To improve the pharmaceutical care ability of adult students,and ensure the safety in clinical medication. According to the requirement of the Ministry of Education of China, the new training scheme for adult Pharmaceutical undergraduates were drawn up by research and practice to meet the development needs of market economy and licensed pharmacist system in China.

ERS is a kind of universal existence in various cellular stress response.Recently, the research shows that ERS may affect bone metabolism balance from different ways.However, the specific mechanism is still not clear.The relationship between ERS and osteoporosis needs further research.This article will firstly introduce the pathways of ERS, then the relationship between the ERS and osteoporosis will be discussed from pancreatic beta cells, osteoblasts, osteoclasts and mesenchymal stem cells.Lastly, I will give perspectives on the future research on treatment of osteoporosis drug.

Objective To establish cell models with different insulin sensitivity status and examine the expression of protein kinase B (PKB/Akt) in the same conditions. Methods 3T3-L1cells were cultured with different glucose concentrations (3.0, 5.5 and 50.0 mmol/L respectively).Insulin sensitivity, as presented by insulin-induced glucose transport rate in the cells, was tested by 3H-2-DG incorporation. PKB expression in cells was determined by RT-PCR. Results The insulin-induced glucose transport rate in 3T3-L1 cells was affected by different concentrations of glucose. The transport rate of 3H -2-DG in cells cultured in low glucose concentration was increased by 152% and 50% compared with high glucose concentration and control group, respectively. There was no difference in PKB mRNA expression among the three groups under the same conditions,whereas there was an obvious reduction of PKB expression in the three groups after the cells were treated with glucose and insulin. Conclusions 3T3-L1 cells cultured with different concentrations of glucose present the different insulin sensitivity status, but the difference of PKB mRNA expression has not been observed in the same condition.

Tumor microenvironment (TME) plays a key role in the development and progression of tumors, such as pro?moting local drug resistance, immune escape, and distal metastasis. According to the TME of different individuals, accurate evaluation and selection of clinical medication can effectively control the malignant transformation of carcinoma in situ and metastatic cancer. At present, the main method to treat cancer is chemotherapy, TME can regulate the reaction of the tumor cells to the standard chemotherapy and target drug therapy, so the combination of the targeted TME therapy and chemothera?py will achieve better clinical efficacy. In this review, we summarized the mechanisms of TME in breast cancer, including ex?tracellular matrix, carcinoma-associated fibroblasts, carcinoma-associated macrophages, regulatory T cells and bone marrow mesenchymal stem cells, which providing a theoretical basis for the development of TME targeted therapy.

Objective To investigate and compare the predictive value of 2 prediction scoring systems for diagnosis of coronary heart disease (CHD) in patients with suspected symptom, and provide information for diagnosis and therapy. Methods By prospectively studying a database of 272 patients with suspected CHD,the total score was calculated by prediction scoring system including PROCAM (The Prospective Cardiovascular Munster Study) and SCP(Suspected CHD Prediction Scoring System) with the data of clinic parameters and risk factors. All patients received coronary angiography and they were categorized into the CHD group (n =94) and non CHD group ( =178) according to the angiography result. The relationship between total scores and the SYNTAX score was evaluated by Spearman analysis and the value of the prediction scoring system was evaluated by the ROC (receiver operating characteristic) system. Results The score of PROCAM was from 6. 00 -77. 00(41. 76 ± 19. 91), and the score was significantly correlated with the extent and severity of coronary artery atherosclerosis (rs = 0. 420,P = 0. 023). The score of SCP was from 1. 00 - 13. 00(8. 64 ± 3. 42), and it was significantly correlated with the SYNTAX score (rs = 0. 482,P = 0. 016). The areas under ROC was 0. 770 (P = 0. 007) in PROCAM and that was 0. 733 (P = 0. 012) in SCP. Conclusions The nature and extent of coronary artery atherosclerosis could be evaluated by the scoring system effectively,which had a good correlation with CAG result.

