OBJECTIVE:To discuss the connotation,significance and methods of pharmacoeconomics of Adverse Drug Reactions(ADR).METHODS:The related studies evaluating the economic impact of ADR both at home and abroad were sum_ marized by literature review.RESULTS&CONCLUSION:There existed a big gap in the researches between China and foreign countries.Approaches to assessment of the economic costs of ADR were found to be cost study,cost-efficiency analysis of drug safety.The cost study includes the following3steps:defining ADR,estimating the incidence of ADR and measuring the costs of ADR.

OBJECTIVE:To provide reference for the development China as clinical research center in Asian-pacific re?gion.METHODS:To discuss the strengths,weaknesses,opportunities and threats of China as a regional clinical research center by analysis.RESULTS&CONCLUSION:Against the background of globalization of pharmaceutical research and development,expansion of the global clinical research markets provide great opportunities for China to develop its clinical re?search,and developing a good regulatory environment as well as improving the management of the clinical trial center will af?filiate China to be a competitive clinical research center in Asian-pacific region.

In order to raise international comprehensive medical talents to have strong competition capability,the bilingual teaching is on the rise in the domain of medical education. Questionnaire-based survey among the 5-year-proguam medicinal undergraduate students was conducted to investigate the students'learning condition,acquaintanceship and requirements on the bilingual teaching so as to further reform and explore ways to improve the quality of bilingual teaching

Objective To explore the mechanism of Huagan Jiedu decoction in treatment of chronic hepatitis B by testing the influence of the decoction on Serum IL-2, IL-4 and IFN-γ of rat models of chronic hepatic injury. Methods The model of Chronic hepatic injury was established by subcutaneously injecting 40% CCl4-olive oil solution in rats according to the ratio of 3ml per kg. of body weight. 60 healthy rats were divided randomly into a normal group, a model group, a low dose of Huagan Jiedu decoction group, a large dose of Huagan Jiedu decoction group, and a control group (Qingre Jiedu tablet group), 15 cases in each group. The Serum IL-2, IL-4 and IFN-γ were detected in each group separately. Results Compared with the normal group, the Serum IL-2 and IFN-γ were decreased (t=2.401, 2.337, P=0.0349, 0.0378) and the Serum IL-4 was increased (t=2.896, P=0.00861 ) in the model group; Compared with the model group, the Serum IL-2 and IFN-γ were increased (t=2.417, 2.344, P=0.0341, 0.0372, P＜0.05; t=3.114, 2.988, P=0.0052, 0.0068) in the large Huagan Jiedu decoction group and the control group, while the Serum IFN-γ was increased (t=3.049, P=0.0062) in the low dose of Huagan Jiedu decoction group and the Serum IL-4 was decreased (t=3.102, 3.017, 2.979, P=0.0061, 0.0065, 0.0069)in both Huagan Jiedu decoction groups and the control group. Conclusion Large dose of Huagan Jiedu decoction has sound therapeutic effects on rats with chronic hepatic injury by decreaseing the content of the Serum IL-4 and increasing IL-2 and IFN-γ, and adjusting th1/th2 balance.

OBJECTIVE:To investigate the way to provide suitable pharmacecaical care for antineophastic drug-induced ADR by clinical pharmacists. METHODS:For one case of 5-FU chemotherapy-induced neutropenia associated with fever and diarrhea, clinical pharmacists provided advices on antibacterial treatment,including imipenem/cilastatin 0.5 g,q6 h,ivgtt;norvancomycin 0.4 g,q6 h,po;levofloxacin 0.4 g,qd,ivgtt;loperamide with initial dose of 4 mg for anti-diarrheal medication,maintaining at 2 mg,q4 h. RESULTS:After 22 days of appropriate antibacterial and anti-diarrheal treatment,the patient's body temperature and he-mogram returned to normal,diarrhea stopped and β-HCG decreased to 61.58 U/L;then the patient was discharged from hospital. CONCLUSIONS:It is beneficial to optimize chemotherapy plan and ADR disposal,and ensure the safety of the treatment that clini-cal pharmacists assist physicans to optimize therapy plan and provide pharmaceutical care.

