Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays an important role in lipid reg-ulation through interaction with low-density lipoprotein cholesterol receptors , and several types of PCSK 9 inhibi-tors are gradually becoming research hotspots due to their lipid lowering effect .Among them PCSK9 monoclonal antibodies are the closest to clinical application , and a number of phase Ⅲclinical trials in PCSK9 monoclonal antibodies have been completed in recent years .We systemically reviewed the current clinical research on PC-SK9 monoclonal antibodies in this paper , in order to understand their efficacy and long-term safety in reducing the risk of cardiovascular diseases .

Objective:To confi rm acidic extracts of Chinese materia medica having an inhibition to melanin synthesis. Methods: By L-DOPA oxidation method, the in vitro determination was studied to get tyrosinase activity’s inhibition of acidic extracts from 28 kinds of Chinese materia medica with high, middle and low concentration solution. Results: First, Acidic extracts from 28 kinds of Chinese materia medica at high concentration (25g/L) showed potent inhibitory action on tyrosinase activity. The highest inhibition rate was 96.50%, which was from the acidic extract of Fructus Mume. The next was fructus schizandrae with 85.33% inhibition rate. Compared with a 56.67% inhibition rate of 2 mmol/ml control sample arbutin, both Fructus Mume and fructus schizandrae had a large signifi cant deviation ( P

Objective To analyze the clinical characteristics of renal cell carcinoma (RCC) and unveil the current status of diagnosis and treatments. Methods The registry data from 23 medical centers cover different areas of China. A total of 2030 new cases of RCCs in the 23 centers from Au-gust 2007 to October 2008 were collected, in which 1975 cases had integrated data for analysis. The symptoms, diagnostic techniques, pathology features, and therapeutic selection were analyzed. Re-sults A total of 1975 new cases were reviewed, with 1329 males and 634 females. The male and fe-male ratio was about 2.1 : 1.0. Of all cases, 1238 patients (62.7%) were asymptomatic and detected by examination, while 711 patients (36.0%) were symptomatic. 1260 patients (63.8%) were clinical stage Ⅰ , most of them were asymptomatic. 1844 patients were treated surgically, 1500(81.3%) un-derwent radical nephrectomy, 325 (17. 6%) underwent partial nephrectomy. Among the operations, open operation was performed in 1493 cases(81.0%), laparoscopic procedure in 351 cases(19.0%). There were 1522(84.5%) clear cell carcinomas, 98 (5.44%) papilliform renal cell carcinomas. Con-clusions Routine health examination could be an important way to diagnose early stage RCC. Open radical nephrectomy is the most often used surgical technique among the centres of present study.

ObjectiveTo evaluate the efficacy of allogeneic stem cell transplantation (allo-HSCT) in treatment of hematologic malignancies and observe hematopoietic reconstitution, graft versus host disease (GVHD) occurrence,transplant-related complications and the outcome of disease.Methods20 patients with hematologic malignancies cured by allo-HSCT were analyzed retrospectively. 15 males and 5 females patients were enrolled, and the median age was 39(8-59)years. Mobilization of donor’ s stem cells using rhG-CSF program 3 days before transplantation.Conditioning regimen:the patients with HLA-matched used modified Bu/Cy programs,the patients with HLA-mismatched (with 1 to 3 loci mismatched) used the modified Bu/Cy+ ATG program;the patient with T-ALL and the patient with MM used Flu+Bu/Cy program. GVHD prevention programs: mycophenolate mofetil + cyclosporine + short course methotrexate. Results20 patients were successfully engrafted,the median time of absolute neutrophil count (ANC) ＞ 0.5×109/L was 13 (12-17) days,the median time of Plt ＞ 20×109/L was 16(12-23)days, and the hematopoietic reconstitution was rapid in those patients who were transplanted by the donors with the collected amount of CDh cells ＞ 2.5× 106/kg (recipient body weigh) or the collected amount of mononuclear cell ＞ 5.0×10s/kg (recipient body weigh).No severe hemolytic reaction occurred in 11 cases of blood group incompatibility between donor and recipient after transplantation,11 cases (55 ％) developed acute GVHD (aGVHD):4 cases Ⅰ degree aGVHD,4 cases Ⅱ degree aGVHD,2 cases Ⅲ degree aGVHD,1 case Ⅳ degree aGVHD,all patients were improved after treatment.All patients attained complete remission (CR) after transplantation.Follow-up 6 (2-14) months,1 patient died in 5 months after transplantation because of leukemia relapse, 1 case died in 4 months after transplantation because of self-disabling autoimmune hemolytic cyclosporine, chronic GVHD(cGVHD)and multiple organ failure,the remaining patients still were in CR state.ConclusionAllo-HSCT is the effective way to treat hematologic malignancies. Engraftment is closely related with the quantity of hematopoietic stem cells from donor.Blood group incompatibility was not an obstacle for transplantion.Relapse,GVHD,infection are the major cause of death after transplantation.

