计学意义（P＜0.05），治疗后随访6个月无复发病例。结论糖皮质激素甲泼尼龙与环磷酰胺联合应用治疗肾病综合征能够起到协同增效的作用，应在临床进一步推广使用。

Objective To prepare nephritis dripping pills and study its pharmacodynamic effects. Methods The nephritis dripping pills were self-made, and the preparation was optimized by using orthogonal method. The model of chronic renal failure was established through resection of 5/6 kidney, the effect of nephritis dripping pills on rats was investigated by urinary protein and renal pathology analysis. Results The optimal preparation for nephritis dripping pills was as follows:taking PEG4000:PEG6000 =2:1, drug:matrix =1:3, setting temperature at 80 ℃ and dropping distance as 7 cm. The pharmacodynamic results showed that:compared with the model control groups, the nephritis dropping pills and renal failure pills significantly reduced the 24 h urine protein levels (P<0. 01),and the nephritis dripping pills were significant superior to renal failure pills (P<0. 05). The histopathological results showed that the renal tubular of treated groups remitted to normal, renal interstitial presented a small amount of inflammation cell infiltration and renal interstitial fibrosis was suppressed. Conclusion The preparation of nephritis dripping pills is relatively stable,and have good therapeutic effects on chronic renal failure,but the optimal dose should be further verified.

目的:考察阿利吉仑单用或与阿托伐他汀联用对动脉粥样硬化小鼠炎症因子的影响.方法:将12周龄apoE-/-雄性小鼠给予高脂饮食,随机分为6组(n=8),包括模型对照组,肼屈嗪组、阿利吉仑低剂量组、阿利吉仑高剂量组、阿托伐他汀组、阿利吉仑与阿托伐他汀联合用药组,均治疗12周.采用酶联免疫吸附的方法(ELISA)测定血浆中白介素-6(IL-6)、C反应蛋白(CRP)和单核细胞趋化蛋白-1(MCP-1)的水平;光学显微镜下测定动脉粥样硬化病变区与总主动脉面积.结果:与模型对照组相比,阿利吉仑单独用药对炎症因子MCP-1的影响无显著性差异.阿利吉仑单独或者联合阿托伐他汀用药能够显著降低炎症介质IL-6、CRP的血浆水平(P＜0.05),且阿利吉仑高、低剂量组之间对CRP和IL-6水平的影响亦有差异;阿利吉仑联用阿托伐他汀与阿托伐他汀组对MCP-1、IL-6、CRP水平的影响均无显著性差异(P＞0.05).组织病理学结果显示:单用阿利吉仑或联合应用阿托伐他汀都有不同程度的降低动脉粥样硬化面积,与模型对照组相比均有显著性差异,且单用阿利吉仑组、阿托伐他汀组均与联合用药组有显著性差异(P＜0.05).结论:阿利吉仑对动脉粥样硬化小鼠体内炎症因子水平有一定影响,并显示出一定的剂量依赖性,同时与阿托伐他汀合用有一定的联合治疗作用.

Objective To evaluate the clinical efficacy and safety of valsartan alone or combined therapy in the treatment of essential hypertension.Methods The CENTRAL ,CBM ,Medline ,Embase ,PubMed ,CNKI ,VIP and Wanfang data were searched for RCTs published until June 2015 on valsartan monotherapy or combination therapy for the treatment of essential hypertension.Two reviewers independently retrieved RCTs based on inclusion and exclusion criteria ,assessed the quality of in‐cluded trials ,and extracted relevant data.The data were analyzed by using RevMan 5.3.5 software package.Results A total of 21 RCTs ,including 8 743 patients ,were finally included.Meta‐analysis results showed that the efficacy of valsartan monothera‐py was superior to that in control group.There were no significant differences in the systolic blood pressure ,diastolic blood pressure and the incidence of adverse side effects between valsartan monotherapy group and control group.However ,the im‐provement in the systolic blood pressure ,diastolic blood pressure and the incidence of adverse side effects were better in valsar‐tan combination group than in valsartan monotherapy group and there was a statistically significant difference(P<0.05) .Con‐clusion Valsartan combined with one or more antihypertensive drugs is more safe and effective than valsartan monotherapy in the treatment of essential hypertension.Valsartan combination administration is recommended to treat essential hypertension in clinical practice.

本文通过阐述多元谱效关联技术的研究现状，研究国内外相关文献，结合工作实践，分析多元谱效关联技术的局限性，提出扩展多元谱效关联技术的研究新思路，利用先进的计算机技术方法对获取的中药指纹图谱和药效学数据进行分析，为中药多元谱效关联技术应用于中药的质量评价和控制提供新的思路和方法。

It is very obvious that the influence on the clinical effects and safety caused by the decoction method of Traditional Chinese medicine. Basing on years of experience in teaching and practice,the authors discussed the relationship between the decoction method of traditional Chinese medicine and the rational use of drugs from different part in the dispensing process in order to get relief personnel attention.