OBJECTIVE:To explore the mode,methods and role of clinical pharmacists providing pharmaceutical care for pa-tients with natural killer/T-cell lymphoma (NK/TL) complicated with diabetes. METHODS:Clinical pharmacists participated in SMILE chemotherapy plan for a NK/TL patients with diabetes mellitus,evaluated potential chemotherapy risk during first chemo-therapy,implemented individual medication monitoring and put forward suggestion. It included insulin injection 4 U,ivgtt,to con-trol the increase of blood glucose induced by dexamethasone;sodium bicarbonate 40 ml,ivgtt,bid to alkalize urine;allopurinol 0.1 g,po,tid to inhibit uric acid;fluid infusion 4 000 ml/d to prevent renal failure;mesna 0.4 g/time to protect urinary passage;monitorring potential allergic reaction and arrest of bone marrow;providing medication education on the application of calcium foli-nate in SMILE chemotherapy regimen. RESULTS:Physicians adopted the suggestions of clinical pharmacist,and chemotherapy was carried out smoothly. No ADR was found,and patients manifested good medication compliance. CONCLUSIONS:Clinical pharmacists participate in chemotherapy,evaluate potential risk and provide individual medication monitoring,which optimize ther-apy plan,reduce medication risk and guarantee the safety of drug use.

Recent studies show that the abnormalities of dickkopf-1 (DKK-1)are closely related to the bone metastasis and therapeutic effect of breast cancer,prostatic carcinoma,multiple myeloma,neuroblastoma and non-small cell lung cancer.Clinical researches of large sample on the relationships between serum DKK-1 concentration and malignant tumors bone metastases have important clinical significance for evaluating the value of DKK-1 as a clinical biological biomarker of bone metastases and understanding the tumor mechanisms of bone metastases.

Objective The aims of this study were to investigate the expression of microRNA-30a(miR-30a)in human bladder cancer cell lines and their effects on the proliferation,apoptosis and migration of human bladder cancer cells.Methods The expression levels of miR-30a in bladder cancer cell lines(5637 and T24)and bladder epithelial immortalized cells(SV-HUC-1)were detected by real-time quantitative PCR(qRT-PCR).The expression of miR-30a was up-regulated or down-regulated by T24 cells transfected with miR-30a mimic or 5637 cells transfected with miR-30a inhibitors and controls using NC mimic or NC inhibitor.The effects of miR-30a expression on the proliferation,apoptosis and invasion of bladder cancer cells were investigated by flow cytometry,MTT and Transwell assays.Results The expression level of miR-30a in two bladder cancer T24 and 5637 cell lines was significantly lower than that in normal bladder SV-HUC-1 cell line(P<0.05),and the expression level of miR-30a was lower in the high degree of malignancy in bladder cancer T24 cells than that in malignant degree of relatively low 5637 cells.After 72h transfection,the values of optical density(OD)in the miR-30a mimic group(0.83±0.09)was significantly lower than that in NC mimic group(1.21±0.12)in T24 cells(P<0.01).The OD values of miR-30a inhibitor group(1.28±0.14)was significantly lower than that in the NC inhibitor group(1.09±0.14)in 5637 cells(P<0.01).The apoptotic rate of miR-30a mimic group in T24 cells(21.27±2.42)% was significantly higher than that in the NC mimic group(10.61±1.29)%(P<0.01).The apoptotic rate of the miR-30a inhibitor group in 5637 cells(6.78±2.57)% was significantly lower than that in the NC mimic group(13.42±1.40)%(P<0.01).The number of transmembrane cells in miR-30a mimic group in T24 cells(183.57±16.61)was significantly lower than that in NC mimic group(465.80±9.20)(P<0.01).The number of transmembrane cells in the miR-30a inhibitor group in 5637 cells(581.25±11.02)was significantly lower than that in NC mimic group(397.13±7.57)(P<0.01).Conclusion Up-regulation of miR-30a can inhibit the proliferation of bladder cancer cells,promote cell apoptosis and reduce the ability of migration and invasion in bladder cancer cells.The low expression of miR-30a in bladder cancer cells may be related to the development and metastasis in bladder cancer.

Objective To investigate diagnosis and treatment of venous cerebral infarction.Methods The reasons, clinical findings, imaging characters, treatment methods and prognosis of 19 patients diagnosed venous cerebral infarction were analyzed.Results The most frequent symptoms were headache, focal deficits, epilepsy, increased CSF pressure.Among 19 cases, multiple cerebral lesions were found in 12 cases, lobes lesions in18 cases, cerebral infarction with hemorrhage in 3 cases. After various treatments, 16 patients were discharged and one patient died and 2 patients gave up treatment. Conclusions Venous cerebral infarction has complicated causes, non-specific chinical manifestations and characteristic MR images. Anticoagulation and thrombolysis treatment in early stage may have good therapeutic effect.