ObjectiveTo observe the efficiency of hematopoietic stem cell transplantation to the treatment of hematological malignancies and explore prevention and treatment of the complications correlated with HSCT. Methods110 patients with hematological malignancies which were treated by HSCT were recruited. 61 patients were treated with autologous peripheral blood hematopoietic stem cell transplantation (auto-PBSCT), 49 patients were treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT).Among them,there were 28 patients were used by all HLA-identical sibling allo-PBSCT,20 patients were used by haploid allogeneic bone marrow and peripheral blood stem cell transplantation, one case of acute lymphoblastic leukemia in children were treated with cord blood stem cell transplantation.Results109(99.1％) patients acquired hemopoietic reconstruction. The median time of neutrophils≥0.5×109/L, and platelets≥20×109/L were 10 days and 12 days in auto-PBSCT,and were 12 days and 15 days in allo-PBSCT.The incidence of Ⅰ-Ⅲ degree of acute GVHD (aGVHD) in allogeneic transplantation was 28.6 ％(14/49),however,the incidence of chronic GVHD (cGVHD) was 32.6 ％(16/49).The median follow-up time was 36 (1～60) months.84 patients (76.4 ％) were disease-free.Among them,73.8 ％(45/61) were in auto-PBSCT group,(79.6 ％)39/49 were in allo-HSCT group.26 patients (23.6 ％) were died.There were 26.2 ％(16/61) who were in auto-PBSCT group died of disease relapse,3.3 ％(2/61) had disease relapse.There was no transplant-related deaths.18.4 ％(9/49) who were in allo-HSCT group died of disease relapse, 6.1％(3/49)had disease relapse, 2.0 ％(1/49)died of transplant-related deaths. ConclusionHematopoietic stem cell transplantation is a safe and effective way for the treatment of malignant hematopathy patients,also an important mean for treatment of blood diseases.

OBJECTIVE:To promote the work of clinical TCM pharmacists.METHODS:The problems faced by clinical TCM pharmacists were analyzed in respects of status quo of training in colleges and universities,status quo of hospital post training and status quo of continuing education.From the ability of post service,the ways to determine the duty orientation and improve the training quality of clinical TCM pharmacists were discussed theoretically.RESULTS & CONCLUSIONS:According to the nature of different types of medical institutions as TCM hospital,western medicine hospital,township community hospital and clinics,the responsibilities of clinical TCM pharmacists should be differentiated.TCM curriculum system of colleges and universities should be improved by adding social pharmaceutical education and TCM practical teaching.Based on the ability of post service,great importance should be attached to professional training of clinical TCM tablets after their employment.The theory,practice and research ability of clinical TCM talents should be improved by strengthening continuing education.The medical and pharmaceutical clinical TCM inter-disciplinary talent can be cultivated by improving rational drug use standard system.

Objective To investigate the effects of fast-track surgery on postoperative rehabilitation of patients with liver cancer. Methods Forty-one patients with liver cancer who had been admitted to Zhongshan Hospital of Fudan University from 9 to 30 in July 2008 were randomly divided into fast-track surgery group (n =20) and routine treatment group (n =21) according to the random number table. Patients in fast-track surgery group were preoperatively educated in order to lessen their anxiety. Bowel preparation was not applied before operation, and they were orally administered with 1000 ml of enteral nutrition emulsion (1300 kcal), then they were fasted for 4 hours before operation. Urethral catheter and gastric tube were removed after operation. They were orally administered with 1000 ml of enteral nutrition emulsion on postoperative day 2, and were encouraged to partake in off-bed activity shortly after the operation. The off-bed time, anus exhaust time, postoperative complica-tions, hospitalization time, expense, nutritional and metabolic indexes on postoperative day 1, 3 and 5, hepatic and renal function, immune and stress indexes between the 2 groups were compared by t test and chi-square test. Results There were significant differences in off-bed time, anus exhaust time, patients' weight, expense, total bilirubin level on postoperative day 1, 3 and 5, and level of serum TNF-α on postoperative day 3 between the 2 groups (t =7.065, 5.483, 3.754, 2.291,2.289, 3.218, 3.192, 2.434, 2.089, P <0.05). Conclusions Fast-track surgery can accelerate the postoperative rehabilitation of patients with liver cancer.

