OBJECTIVE: To evaluate the efficacy and safety of huperzine A for patients with mild and moderate Alzheimer disease(AD). METHODS: The randomized controlled trials (RCTs) comparing huperzine A with placebo retrieved from Medline, Embase, the Cochrane Library, CBMdisc and CNKI were enrolled. The methodology quality of the included studies was evaluated and a Meta-analysis was performed using RevMan4.2 software. RESULTS: A total of five RCTs were included. The Meta-analysis results showed that as compared with placebo, huperzine A treatment significantly increased the scores of MMSE, decreased the scores of ADL(activities of daily living), moreover, the associated therapeutic effect increased gradually with the prolonging of the treatment time yet with small publication bias; huperzine A treatment significantly increased the scores of MQ(memory quotient), but some publication bias might be existed because of the small number of RCTs included. The sensitivity analysis on the comparison of HDS score changes showed that the influence of the quality of the RCTs could reverse the results. The comparison on effective rate showed that huperzine A was more effective than placebo. The comparison on safety showed that huperzine A was more likely to induced side effects than placebo, but the publication bias was big because there was only a few literature included. CONCLUSION: According to the Meta-analysis’s results, we think huperzine A is effective in improving memory and cognitive function of AD patients, and there is significant difference in clinical efficacy as compared with placebo, and there is small publication bias. In terms of safety, huperzine A has higher incidence of side effects than placebo, but the side effects are mostly mild and have little impact on the treatment. The above conclusion may serve as reference for clinical medication.

Objective To explore the safety and clinical effects of laparosepie splenectomy.Methods Clinical data of 24 cages of laparoscopic splenectomy in our hospital from 2002 to 2008 were retrospectively analvzed.Among these 24 cases,there were 6 cases with liver cirrhosis,10 cases with ITP,2 cases with hemolytic anemia(Evens syndmm),2 cases with spelenic rupture,and 4 cases optimum spleen ambuty.Results All the 24 cases were successfully underwent laparoscopic splenectomy.The mean operation time wag 146 minute.the mean volume of blood loss was 220 ml.the postoperative gastrointestinal peristalsis time Was from 24 to 48 hours.The mean hospitalization time was 9 days after operation.Conclusions Provided mastering operation indication and technique,Laparoscopie spleneetomy is a safe and minimally invasive surgery.

OBJECTIVE:To investigate the characteristics and related factors of drug-induced hyperkalemia,present preven-tive measures and provide reference for the rational drug use. METHODS:46 literatures of individual cases and group cases of drug-induced hyperkalemia publicly reported in domestic medical journals from 1979 to 2014 were collected and analyzed statistical-ly,including 66 cases. RESULTS:66 cases with drug-induced hyperkalemia were mainly involved in cardiovascular drugs and im-munosuppressants. Most of them were improved after drug withdrawal and symptomatic treatment,and 2 cases died. CONCLU-SIONS:Drug-induced hyperkalemia are potentially dangerous. It is necessary to be vigilant,prevent and control timely and reduce the incidence of severe adverse reactions.

Objective To investigate the influence of zoledronic acid injection on body temperature of patients with primary osteoporosis.Methods A total of 142 patients with primary osteoporosis who received intravenous zoledronic acid treatment in Peking university people's hospital during 2013-2014 were enrolled in this study.The body temperature before and after intravenous zoledronic acid treatment were recorded and analyzed with SPSS 17.0 software.Results The patients'body temperature at different time points after intravenous zoledronic acid treatment was significantly different (P =0.000).Prophylactic use of NSAIDs could significantly reduce patients' body temperature at the second day after intravenous zoledronic acid.Conclusion NSAIDs can be given orally on the same day of intravenous injection of zoledronic acid,and continued for three days.

