OBJECTIVE:To explore the role of clinical pharmacists in the drug therapy for patient with tonsil cancer. METH-ODS:Clinical pharmacists participated in the drug therapy for a patient with tonsil cancer. Referring to related clinical guidelines, literatures and the characteristics of chemotherapy drug effects,combined with clinical symptoms and economic situation of pa-tient,clinical pharmacists assisted physicians to formulate chemotherapy plan of nedaplatin combined with docetaxel (Nedaplatin for injection 100 mg,d1;50 mg,d2;ivgtt,qd+Docetaxel injection 100 mg,d1,ivgtt,qd,every 3 weeks for 1 cycle)according to effectiveness and safety. Clinical pharmacists closely monitored the occurrence of ADR as depression of bone marrow,gastroin-testinal reaction and allergic reaction,and provided medication education and discharge education,such as the use of pretreated che-motherapy drugs,diet and drinking water during chemotherapy,the prevention of ADR,etc. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient completed chemotherapy smoothly,and no ADR was found. CONCLUSIONS:In the case of there is no unified standard for chemotherapy program of tonsil cancer at present,clinical pharmacists assist physicians to formulate chemotherapy plan according to the patient's condition,the characteristics of drug effects and economical situation,as well as conduct pharmaceutical monitoring actively so as to guarantee the safety and effectiveness of chemotherapy.

Objective : To study the mechanism of neurotrophin receptor⁃interacting MAGE homolog (NRAGE) on the proliferation and invasion of colorectal cancer (CRC) cells. Methods : The clinicopathological data of 84 CRC patients were selected. Fluorescence quantitative PCR (qPCR) and Western blot were used to detect the expression of NRAGE in CRC tissues and adjacent normal tissues. The relationship between the expression of NRAGE in cancer tissues and clinicopathological characteristics was analyzed statistically. RT⁃PCR and Western blot were used to detect the expression of NRAGE mRNA and protein in CRC tumor cell lines HT29 , SW480 , SW620 , LOVO and colorectal normal cell line FHC. MTT proliferation experiment and Transwell migration experiment were used to observe the tumor cell proliferation and migration ability of the NC group , overexpression NRAGE group and NRAGE knockdown group. The expression differences of AKT , p ⁃AKT , ERK1/2 , p ⁃ERK1/2 , E ⁃cadherin , N ⁃cadherin and Vimentin were detected by qPCR and Western blot. Results : Compared with adjacent tissues , NRAGE mRNA and protein expression in CRC cancer tissues were significantly higher. The expression of NRAGE in cancer tissues was related to tumor stage , distant metastasis and lymph node metastasis (all P < 0. 05) . Compared with FHC cells , CRC tumor cell lines HT29 , SW480 , SW620 , and LOVO cells had higher NRAGE mRNA and protein expression (P < 0. 05) . Compared with the NC group , the proliferation and migration ability of CRC tumor cells in the overexpression NRAGE group was significantly enhanced , while the knockdown group was significantly weakened. Compared with the NC group , the SW480 cells in the overexpression NRAGE group had higher p ⁃ERK1/2 protein expression , but there was no significant difference in the expression of ERK1/2 , AKT and p ⁃AKT. After the SW480 cells in the overexpression NRAGE group were treated with ERK inhibitor U0126 , the proliferation and migration ability of SW480 cells significantly reduced. Methods NRAGE can promote the epithelial⁃mesenchymal transition of CRC cells and enhance the proliferation and migration of CRC tumor cells by activating ERK signaling pathway.

OBJECTIVE To explore the characteristics and regulations of adverse drug reactions （ADR） caused by apatinib， and to provide a reference for the safe use of apatinib in clinic. METHODS Case and group reports on ADR and safety evaluation of apatinib were retrieved from Chinese and English databases such as CNKI， Wanfang medical network， VIP and PubMed since its listing in 2014， literature data were extracted and statistically analyzed after screening. RESULTS Totally 101 cases were included， involving 221 ADR. In the above cases， the male-to-female ratio was 1.24∶1， with the highest proportion of patients aged 51 to 70 years， most of the patients were given a dose of 500 mg or more， and the patients given low dose of apatinib combined with other antitumor drugs were also likely to have ADR. One to two types of adverse reaction were the most common， while the types could reach up to six. Most ADR occurred within 30 days after medication， and the systems/organs involved were mainly the cardiovascular system damage，skin and its accessories damage， gastrointestinal system damage and urinary system damage； the main clinical manifestations were hypertension/aggravation，hand-foot syndrome，abdominal pain diarrhea and albuminuria， etc. Hypertension/aggravation， hand-foot syndrome and myelosuppression were the most common serious ADR. Most ADR could be improved/cured by suspension of administration， dose downregulation and symptomatic treatment. All 4 patients who died had underlying diseases， and their ECOG scores all ≥2 points. Special ADR （such as reversible posterior encephalopathy syndrome， psychiatric disorders， and cognitive impairment） were mostly caused by apatinib itself， or may be caused by apatinib in combination with the primary or underlying disease. CONCLUSIONS Advanced age， large dose， combination medication， underlying diseases and poor physical condition might be the high risks for ADR caused by apatinib. It is recommended to monitor the blood pressure，urine protein and skin of hands and feet of all patients with medication on a daily basis，pay attention to the occurrence of special ADR， and timely detect abnormal states and give effective intervention，so as to avoid the aggravation of ADR and other secondary ADR.