Objective:To explore the role of clinical pharmacists in the development of individualized drug treatment regimens for the osteosarcoma children with irregular body weight .Methods:Clinical pharmacists involved in the calculation of body weight surface area increased to that of adult for one case of osteosarcoma child during the chemotherapy , comparatively analyzed the suitable calcula-tion formula of surface area for the children in our country and helped clinicians make accurate dose of chemotherapy drugs .Mean-while, according to the pathological and physiological characteristics of the child , clinical pharmacist also provided advice on adjuvant drug use such as antiemetic regimen etc .Results:Physicians adopted the suggestions of clinical pharmacists and the chemotherapy was successfully completed .Overdose adverse reactions were avoided without the use of foreign general calculation formula of body surface area for the overweight child , and inadequate dose was also avoided for the conservative treatment , which could lower the risk of re-duced potential anticancer efficacy .Conclusion:Clinical pharmacists can help doctors perform safer and more effective drug treatment program and reduce adverse drug reactions in the treatment of special patients through participation in the development of individualized medication for cancer children to obtain maximum profit .

Emergencies ; Rescue Work

AIM　To investigate the chemical constituents of the rhizomes of Dioscorea panthaica Prain et Burkill and look for new active compounds. METHODS　The compounds were isolated with silica gel and HPLC, and their structures were elucidated on the basis of chemical evidences and spectral analysis (IR, ESI-MS, 1HNMR, 13CNMR, DEPT, 1H-1H COSY, HMQC, HMBC, NOESY). RESULTS　Three steroidal saponins were isolated from the rhizomes of Dioscorea panthaica. They were elucidated as 26-O-β-D-glucopyranosyl-3β,26-diol-23(S)-methoxy-25(R)-Δ5,20(22)-diene-furosta-3-O-［α-L-rhamnopyranosyl-(1→2)-O-α-L-rhamnopyranosyl-(1→4)］-β-D-glucopyranoside (I), pseudoprotodioscin (II), 26-O-β-D-glucopyranosyl-3β,26-diol-25(R)-Δ5,20(22)-diene-furosta-3-O-α-L-rhamnopyranosyl-(1→2)-O-β-D-glucopyranoside (III). CONCLUSION　Compound I is a new steroidal saponin and was named as dioscoreside C. Compound II and III were obtained from this genus for the first time.

OBJECTIVE:To explore the role of clinical pharmacists in the treatment of pan-drug resistant Acinetobacter bau-mannii infection. METHODS:Clinical pharmacists participated in the treatment for a severe pneumonia case of pan-drug resistant A. baumannii infection. Clinical pharmacists supplied overall pharmaceutical care and suggestions with respects to initial medication scheme evaluation,pathogen judgment,therapy drug selection,ADR disposal,etc.,including anti-infective treatment of moxifloxa-cin 0.4 g,ivgtt,qd+meropenem 0.5 g,ivgtt,q8 h+linezolid 0.6 g,ivgtt,q12 h;anti-pan-drug resistant A. baumannii infection of cefoperazone sodium and sulbactam sodium 3.0 g,ivgtt,q8 h+tigecycline 50 mg,ivgtt,q12 h;liver protection of ademetionine 1, 4-Butanedisulfonate 1.0 g,ivgtt,qd+reduced glutathione 1.8 g,ivgtt,qd. RESULTS:After 25 d treatment,the patient hadn’t been fe-vered,and hemogram and hepatic function index decreased to normal value. CONCLUSIONS:Clinical pharmacist should be en-gage in anti-infective treatment and pharmaceutical care,and provide physicians reasonable medication suggestion so as to promote care rate in the clinic.

OBJECTIVE:To investigate thinking and working skill of clinical pharmacist working in the tumor hospital. METHODS:Medical care can be improved by strengthening theoretical learning and clinical practice,exploring thinking and skill in the working. RESULTS:The way that clinical pharmacists participated in the treatment can improve the curative effect and reduce incidence of ADR. CONCLUSION:Clinical pharmacists should direct medication according to patients’condition to guarantee safety and effectiveness of drug use.

Objective To investigate the significance of cyclooxygenase-2 (COX-2),vascular endothelial growth factor(VEGF) protein expression and angiogenesis in hepatocellular carcinoma(HCC).Methods Tissue sec- tions from 40 HCC patients were examined immunohistochemically for protein expression of COX-2 and VEGF.Mi- crovessel density(MVD) was counted by endothelial cells immunostained by anti-CD34 antibody.Results The ex- pression of COX-2 protein in well differentiated HCC was stronger than that in moderately differentiated HCC and poorly differentiated HCC(P