Background Radiation-induced optic neuropathy (RION) is a severe complication after radiotherapy for head and neck cancer,which threatens the visual acuity and quality of life of patients.Till now,there is no recognized treatment for RION.It is of great significance to study the natural progression of the RION,and to prevent and treat RION.Objective This study was to establish an ideal radioactive optic nerve injury animal model.Methods Healthy 8-week SD rats with hygiene grade were randomly divided into normal control group and model group,with 6 rats in each group.The total 30 Gy dose of radiation with 3 portions was used to irradiate the head model group rats;ELISA was performed to analysis the changes of endothelin-1 (ET-1) and Von Willebrand factor (vWF) concentrations in blood 2,4 and 8 weeks after irradiation.Hematoxylin-eosin staining and transmission electron microscope were performed to observe the changes of optic structure.The use and care of the experimental animals complied with the ARVO statement.Results The concentrations of ET-1 in the model group were (23.18± 0.11),(27.98 ±0.22),(33.90 ±0.1 1),(65.25 ±0.38) and (43.82 ± 0.09) pg/ml before irradiation,1 day,2,4,6 weeks after irradiation,those in the normal control group were (22.65 ± 0.14),(23.18 ± 0.19),(23.68 ± 0.15),(24.23±0.12) and (23.58±0.16)pg/ml.The concentrations of vWF in the model group were (63.16±2.21),(88.32± 2.06),(123.38 ± 1.36),(191.40 ± 0.61) and (141.69 ± 0.82) pg/ml before irradiation,1 day,2,4,6 weeks after irradiation,those in the normal control group were (62.82 ± 1.56),(63.35 ±2.06),(64.12 ± 1.76),(63.52±2.02) and (63.48 ± 1.55)pg/ml.There were significant differences of ET-1 and vWF concentrations among different groups and time points (ET-1:Fgroup =32.160,P =0.012;Ftime =21.180,P =0.023.vWF:Fgroup =73.110,P=0.001;Ftime =46.180,P =0.002).The nerve fiber bundles was swelled with disordered arrangement and vacuolization 8 weeks after irradiation.Axon swell and atrophy,axons with myelin sheath layer plate separation were obtained.The rates of axon demyelination in the normal control group and model group were (1.35 ±0.79) ％ and (14.44±2.32)％,respectively.There was a statistically significant difference between the two groups (t =14.07,P＜0.01).Conclusions The total 30 Gy dose of radiation on the head of rats can make stable radioactive optic nerve injury model.This model making method is simple,cheap and practical,which is worth further study.

Objective To investigate the efficacy and safety ofQingre Huoxue Mixture in the treatment of blood heat type psoriasis vulgaris.Methods The patients were divided into treatment group and control group according to random number table method, with 52 cases in treatment group and 50 cases in the control group, 10 cases failed to complete the trial. Treatment group was givenQingre Huoxue Mixture, and the control group received oral administration of compoundQingdaiCapsule. The treatment lasted for 8 weeks. PASI score, TCM syndrome integrals, DLQI score, serum IFN-γ and IL-10 were detected, and hematuria routine and liver and kidney function were under safety testing before and after treatment.Results After treatment, PASI score, DLQI score and TCM syndrome integrals in the treatment group decreased significantly (P<0.001); the expression of serum IFN-γ decreased significantly (P<0.001); the expression of serum IL-10 increased significantly (P<0.001), with the total effective rate of 100% (52/52). After the treatment, TCM syndrome integrals in the both groups decreased significantly (P<0.001). After the treatment, the rash burning and itching scores in the treatment group were lower than the control group, with statistical significance (P<0.001). In terms of safety, the treatment group had no abnormal indicators.ConclusionQingre Huoxue Mixture has obvious curative effect, which can reduce the patients with psoriasis, improve the life quality of patients, and improve the clinical symptoms of rash burning and itching, reduce serum IFN-γ, and increase serum IL-10.

Objective To explore the effect of sitting and lateral sputum aspiration on the retention time of tracheal cannula in patients with neurosurgical tracheotomy. Methods Totally 120 cases of neurosurgery tracheotomy in hospitalized patients complicated with pulmonary infection by random number table method, 58 cases were divided into experimental group and control group 62 examples, two groups of patients with sputum top all joint taps to the back of the chest, the experimental group after taps take seat effectively causes cough; In the control group, the lateral position was used to effectively cough or induce cough, and the daily sputum volume of the two groups of patients was observed. To observe the time when the body temperature was restored to normal after the phlegm of the two groups of patients, the time of the lung auscultation, and the time of the tracheal tube retention. Results Implementing position row of phlegm daily sputum volume within a week the experimental group were (44.84±6.85) ml, (44.60±6.80) ml, (43.79±5.98) ml, (44.38±5.42) ml, (42.22±5.45) ml, (38.12±4.77) ml, (36.88±4.57) ml and control group were(36.13±7.34) ml, (35.15±7.34) ml, (36.13±7.34) ml, (37.13±7.34) ml, (37.13±7.34) ml, (32.97±7.17) ml, (31.35±4.36) ml, the difference had statistical significance (t=4.30-7.31, P<0.01);In the two groups, the time of normal body temperature recovery, the time of hearing and the time of the lung and the time spent in the tracheal tube were compared, and the experimental group were respectively (9.93±2.02) d, (32.33±1.50) d, (37.33±1.50) d, while control group were(15.77±1.05) d, (37.63 ± 2.33) d, (42.63 ± 2.33) d, the difference had statistical significance (t=20.04, 14.71, P<0.01). Conclusions It is better to reduce the retention time of tracheal tube in patients with neurosurgical patients than the lateral position.

