Objective To investigate the off-label use of antibacterials in out-patient department and emergency depart-mentand give reference for management .Methods About 10% of antibacterials prescriptions in out-patient department and emergency department were randomly extracted .Off-label use was analyzed by assessing off-label use percentage ,reviewing off-label types and evaluating the rationality .Results 23 600 antibacterial prescriptions ,including 43 antibacterials in 9 catego-rieswere analyzed ,and the off-label use percentage of 22 .00% .Cephalosporins contributed most in the amount of off-label use prescriptions ,while nitroimidazoleseries got the highest off-label percentage of 73 .45% .Improper frequency and dosing were the most obvious phenomena ,with the ratio of 55.64% and 52 .60% ,respectively .For oral drugs ,most frequent off-label use type of these drugs was improper dosing (72 .46% ) .For injections ,frequent off-label use type of these drugs were manifested improper frequency (82 .18% ) and improper solvent (38 .80% ) .Conclusion Off-label use of antibacterials in hospital was in a critical situation and most of the prescriptions were lack of rational evidence .Standardized administration should be introduced .

Objective To establish a HPLC method for determination of berberine hydrochloride in Dongbai Tonglin Heji.Methods The separation column of Kromasil C18(150 mm×4.6 mm,5 μm) was used.The mobile phase was acetonitrile and 0.05 mol/L NaH2PO4 solution(pH was adjusted to about 3 with phosphoric acid).The flow rate was 1.0 ml/min with the column at room temperature and the detection wavelengths at 345 nm for berberine hydrochloride.Results The linear range of berberine hydrochloride was 1.00~50.00 μg/ml(r=0.999 6).The average recoveries of berberine hydrochloride were 104.70%(RSD 1.60%, n=5).Conclusion This method is accurate, sensitive, selective and reproducible.It provides an alternative method to improve the quality control of Dongbai Tonglin Heji.

The PBL and CBL model pays more attention to the cultivation of students' ability than the traditional education model, which is in line with the current demand for clinical pharmacy training. This study has summarized the practice of PBL combined with CBL in clinical pharmacy training for com-munity clinical pharmacists in the Pharmacy Department of the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine. The results show that PBL combined with CBL teaching is superior to traditional teaching in stimulating students' interest in learning, clarifying their learning objectives, en-hancing their ability to analyze and solve problems, autonomous learning, information seeking skills, team cooperation awareness, clinical thinking and so on. This teaching has a good response in community clini-cal pharmacist training, and it is worth promoting.

Objective To investigate the effects of miR-93 on proliferation and apoptosis of osteosarcoma cells and the possible mechanism .Methods The expression levels of miR-93 and the naked cuticle homolog 2 (NKD2) in 6 osteosarcoma cell lines (143B, HuO9, Saos2, MG63, U2OS and G292) and one osteoblast cell line hFOB 1.19 were determined by quantitative real-time PCR and Western blot assays, respectively. MiR-93 down-regulated 143B and HuO9 cells were constructed by lipofection transfection, and their proliferation and apoptosis were detected by MTT and flow cytometry assays , respectively.Luciferase reporter assay was used to determine whether the 3′UTR of NKD2 mRNA was a binding target of miR-93.In addition, 143B cells were transfected with NKD2 cDNA, and the effects of NKD2 on proliferation and apoptosis of osteosarcoma cells were investigated .Results Up-regulation of miR-93 and down-regulation of NKD2 were detected in osteosarcoma cell lines .MTT and flow cytometry assays showed that miR-93 promoted proliferation and inhibited apoptosis in osteosarcoma cells .Luciferase assay confirmed that miR-93 targeted NKD2 directly. In addition, overexpression of NKD2 inhibited proliferation and promoted apoptosis of osteosarcoma cells were found .Conclusions MiR-93 targets NKD2 to promote proliferation and inhibit apoptosis of osteosarcoma cells . The findings may have significant implications in the diagnosis and treatment of osteosarcoma .

Objective:The clinical characteristics and prognosis of 20 patients with small B-lymphocyte proliferative disease with t (14;19) (q32; q13) were analyzed to improve the understanding of such rare cases.Methods:The clinical data of 20 patients with t (14; 19) (q32; q13) small B lymphocyte proliferative disease treated in the First Affiliated Hospital of Nanjing Medical University from April 2013 to December 2020 were retrospectively collected and analyzed. Among them, 10 cases were chronic lymphocytic leukemia (CLL) and 10 cases were other small B-cell malignancies.Results:Among the 20 cases, 10 were male and 10 were female, and the median age at diagnosis was 53.5 (35-88) years old. All patients had absolute lymphocytosis, 19 patients had lymphadenopathy, and 10 patients had splenomegaly. With a median follow-up of 36 (4-163) months, three patients died, and 11 patients had a time to treatment (TTT) ≤12 months. Ten patients (50%) were accompanied by +12, two patients (2/17, 12%) were accompanied by 13q-. Moreover, we found that t (14;19) was associated with unmutated immunoglobulin heavy-chain variable (IGHV) somatic mutation (17/19, 89%) and a biased use of IGHV4-39 (7/17, 41%) was observed. Next-generation sequencing detected one or more gene mutations in 14 (14/17, 82%) cases and a total of 25 gene mutations had been revealed, of which the most frequent were NOTCH1 (35%) , followed by SF3B1 (24%) and KMT2D (18%) . For 10 CLL patients, five (50%) were defined as Rai Ⅲ/Binet C. It is noteworthy that among the 20 cases, two cases actually involved Richter transformation.Conclusions:Small B-cell malignant tumors with abnormal t (14; 19) show unique clinical biological characteristics, often accompanied by a variety of adverse prognostic factors, and tend to have an aggressive clinical course.

Objective To explore the efficacy and safety of dabigatran etexilate in the treatment of elderly patients with non-valvular atrial fibrillation (NVAF), so as to provide reference for clinical treatment and rational drug use. Methods Eighty elderly patients with NVAF in The Seventh People's Hospital of Shanghai from December 2020 to June 2021, aged 65 to 80 years, were enrolled in a self-controlled study. Dabigatran etexilate 110 mg was given orally, twice a day (one in the morning and one in the evening) for 6 months. During the follow-up visit, the coagulation function indexes including APTT, TT, FIB and D-D were observed in patients taking medicine for 1 month and 6 months. Liver function indexes including ALT, AST and TBIL, renal function indicators including UREA and eGFR, and blood routine indexes including HGB and ESR, also were observed in patients taking medicine for 1 month and 6 months. Results Patients were compared at 1 month and 6 months after treatment with dabigatran and before: the difference of coagulation function indexes as APTT and TT was statistically significant (P<0.05);There was no significant difference in liver function index, renal function index and blood routine index (P>0.05); A total of 25 adverse events occurred, and the incidence rate of adverse reactions was 31.25%, there was no adverse events such as serious hemorrhage，life threatening and organ failure hemorrhage occurred．Conclusion Dabigatran has good efficacy and safety in the treatment of the elderly NVAF.