Based on the reality of Anhui Medical University,the paper analyzes the adverse factors of carrying out combination with teaching for the literature retrieval course from the perspectives of emphasis,professional knowledge structure and teachers of professional courses,and puts forward corresponding countermeasures from implementation of teaching and teaching effect,in order to provide reference for medical colleges to carry out literature retrieval course effectively.

Objective:To study how to guide the individual dose of clopidogrel in line with the genetic testing results. Methods:Clinical pharmacists decided how to optimize the prescription of clopidogrel according to the genotype combined with the drug metabolism and drug interactions for three patients respectively with slow clopidogrel metabolism,intermediary metabolism and super fast metabolism. Results:The slow clopidogrel metabolism patient with subacute stent thrombosis after half a month of coronary stenting was switched to orally administrate with ticagrelor. The super fast metabolism patient suffered from repeatedly subcutaneous hemorrhage with antiplatelet therapy was suggested to lower the dose of clopidogrel,temporarily withdraw Maixuekang capsules and conventionally administrate with vitamin C tablets orally. The intermediary metabolism patient with late stent thrombosis co-treated with lansoprazole was suggested to increase the dose of clopidogrel or use ticagrelor instead,and when it was necessary,panxitorazole,ray Bella or the other ranitidine acid suppression drugs such as ranitidine could be considered. Conclusion:Through genetic testing and drug interactions,clinical pharmacists guide the clinical use of clopidogrel and the optimization of antiplatelet therapy.

Over-expression of P-glycoprotein (Pgp) is associated with the development of multi-drug resistance ( MDR). Pgp has been focused on as the main target in designing chemotherapy strategy. In this article we review some of the latest advancement in designing and evaluation methods of P- glycoprotein inhibitors.

Auditory Cortex ; metabolism ; Humans ; Magnetic Resonance Spectroscopy

Objective To explore the effects and mechanisms of urokinase-type plasminogen activator (uPA) on high glucose-induced rat mesangial cells proliferation and phenotype transformation. Methods Rat mesangial cells were cultured and incubated in media containing either 5 mmol/L D-glucose or 30 mmol/L D-glucose with or without addition of wortmannin, or uPA (105 U/L) for different time periods. At the end of the incubation period, mesangial cells proliferation was assessed by MTT assay and flow cytometric analysis. Cyclin-dependent kinase 2 (CDK2) and p27kip1 expression and activation of Akt were evaluated by Western blotting and Akt kinase assay respectively. Furthermore, the expression and distribution of α-SMA were detected with laser confocal microscopy. Results MTT assay and flow cytometric analysis demonstrated that high glucose induced mesangial cells proliferation (P＜0.05) and an incresed proportion of cells in G2/M+S stage after 24 h incubation (P＜0.01), which were attenuated by uPA or wortmannin (P＜0.01). High glucose induced the enhance of Akt activity after 3 h (P＜0.05), and the effect was inhibited by wortmannin or uPA (P＜0.01). High glucose did not alter CDK2 expression (P＞0.05),but significantly inhibited p27kip1 expression (P＜0.05), which was attenuated by wortmannin or uPA (P＜0.01). High glucose induced the up-regulation of α-SMA expression and perinucleus location in mesangial cells after 24 h (P＜0.01), which were alleviated by wortmannin or uPA (P＜0.01). Conclusion uPA up-regulates p27kip1 expression and counteracts high glucose-induced mesangial cells proliferation and phenotype transformation via blocking PI3K-Akt signaling pathway.

Objective To develop a method for the simultaneous separation and determination of 10 kinds of sedative hypnotica drugs in the functional food with high performance liquid chromatography mass spectrometry system.Methods The mobile phase consisted of acetonitrile and 15 mmol/L ammonium acetate solution(0.1% formic acid ),chromatographic column was Zobax SB C 18.Identification was based on the compound's absolute retention time,protonated molecular ion,and representative fragment ion by multiple reaction monitoring.The condition of determination was investigated and optimized.Results With this method,the linear range for the 10 drugs was 10-1 080 ?g/kg,the average recoveries ranged from 80.5%-97.1% and the detection limits were from 0.35-12.0?g/kg respectively.Conclusion The method established in the present paper is applicable to monitoring sedative hypnotica drug in the functional food.