Objective To explore the mechanism of endotoxemic injury in kidneys and protective effect of dexamethasone on renal cells.Methods Fifty-four eighteen-day Wistar rats were divided into control,endotoxemic(LPS)and dexamethasone groups randomly,18 rats in every group.Rats in control group were injected intraperitoneally with the same volume(0.1 mL)of 9 g/L sodium chloride as other two groups.All rats in LPS group were injected with a single bolus of LPS(4 mg/kg).The rats in dexamethasone group received LPS(4 mg/kg)and dexamethasone(5 mg/kg).Then they were sacrificed at 6,24 and 72 hours after injection.The ultrastructure was observed by electron microscope.Results In LPS group,glomerular basement membrane became thick and foot processes had coalescent partly,mitochondrial cristae became dissolved in proximal tubular endothelial cells and microvillus of distal tubular diminished at 6,24 hours after LPS injection.The morphological changes of apoptosis were found in the proximal tubular at 72 hours after LPS injection.These changes were in dexamethasone group.Conclusion Apoptosis participates in LPS injury of kidneys and dexamethasone have protective effect on injuried renal cells.

Objective To investigate the sniff nasal inspiratory pressure (SNIP) of Chinese boys. Methods 299 healthy boys aged 5-12 years were measured with SNIP. Their height, weight, and age were recorded. Results The SNIP averaged (76.9±22.6) cmH2O, and was (59.1±14.2) cmH2O, (76.9±19.5) cmH2O, (85.3±23.5) cmH2O and (83.0±22.6) cmH2O in the boys of 5-6 years old, 7-8 years old, 9-10 years old and 11-12 years old, respectively. It was significantly different among boys of 5-6 years old, 7-8 years old and 9-10 years old (P<0.05), but no significant difference between 9-10 years old and 11-12 years old (P=0.55). Regression analysis indicated significant relations of SNIP with age, height, weight and Body Mass Index (P<0.01). Conclusion The SNIP of Chinese healthy boys are different from abroad. It is necessary to establish the Chinese children SNIP reference range.

Objective: To propose updates and amendments for the nitroglycerin tablets quality in the Chinese pharmacopoeia 2020 due to the failure of effective separation of 4 known impurities and nonseparation of free nitrate ion and excipients.
Methods: Related substances were analyzed using gradient elution by HPLC, and free nitrate ion was determined on SAX column by different HPLC method.
Results: Using the improved method to test the related substances and free nitrate ion of nitroglycerin tablets,the content of the maximum individual impurity were not more than 0.5%, the total content was not more than 2.4% and the content of free nitrate ion was not more than 6.3%.
Conclusion: The improved method is accurate and feasible. It provided a reference for the updates and amendments of the quality standard of nitroglycerin tablets in the Chinese Pharmacopoeia 2020.

Objective To explore the effect of sodium arsenite (iAs3+) and sodium hydrogen arseuate (iAs5+) exposure on rat multidrug resistance protein 2 (MRP2) expression,and the correlation of liver arsenic and its methylation products,and to provide a basis for further elucidating the mechanism of arsenic toxicity.Methods Seventy wistar rats were randomly divided into seven groups,10 rats in each group.Control group was administrated with deionized water.Sodiun arsenite high-dose group,middle-dose group,low-dose group were administrated with different concentrations of sodium arsenite:20.0,6.7 and 2.2 mg/kg BW every day,respectively.Animals were sacrificed 90 days later by cervical dislocation to collect liver,the expression of MRP2 in the membrane of hepatocyte was determined by Western blotting.HPLC-HGAFS was employed to determine the content or level of arsenic and its methylation products.Correlation between expression of MRP2 and arsenic methylation products was analyzed using Pearson's linear correlation method.Results The MRP2 protein levels of control group,iAs3+ and iAs5+ high-,middle-,low-dose groups were 1.21 ± 0.13,1.85 + 0.09,1.65 + 0.19,1.61 + 0.18,1.69 + 0.04,1.42 + 0.19,1.27 ± 0.10.Compared to control group,MRP2 protein levels of iAs3+ high-,middle-,low-dose group and iAs5+ high-dose group were increased (P ＜ 0.05); Compared with the low-dose group,MRP2 protein levels of iAs3+ and iAs5+ high dose groups were increased(P ＜ 0.05); Comparing the matched doses group of iAs5+ and iAs3+,MRP2 protein levels of iAs3+ high-,middle-,low-dose group were higher than iAs5+(P ＜ 0.05).Meanwhile,there was a significant positive relationship between the expression of MRP2 and the content of iAs3+,MMA and DMA in iAs3+ exposed group(r =0.575,0.678,0.395,all P ＜ 0.05).There was also a significant correlation between the expression of MRP2 and MMA and IMA in iAs5+ exposed group(r =0.593,0.643,all P ＜ 0.05).There was no significant relationship between the expression of MRP2 and the content of iAs5+in iAs5+ exposed group.Conclusions The expression of MRP2 is increased with increasing dose of arsenic exposure,thus resulting in compensatory changes on MRP2 expression in the liver cell membrane.MRP2 efflux may play an important role in the metabolic pathways of iAs3+.The level or load of arsenic methylation in liver is closely related with MRP2 expression.