Objective To evaluate gene associated with retinoid-interferon-induced mortality-19 (GRIM-19) expression levels and the correlation with its target gene product signal transducers and activator of transcription 3 (STAT3)in human breast cancer tissues and normal gland tissues,and to analyze their roles in the tumorigenesis of breast cancer.Methods The expression of GRIM-19 and STAT3 protein and mRNA in 40 cases of breast cancer tissues and 40 cases of normal gland tissues was detected by immunohistochemistry and Western blot.The correlation of the expression of GRIM-19 and STAT3 to various clinicopathologic characteristics of breast cancer were analyzed statistically.The mRNA expression and gene mutation of GRIM-19 in breast cancer cell line MCF-7 and 25 specimens of breast cancer and normal gland tissue were detected by reverse transcription-polymerase chain reaction(RT-PCR)and sequencing.Results The protein and mRNA expression of GRIM-19 was obviously lower in breast cancer than in normal gland tissues (P ＜ 0.05) while the protein and mRNA expression of STAT3 was obviously higher in breast cancer than in normal gland tissues(P ＜0.05).The expression of GRIM-19 and STAT3 was negatively correlated with each other(x2 =8.25,P ＜0.01).Breast cancer samples exhibited low level of GRIM-19 and moderate to high level of STAT3 expression.In contrast,the normal gland tissue was characterized by high level of GRIP-19 and low level of STAT3 expression.The protein expression of GRIM-19 was correlated with the histological grading and clinical stage of breast cancer(P ＜ 0.05).STAT3 was not correlated with clinicopathologic characteristics of breast cancer (P ＞ 0.05).No mutation of GRIM-19 gene was detected in breast cancer tissues,normal gland tissues or MCF-7 breastcancer cells.Conclusions The low expression of GRIM-19 and the high expression of STAT3 co-exist in breast cancer.Downregulation of GRIM-19 was closely correlated with increased histological grade,clinical stage and STAT3 in breast cancer.The potential role of GRIM-19 in breast cancer development may be through these correlations.

Objective To explore how clinical pharmacists exert their effects in drug therapy.Methods The pharmaceutical practice of clinical pharmacist participating in the treatment of one case of warfarin related nephropathy (WRN) was reported.Early identification of warfarin associated nephropathy and early treatment were necessary and the anticoagulant regimen was optimized.Pharmaceutical education was conducted by clinical pharmacist.Results With guidance by clinical pharmacist,the psychological burden of the patient was reduced,the patient compliance was improved,and the patient understanding of adverse drug reactions was increased.Conclusion Clinical pharmacists involved in clinical treatment practice is conducive to timely detecting and treating patients with adverse drug reactions,and improving the level of drug treatment.

[Objective] To investigate the effect of Xiao Si Wu Granules (XSWG), a preparation composed of Xiao Chaihu Decoction, Siwu Decoction and Witling Powder, on renal renin-angiotensin system (HAS) in diabetic rats. [Methods] Twenty-four Wistar rats were randomly divided into the normal, control and XSWG groups. Except the nonnal group, the rats in other groups were given one-dose intraperitoneal injection of streptozotocin (STZ) 65 mg/kg to induce diabetes mellitus (DM). After the establishment of diabetic models, XSWG group was treated with XSWG 1.8 g?kg-1?d-1 and the other two groups with the same dose of saline for 12 weeks. After treatment, the intrarenal angiotensin Ⅱ (Ang Ⅱ ) concentration was detected with radioimmunoassay method, renocortical antiotensin-converting enzyme (ACE) activity with ultraviolet spectrophotometry and renocortical angiotensin Ⅱ receptor type 1 (AT1) mRNA level with reverse transcriptase polymerase chain reaction (RT-PCR). [Results] AngⅡ concentration and renocortical ACE activity were increased, and renocortical AT1 mRNA level was decreased in the model group, the difference being significant as compared with the normal group ( P