Objective To explore the effect of sodium cantharidinate and vitamin B6 injection on plasma D-dimer level in patients of advanced esophageal cancer after chemotherapy and the relationship between plasma D-dimer level and clinical pathological parameters thereof. Methods Fifty-eight patients with advanced esophageal cancer confirmed by path-ological examination were randomly divided into two groups. Twenty-nine patients (experimental group) received chemother-apy (PF chemotherapy) combined with sodium cantharidinate and vitamin B6 (0.5 mg once daily). Twenty-nine patients (con-trol group) received same volume of saline. And there were 20 healthy volunteers as the normal control. The plasma D-dimer level was determined one day before the first cycle of chemotherapy and the third cycle of treatment. Results The plasma D-dimer level was significantly higher before chemotherapy in patients with advanced esophageal cancer than that in normal control group (P<0.05). There were no significant differences in plasma D-dimer level between patient gender, age, clinical stage and pathological levels. The D-dimer level was significantly down-regulated after chemotherapy. The D-dimer level was significantly lower in experimental group than that in control group (P<0.05). The incidences of digestive and hemato-logical adverse reactions were much lower in experimental group than those in control group. Conclusion The elevated plasma D-dimer level was found in patients with advanced esophageal cancer, and which was down-regulated by chemother-apy. The chemotherapy of sodium cantharidinate and vitamin B6 can further reduce the D-dimer level, and relieve the ad-verse reactions of chemotherapy.

Objective To investigate the change pattern of perioperative plasma D-dimer levels in patients with lung cancer, and the relationship between plasma D-dimer level and clinical pathological features thereof. Methods A to-tal of 64 patients with lung cancer were taken as cancer group, and 15 cases of benign lung disease were used as control group. The plasma levels of D-dimer were determined 2 days before operation, 1 day, 5 days and 9 days after operation in two groups. The clinical pathological parameters and type of surgery were evaluated at the same time. Results Plasma D-dimer levels were significantly higher in patients with lung cancer than those in control group (t=3.087, P<0.05). D-dimer levels were significantly lower in patients of TNM stageⅠthan those in patients of stageⅡorⅢ(P<0.05, respectively). Plas-ma D-dimer levels were significantly higher in patients with small cell cancer than those of patients with non-small cell can-cer (P<0.05). The perioperative plasma levels of D-dimer changed with time trends (P<0.001). In cancer group, D-dimer levels increased on the first day after operation, and then significantly decreased on the fifth and ninth day after operation (P<0.05). In control group, D-dimer levels increased on the first day after operation. The level of D-dimer was the same lev-el on the fifth day and the first day after operation (P=0.174). The level of 9 days after operation decreased to the level before operation (P=0.631). There was significant difference in overall data between cancer group and control group (P=0.005). D-dimer levels were significantly higher in cancer group than those of control group except for the fifth day after operation. Con-clusion Plasma D-dimer levels were much higher before operation in patients with lung cancer than those of controls. Plas-ma D-dimer levels were associated with TNM stage and cell type. D-dimer levels were significantly increased from the first day after operation, and then decreased significantly until the 9-day after operation, which were lower than that before opera-tionin lung cancer patients. But the level was still higher than that in patients with benign lung diseases.

Objective To summarize the experience in the treatment of Marfan syndrome of pregnancy complicated with acute type A aortic dissection.Methods Three women with Marfan syndrome of pregnancy complicated with acute type A aortic dissection were treated.The average age was 28.6 (25-31) years,and the average gestational age was 36.5 (32-38) weeks.At first caesarean operation were performed under general anesthesia.Bentall + Sun' s operation was performed under deep hypothermic circulatory.After operation,the mother and fetus were followed up.Results Three women and their fetus were safe.The average extracorporeal circulation time,aorta clamp time and circulatory arrest time were 265 (210-280) min,135 (120-160) min and 26.5 (20-29) min,respectively.After a mean follow-up of 2.0 (1.0-2.5) years,3 patients were living well.CT angiogram detected normal aortic,with no signs of distal dilation.Three fetus were normal in development and neurocognitive function.Conclusion Methods of surgical repair and fetal delivery should be chosen based on aortic pathological changes and gestational age to maximize the safety of the mother and fetus.