Objective To observe the curative effect of pure 1 25 I treatment to non-small cell lung cancer combined obstructive pneumonia.Methods 28 cases with non-small cell lung cancer combined obstructive pneumonia were enrolled.Treatment planning system was used to calculate the dosage of tumor and make up the therapeutic plan.CT-guided radiation treatment of particle im-plantation was then conducted.Follow-up was done to evaluate the curative effect one to two months after treatment.Results The total effective rate of therapeutic evaluation was 89.3%.Clinical symptoms including chest distress,hard breathing and fever were ameliorated remarkedly.Life quality score of appetite and fatigue was also improved.White blood cell reduced significantly in blood routine examination.Conclusion There is a definite curative effect of pure 1 25 I treatment to non-small cell lung cancer combined ob-structive pneumonia.

Purpose To investigate the significance of procedural arteriography in interventional embolization of adrenal metastasis, due to the fact that it is usually difficult to seek feeding arteries in the treatment of adrenal metastasis using interventional embolization. Materials and Methods Eighteen patients with adrenal metastasis were treated with procedural arteriography and interventional embolization therapy, the source and number of feeding arteries was retrospectively analyzed. Results The total success rate of procedural arteriography was 95.5%. The abnormal feeding arteries which were discovered by procedural arteriography accounted for 29.0%. The number of feeding arteries was two, which were mainly derived from inferior suprarenal artery and superior suprarenal arteries. Conclusion The source of feeding arteries of adrenal metastasis is abundant and the variability is obvious, thus procedural arteriography should be used to the greatest extent during operation of digital subtraction angiography to avoid omission of feeding arteries.

Objective To study the effect of soluble, refolded, recombinant extracellular domain of the human Fc gamma receptor Ⅱ a (huFcγRⅡa) on the binding of human IgG to cells. Methods Extra-cellular domain of the huFcγRⅡ a gene was amplified from recombinant plasmid pe3huR Ⅱ by PCR and then cloned into pET-28a vector. The recombinant plasmid pETshuR Ⅱ was transformed into E. coli BL21 (DE3) after identified by PCR and doubly digested. The inclusion bodies of fusion protein were extracted and purified by washing, dissolved in 6 mol/L guanidine buffer, and refolded by rapid dilution technique. The refolding protein activity was tested by ELISA and flow cytometry. Results Extraceilular domain of the huFcγRⅡa gene was successfully cloned into pET-28a. The results of SDS-PAGE showed that the molecular mass (Mr) of the expressed protein was 24.8 × 103, and the expression rate was 30%. The purity of recom-binant shuR Ⅱ was up to 90% after washing. ELISA showed that the recombinant shuR Ⅱ was able to bind human IgG in a dose dependent manner, shuRⅡ could competitively inhibit the binding of human IgG to huFcγRⅡa expressed on the surface of COS-7 cells by flow cytometry. Conclusion The results demon-strate that it is possible to obtain large quantities of recombinant shuR Ⅱ which has comparable binding prep-erties to those of the whole membrane bound huFcγR Ⅱ a.

Objective:To detect the proportion of lymphocyte subsets in peripheral blood of the ad-vanced breast cancer patients before and after chemotherapy with docetaxel and thiotepa,as well as the association between the proportion of peripheral blood lymphocyte subsets with the response rate and prog-nosis.Methods:The proportions of lymphocyte subsets (CD3 +T cell,CD3 +/CD4 +T cell,CD3 +/CD8 +T cell,CD3 -/CD16 +56 +NK cell,CD3 +/CD16 +56 +T cell,CD19 +B cell,CD4 +/CD25 +T cell,CD8 +/CD28 -T cell,CD8 +/CD28 +T cell)in the peripheral blood of 86 patients were analyzed with flowcytometry before and after chemotherapy.The result was analyzed in combination with clinico-pathological data.Results:The proportion of regulatory T cells (Treg)after chemotherapy in the disease control patients decreased significantly compared with that of the progressive patients (P=0.034).The difference of the proportions of Treg before and after chemotherapy affected significantly the overall survi-val (OS).The OS of the patients with decreased proportion of Treg was significantly longer than that of the patients with increased proportion of Treg,which was 23.5 and 9.4 months respectively (P<0.05). Conclusion:The patients with decreased proportion of Treg after chemotherapy had higher response rate and better survival benefit.