Objective To explore the most effective route of mesenchymal stem cell transplantation (MSCs) in D-galactosamine (D-gal) induced porcine model with acute liver failure (ALF) and the potential mechanism.Methods BA-MA mini-pigs with D-gal-induced ALF were transplanted with porcine mesenchymal stem cells (MSCs) through four routes:intraportal injection (InP),peripheral intravenous injection (PV),hepatic intra-arterial injection (AH) and intrahepatic injection (IH).The survival time was recorded.The blood samples before and after MSC transplantation were collected for detecting liver function.Liver histology was interpreted and scored.Hepatic apoptosis and regeneration were detected by Terminal Deoxynucleotidyl Transferase dUTP Nick End Labeling (TUNEL) assay and Ki-67 assay.The protein expression of cleaved caspase-3,survivin,AKT and ERK were analyzed by Western blot.Results The average survival time in each group was (10.7 ±1.6) days (InP),(6.0 ±0.9) days (AH),(4.7 ±1.4) days (PV),(4.3 ± 0.8) days (IH) when compared with D-gal group [(3.8 ± 0.8) days].The histopathological scores revealed a significantly decrease in InP group (3.17 ± 1.04,P ＜0.05) and AH group (8.17 ± 0.76,P ＜ 0.05) when compared with that in D-gal group (11.50 ± 1.32).The apoptosis rate in InP group (25.0 ± 3.4％,P ＜ 0.05) and AH group (40.5 ± 1.0％,P ＜ 0.05) was lower than that in D-gal group (70.6 ± 8.5％).The expression of active caspase-3 was inhibited,while the expression of survivin,AKT and ERK was elevated in InP group.Conclusions The intraportal injection was superior to other pathways for MSCs transplantation.Intraportal MSC transplantation could improve liver function,inhibit cell apoptosis,promote cell proliferation and prolong the survival in porcine ALF model.

OBJECTIVE:To systematically review the effect of CYP2C19 genetic polymorphism on lansoprazole pharmacoki-netics,and provide evidence-based reference for clinical individualized medication of lansoprazole. METHODS:Retrieved from PubMed,EMBase,Web of science,Cochrane Library and CJFD,retrospective studies about the effect of CYP2C19 genetic poly-morphism on lansoprazole pharmacokinetics were collected,Meta-analysis was performed by Rev Man 5.2 software after data ex-tract and quality evaluation. RESULTS:Totally 11 retrospective studies were included,involving 200 patients. The gene type in-cluded homozygote express metabolizers (EM),heterozygous express metabolizers (HEM) and slow metabolizers (PM). Results of Meta-analysis showed CYP2C19 polymorphism significantly affected cmax,AUC,t1/2,tmax and CL/F. The cmax and AUC in group PM were higher than group HEM and group EM;CL/F in group EM was higher than group HEM and group PM;t1/2 in group PM was higher than group HEM and group EM,while there was no significant difference in the t1/2 between group HEM and group EM;tmax in HEM and group PM were higher than group EM,while there was no significant difference in the tmax between group PM and group HEM. CONCLUSIONS:CYP2C19 genetic polymorphism shows obvious effect on lansoprazole pharmacokinetics, which is the key factor for causing efficacy of lansoprazole and individual differences among adverse reactions,and clinic should take into account individualized dose regimen of lansoprazole.

Objective To systematically evaluate the efficacy and safety of alprostadil injection in patients with viral hepatitis.Methods Medline,Embase,The Cochrane Library,CBMdisc,CNKI,Wanfang Database and VIP were searched.The quality of included studies such as randomization,blinding,allocation concealment and loss of follow-up were evaluated and meta-analysis was performed by RevMan5.1 software.Results In total,14 RCTs and 1 232 patients were included.Meta-analysis showed that in patients with viral hepatitis,the total effective rate of alprostadil injection treatment was significantly superior to that of conventional therapy (P<0.000 01).Serious adverse drug reactions (ADRs) induced by alprostadil injection were not reported.Conclusion Alprostadil injection is effective and safe for treating viral hepatitis.However,the evidence is not strong due to the generally low methodological quality of RCTs.Further high quality and large sample-sized randomized controlled trials and more pharmacoeconomics studies should be carried out.