Objective To detect retinoid X receptor α (RXRα) mRNA expression in blood of subjects exposed to different concentrations of arsenic via drinking water, to analyze the relationship between RXRα mRNA expression and skin lesion caused by arsenic,and further to explore the skin lesion mechanism of arsenic. Methods Study sites were selected by molecular epidemiology method from high arsenic drinking water area of Bayannur City. Two hundred and thirty-five subjects who had been lived in high arsenic area for more than 10 years were selected;blood samples and water samples were collected from the subjects; according to arsenic concentration in drinking water,they were divided into four groups,<10 μg/L(control group),10-<100 μg/L(low dose group),100- <200 μg/L (middle dose group), and ≥200 μg/L (high dose group). Skin hyperkeratosis and pigment abnormity examination were conducted. The RXRα mRNA expression level in blood samples was detected by real-time quantitative PCR, and then the relationship between expression of RXRα mRNA and different levels of arsenic exposure,and skin lesion induced by arsenic were analyzed. Results ①The results showed that there was a dose-effect relationship between the prevalence of hyperkeratosis, pigment abnormity and arsenic exposure (χ2= 14.597, 12.825, P < 0.05); ②With increasing of arsenic exposure, RXRα mRNA expression in blood decreased firstly and then increased (F = 8.312, P < 0.05), which were significantly different statistically from those of control [(1.20 ±0.53)×10-3]and low dose groups[(0.92 ± 0.49)×10-3,P<0.05];RXRα expression was significantly higher in high dose group[(1.40 ± 0.45)×10-3]than those of middle and low dose groups [(1.12 ± 0.58,0.92 ± 0.49)×10-3,P<0.05]; ③The RXRα mRNA expression in people with different level of skin damage (hyper keratosis and pigment abnormity)were statistically significant(F=4.206,4.389, P< 0.05); degree Ⅲ[(1.98 ± 0.38) × 10-3] hyperkeratosis patients compared with degree Ⅰ [(1.11 ± 0.52) × 10-3] and degree Ⅱ [(1.13 ± 0.42) × 10-3], RXRα mRNA expression was significantly different (P < 0.05), degree Ⅱ and higher degrees [(1.61 ± 0.54) × 10 -3] pigment abnormity patients compared with control [(1.15 ± 0.52)×10-3],RXRα mRNA expression was significantly different (P < 0.05). Conclusions Chronic arsenic exposure has an effect on RXRα mRNA expression in blood. There is a relationship between abnormal expression of RXRα mRNA and skin lesion induced by arsenic.

Objective To understand the changes of skin lesions in population exposed to arsenic through drinking-water in Inner Mongolia after changing water source for 12 years,and to evaluate the long-term harmful effects and the delayed injury to human body due to arsenic exposure and the effect of changing water.Methods The stratified random cluster sampling investigation objects (data derived from the Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention) of the arsenic exposure area before water reform (2004) as the foundation,in 2017,we selected three administrative villages (changed water in 2005) in Bayan Nur City of Inner Mongolia as survey sites.The objects of this study were residents who had been living in the survey site and were eligible for previous survey (n =80,35 males and 45 females).To compare the skin damage of the residents exposed to arsenic before and after the water changed,the water samples of the survey objects were measured arsenic content.According to the content of water arsenic,the respondents were divided into low,medium and high exposure groups (10-,150-,≥300 μg/L),to analyze clinical classification in skin damage before and after changing water.Results The water arsenic content after changing [1.42 (0.18-33.45) μg/L] was lower than those before the changes [238.20 (14.56-824.70) μg/L,Z =-8.34,P ＜ 0.05].A total of 63 persons with skin keratinization,7 persons with hyperpigmentation and 19 persons with depigmentation were identified after the changes of drinking water source,while 38,3 and 18 persons were respectively found before the changes.The detection rate of skin keratinization after water changes was significantly higher than that before water changes [78.8％ (63/80) vs 47.5％ (38/80),x2 =16.78,P ＜0.05].According to the clinical classification of skin damage,23 patients were normal,44 patients were suspicious,10 patients were mild,and 3 patients were moderate or severe after the water changes,compared with those before the water changes (38,18,6 and 18 persons were respectively found),the clinical fractional suspicious detection rate of skin damage in the arsenic exposed population increased,and the medium-severe detection rate decreased,and the differences were statistically significant (x2 =17.80,12.33,P ＜ 0.05).The detection rate of the clinical score of moderate-severe skin damage in men was significantly decreased,and the difference was statistically significant (x2 =7.65,P ＜ 0.05).The normal detection rate of female skin lesions was reduced,and the rate of suspected detection was increased (x2 =5.48,7.65,P ＜ 0.05).In the high-and medium-dose groups,41.9％ (13/31) and 42.9％(12/28) of the arsenic exposure population had a reduced clinical classification of skin damage.The ratios of clinical classification severity of skin damage in the high-,medium-and low-dose groups were 25.8％ (8/31),25.0％ (7/28),and 42.9％ (9/21).The differences were statistical significantly by linear trend chi-square test (x2 =12.96,P ＜ 0.05).Conclusions The skin lesions exposed to arsenic could be effectively improved after changing water.But the skin lesions still appear in some cases due to long-term chronic arsenic exposure.The long-term effects caused by arsenic should be explored persistently.