Objective To analyze the effect of circLRP6 on high glucose-induced renal tubular epithelial cell injury via miR-31-5p/high mobility group protein A1(HMGA1)axis regulation.Methods Human renal tubular epithelial HK-2 cells were cultured in vitro and divided into eight groups:control,high glucose,high glucose+si-NC,high glucose+si-circLRP6,high glucose+si-circLRP6+miR-NC,high glucose+si-circLRP6+miR-31-5p inhibitor,high glucose+si-circLRP6+miR-31-5p inhibitor+si-NC,and high glucose+si-circ-LRP6+ miR-31-5p inhibitor+si-HMGA1.The circLRP6,miR-31-5p,and HMGA1 mRNA levels were determined using real-time quantitative PCR.Cell supernatant IL-6 and tumor necrosis factor-α(TNF-α)levels,lactate dehydrogenase(LDH)activity,and malondialdehyde(MDA)content were also determined.Furthermore,flow cytometry was used to observe cell apoptosis.HMGA1,Bax,and Bcl-2 protein expression was detected by Western blotting.Finally,dual luciferase assay was used to report the targeting relationship of miR-31-5p with circLRP6 and HMGA1.Results Compared with the high glucose group,the HK-2 cell proliferation inhibition rate;cell superserum IL-6,TNF-α,LDH,and MDA levels;apoptosis rate;and Bax protein expression in the high glucose+si-circLRP6 group decreased significantly,whereas Bcl-2 protein expression increased significantly(all P＜0.05).Consequently,miR-31-5p downregulation possibly weakened the protective effect of si-circLRP6 on high glucose-induced renal tubular epithelial cell injury.HMGA1 expression inhibition reversed the effect of the si-circLRP6+miR-31-5p inhibitor on high glucose-induced renal tubular epithelial cell injury.Finally,miR-31-5p exhibited a targeting relationship with circLRP6 and HMGA1.Conclusion Si-circLRP6 protects high glucose-induced renal tubular epithelial cell injury via miR-31-5p upregulation and HMGA1 expression inhibition.

OBJECTIVETo evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) on patients with rheumatoid arthritis (RA) in China.

METHODSFive hundred and sixty-six patients with active rheumatoid arthritis were randomly assigned to receive leflunomide at 20 mg once daily or MTX at 15 mg once weekly in a controlled trial. Five hundred and four patients completed the 12-week treatment and some patients continued the treatment for 24 weeks.

RESULTSBoth leflunomide and MTX could improve the symptoms, signs, and joint function, but there were no changes in X-ray observations of patients with rheumatoid arthritis. In the leflunomide group, the overall rates of effectiveness at 12 weeks and 24 weeks were 86.94% and 92.31% respectively; the rates of remarkable improvement were 64.95% and 79.81% respectively. In the MTX group, the overall rates of effectiveness at 12 weeks and 24 weeks were 84.04% and 83.15% respectively; the rates of remarkable improvement were 56.81% and 75.28% respectively. According to intent-to-treat analysis, the ACR 20% response rates at 12 weeks and 24 weeks in the leflunomide group were 62.54% and 67.18% respectively, compared with 60.08% and 61.32% respectively in MTX group. No statistical differences were shown in the efficacy between the two groups (P > 0.05). The adverse events in the leflunomide group were gastrointestinal symptoms, skin rash, alopecia, nervous system symptoms, decreased leukocyte count, and elevation of alanine aminotransferase (ALT). Most of these side effects were mild and transient. The incidence of adverse events in the leflunomide group was 16.84%, significantly lower than that in MTX group (28.17%, P = 0.002).

CONCLUSIONSLeflunomide is effective in the treatment of RA with less adverse events than MTX. Its efficacy is similar to MTX, but the incidence of adverse events and the rate of withdrawal due to adverse events were lower in the leflunomide group than in MTX group.

Antirheumatic Agents ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Female ; Growth Inhibitors ; adverse effects ; therapeutic use ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Isoxazoles ; adverse effects ; therapeutic use ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Middle Aged