Objective:To observe the changes of neutrophil to lymphocyte ratio and lung function of patients defined by different TCM syndromes with acute exacerbation of chronic obstructive pulmonary disease.Methods:A total of 181 patients with acute exacerbation of chronic obstructive pulmonary disease in our hospital from January 2016 to Novenber 2018 were included and divided into 5 groups accoding to different TCM syndromes, which were wind-cold invading lung syndrome (26), external cold and internal fluid syndrome (40), phlegm-heat obstructing lung syndrome (48), phlegm-dampness blocked syndrome (48), an heart spirit confused by phlegm syndrome (19). Then tested the blood for each group, and calculated NLR; tested c-reactive protein, and lung function, and measured with COPD Assessment Test (CAT) and Modified British Medical Research Council (mMRC); conducted 6MWT, then the BODE index and Charlson Comorbidity Index (CCI) scores were calculated.Results:The NLR, CRP level in patients with external cold and internal fluid syndrome and an heart spirit confused by phlegm syndromeby phlegm were significantly higher than those of other syndrome ( P<0.05 or P<0.01), and FEV1% Pred was significantly lower than that of phlegm-dampness blocked syndrome ( P=0.024); the 6-minute walking distance of patients with external cold and internal fluid syndrome was significantly shorter than that of phlegm-heat obstructing lung syndrome and phlegm-dampness blocked syndrome ( P=0.006, P=0.024). The comparison of mMRC grades among the syndromes was statistically significant ( F=26.367, P=0.049). The BODE index of patients external cold and internal fluid syndrome was higher than that of patients phlegm-heat obstructing lung syndrome ( P=0.015), and the CCI score of patients an heart spirit confused by phlegm syndrome was higher than that of patients phlegm-dampness blocked syndrome ( P=0.012). The BODE index of patients with external cold internal fluid syndrome was significantly higher than that of phlegm-heat obstructing lung syndrome ( P=0.015). The CCI score of patients with mental disorder caused by phlegm was significantly higher than that of phlegm-dampness blocked lung syndrome ( P=0.012). Conclusions:There were significantly differences in neutrophil to lymphocyte ratio, CRP and 6-minute walking distance among different TCM syndromes in patients with acute exacerbation of chronic obstructive pulmonary disease. The inflammation in patients with external cold and internal fluid syndrome and mental disorder caused by phlegmare much severe, but there might be no difference in dyspnea and prognosis among TCM syndromes.

Objective: To study the effects of endoscopic submucosal dissection(ESD) on long-term quality of life (QOL) and gastric function of patients with distal early gastric cancer (EGC), compared with those of surgery. Methods: Patients with EGC who received ESD or surgical resection in Peking Union Medical College Hospital over 1 year ago were selected to be followed up. QLQ-C30, SF-36, EQ-5D and dyspeptic symptom rating scale were used to evaluate QOL. Five-hour gastric emptying rate was used to evaluate distal gastric function. Electronic gastroscopy was used to observe whether the anastomotic stoma was stenotic. According to the age at resection, 1 to 1 matching was performed between the distal 1/3 gastric ESD (E_P) group and the distal subtotal gastrectomy (S_P) group, and then the QOL and gastric function between the two groups were compared. Results: Twenty-five patients were included in group E_P and group S_P respectively. According to QLQ-C30, the scores of cognitive function were 83.3 (83.3, 83.3) in group E_P and 83.3 (83.3, 100.0) in group S_P (P=0.056). The proportion of patients with symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) between the two groups were not statistically different. There was no statistical difference in the scores of EQ-5D and SF-36 between the two groups. According to dyspeptic symptom rating scale, 56.0% patients in group E_Phad burning sensation, but only 28.0% in group S_P had this symptom (P=0.054). 20.0% of patients in group S_Preported nausea, while only 4.0% in group E_P had this symptom (P=0.084). Gastric emptying results showed that the proportion of patients with abnormal 5-hour gastric emptying rate was 31.8% in group E_P, while there was no abnormal emptying in group S_P (P=0.003). Gastroscopy results showed that one patient in group E_P had pyloric stenosis, but 5-hour gastric emptying rate was normal. All anastomotic stomas in group S_p were unobstructed. Conclusion ESD and surgical resection for distal EGC show similar long-term effects on QOL of patients. But the long-term gastric emptying function may decrease after distal gastric ESD.