Objective To explore the effects of regular doses of proton pump inhibitors (PPIs) on intestinal barrier function in the elderly.Methods The elderly hospitalized patients with acidrelated disorders were retrospectively analyzed from April to December 2016 in Department of Geriatrics,the General Hospital of Guangzhou Military Command.Based on the criteria of inclusion and exclusion,all patients received the stomachoscopy examination,and received PPI orally for more than 1 month.The treatment continued for 1-6 months.The blood status was routinely examined at pre-and post-treatment,including the level of liver function,C reactive protein (CPR),procalcitonin (PCT),diamine oxidase (DAO),D-lactate acid and serum endotoxin.Results A total of 88 elderly patients aged 80-96 years were involved.Most patients took PPI for 1 month.The levels of alanine aminotransferase,aspartate amino transferase,CPR and PCT were mostly normal after 1 month of treatment.Meanwhile,there were the comparabilities between the post-and pre-treatment groups in levels of DAO[(6.53±3.00) vs.(6.23±2.42) U/L;t=-0.91,P=0.37],of D-lactate acid[(7.31 ±3.67) vs.(7.62±3.35) mg/L;t=0.73,P=0.47]andof serum endotoxin[(11.69±5.98) vs.(10.97±5.76) U/L;t=-1.66,P=0.10]without statistical significance.Additionally,after 23 patients took PPI for 6 months,there were no statistical significances between the pre-and post-treatment groups in the levels of DAO[(5.35±2.49) vs.(6.59±2.69)U/L,t=1.89,P=0.07],of D-lactate acid[(8.12±3.84) vs.(7.71±3.65) mg/L,t=-0.73,P=0.47]and of serum endotoxin[(10.23 ± 5.51) vs.(10.41±6.45) U/L,t=0.18,P=0.86].Conclusions There is no significant effect on intestinal permeability and intestinal mucosa barrier function in the elderly taking PPI for 6 months.New studies are needed to understand the role of PPI in the intestinal microflora in the elderly.

OBJECTIVETo investigate the relationship between platelet parameters and delayed graft function (DGF) early after kidney transplantation.

METHODSWe retrospectively analyzed the clinical data of 232 recipients within 2 months following kidney transplantation performed between January, 2009 and September, 2013, among whom 29 experienced DGF. The laboratory data of the preoperative and postoperative platelets were collected from all the recipients.

RESULTSCompared with the preoperative levels, the platelet number (PLT) and platelet hematocrit (PCT) were decreased on day 1 after kidney transplantation and was the lowest on day 5 (P<0.05), followed by gradual increase till reaching the highest levels on day 15 (P<0.05) and recovery of the preoperative level in days 30-60. The average platelet volume (MPV), platelet volume distribution width (PDW) and large platelet ratio (P-LCR) were increased on day 1, highest on day 7 (P<0.05), and reduced to the preoperative level on day 15, but then rose again slowly. MPV and P-LCR in days 30 to 60 and PDW in days 45 to 60 were significantly higher than the preoperative levels (P<0.05). The patients with DGF showed lowered PLT than those without DGF since day 2, and this difference was statistically significant in days 7 to 10, while PCT remained comparable between the two groups; MPV, PDW, and P-LCR were higher in DGF group than in DGF-free group with statistically significant difference on days 7, 10, and 15 (P<0.05).

CONCLUSIONPlatelet function is associated with postoperative renal graft function recovery, and platelet parameters can provide new markers for monitoring the occurrence and reversion of DGF.

Biomarkers ; Blood Platelets ; physiology ; Delayed Graft Function ; Humans ; Kidney Transplantation ; Platelet Activation ; Platelet Count ; Postoperative Period ; Retrospective Studies

BACKGROUND:Tissue engineering is considered an ideal treatment for growth plate regeneration.However,most of the current research on regenerative tissue engineering is the traditional scaffold-based strategy.As the limitations of traditional scaffolds are gradually revealed,the research direction is gradually diversifying. OBJECTIVE:To summarize the application of scaffold-based and scaffold-free strategies in the treatment of growth plate cartilage regeneration and their respective advantages and disadvantages. METHODS:The relevant articles were searched from PubMed,Wiley,and Elsevier.The search terms were"growth plate injury,regeneration,tissue engineering,scaffold,scaffold-free,biomimetic,cartilage"in English.The time was limited from 1990 to 2023.Finally,104 articles were included for review. RESULTS AND CONCLUSION:The biomimetic strategy is to reduce the cell composition,biological signals and unique mechanical properties of each region to the greatest extent by simulating the unique organizational structure of the growth plate,so as to build a biomimetic microenvironment that can promote tissue regeneration.Therefore,the design of a biomimetic scaffold is to simulate the original growth plate as far as possible in terms of composition,structure and mechanical properties.Although some results have been achieved,there is still the problem of the unstable regeneration effect.The scaffold-free strategy believes that the limitations of scaffolds will have adverse effects on regenerative therapy.Therefore,the design of scaffold-free constructs relies as much as possible on the ability of cells to generate and maintain extracellular matrix without interfering with cell-cell signals or introducing exogenous substances.However,there are some problems,such as poor stability,low mechanical strength and greater difficulty in operation.Biomimetic strategy and scaffold-free strategy have different emphases,advantages and disadvantages,but they both have positive effects on growth plate cartilage regeneration.Therefore,subsequent studies,whether adopting a biomimetic strategy or a scaffold-free strategy,will focus on the continuous optimization of existing technologies in order to achieve effective growth plate cartilage regeneration therapy.