Objective To evaluate the efficacy and safety of the flexible ureteroscopy (FURS) with holmium laser lithotripsy in the management of stones in ectopic pelvic kidney (PK).Methods We retrospectively reviewed the records of 11 patients,ranged from 37-52 years old,who were underwent FURS with holmium laser for PK stones from January 2007 to April 2012.Three cases had solitary stones in renal pelvis,3 cases had solitary stones at lower calyx and multiple stones were found in 5 cases.Mean size of stone was 2.3 cm (ranged 1.8-3.7 cm).One case had history of ESWL and PCNL before surgery with unsatisfied result and 7 cases were underwent ESWL with poor outcome.The double J stent was placed into the ureter two weeks before the operation.Under the general anesthesia,the ureteral access sheath was placed firstly during operation.Then,flexible ureteroscopy was inserted into the renal pelvis through ureteral access sheath.Holmium laser was used to perform the procedure with the power less than 20 W (0.6-1.0 J/10-20 Hz).The stone fragments were taken out by stone baskets and double-J stent was set at the end of the procedure for additional two weeks.Results The successive rate of the ureteroscopic insertion was 100％.The average operation time was 62 min (ranged 31-87 min).No severe complications such as heavy bleeding,perforation or ureteral avulsion occurred.Small stone fragments were found in 3 cases.All of them located in the lower calyx.Since no one complained about the upper urinary obstruction or related symptoms,conservative observation was considered.All patients discharged the day after the operation.Within three months follow-up,no sign of urinary obstruction was found.Conclusions FURS with holmium laser is a safe,effective and minimally invasive technique.It could be the best option in the management of renal calculi in ectopic pelvic kidney.

Objective To explore the relationship of DVL2 expression and the development of (CCRCC) by comparing the changes of DVL2 mRNA and protein expression in CCRCC specimens and matched normal renal specimens and its clinical significance. Methods DVL2 mRNA expressions in 22 CCRCC tissues, the matched adjacent normal tissues, and 10 CCRCC tissues alone were examined by semiquantitative RT-PCR and fluorescence quantitative PCR (real-time RT-PCR). Meanwhile, the different expression of the CCRCC between TNM Stage Ⅲ + Ⅳ and Stage Ⅰ +Ⅱ was also examined. Furthermore,immunohistochemistry was employed to examine DVL2 protein expression in 22 CCRCC and the matched adjacent normal tissues, and the other 10 CCRCC tissuses without the matched tissues. Results The DVL2 mRNA expression levels in 17 CCRCC tissues were increased by semi-quantitative RT-PCR and by real time RT-PCR compared with that in corresponding adjacent normal tissues, with the difference being significantly different (t = 2.535, P =0.0197). The DVL2 expression of 8 in 13 Ⅲ + ⅣCCRCC was higher than Ⅰ +ⅡCCRCC. Immunohistochemical examination showed that the DVL2 protein was located in cytomembrane and cytoplasm. Moreover, the positive level of DVL2 protein in CCRCC tissues[81.8 % (18/22)]was significantly higher than those in the adjacent tissues. However the expression was not associated with patients' age, gender, TNM stages (Fisher exact frenquently, P >0.05). Conclusion The DVL2 expression in CCRCC is obviously higher than the corresponding normal tissues in the level of mRNA and protein. And the higher DVL2 expression might be closely associated with the development and progression of CCRCC in the level of mRNA, which may be a potential molecular marker of CCRCC development and metastasis mechanism.

Objective: To investigate the gene frequency of HLA-B* 5801 in the population of Chinese Minnan region.Methods:In this study,we enrolled 178 patients requiring allopurinol therapy( including 40 patients with gout,89 patients with hyperuricemia and 49 patients with gouty arthritis) and 100 healthy people.We isolated genomic DNA from their blood and screened for HLA-B*5801 with both PCR and gene sequencing.Results:We found 22%patients and 16%healthy people with HLA-B*5801.The frequencies of HLA-B*5801 in patients and healthy people are 0.13 and 0.09,respectively.The results from PCR and gene sequencing were consistent.Conclusion:The frequency of HLA-B*5801 in the population of Chinese Minnan region is relatively high.Therefore,it is necessary to screen for HLA-B*5801 in allopurinol users before taking the medicine.