OBJECTIVE:To systematically evaluate the efficacy and safety of simvastatin vs. pravastatin in the treatment of hy-perlipidemia,and provide evidence-based reference for the clinical treatment. METHODS:PubMed,Medline,EMBase,Cochrane Library and CJFD were retrieved to collect the randomized controlled trial(RCT)of efficacy and safety of simvastatin(test group) and pravastatin (control group) in the treatment of hyperlipidemia. The methodological quality of included studies was evaluated. The Rev Man 5.2 software was chosen for data analysis. RESULTS:14 RCT involving 1 019 patients were included. Meta-analysis showed that simvastatin had more significant effect in the decreasing of TC [MD=-0.34,95%CI(-0.52,-0.16),P<0.001] and LDL-C[MD=-0.31,95%CI(-0.45,-0.17),P<0.001] than pravastatin;and simvastatin and pravastatin had the similar effect in TG[MD=-0.06,95%CI(-0.18,0.05),P=0.28)] and HDL-C[MD=0.00,95%CI(-0.04,0.04),P=0.85]. Adverse drug reaction rate results showed they were similar[OR=0.70,95%CI(0.36,1.39),P=0.31]. CONCLUSIONS:Simvastatin is more effective in lipid-lowering than pravastatin with similar safety. Due to the limited number and low quality of included studies,it remains to be further verified with more reasonably designed,multi-center and large-sample studies.

OBJECTIVE:To investigate the way to provide suitable pharmacecaical care for antineophastic drug-induced ADR by clinical pharmacists. METHODS:For one case of 5-FU chemotherapy-induced neutropenia associated with fever and diarrhea, clinical pharmacists provided advices on antibacterial treatment,including imipenem/cilastatin 0.5 g,q6 h,ivgtt;norvancomycin 0.4 g,q6 h,po;levofloxacin 0.4 g,qd,ivgtt;loperamide with initial dose of 4 mg for anti-diarrheal medication,maintaining at 2 mg,q4 h. RESULTS:After 22 days of appropriate antibacterial and anti-diarrheal treatment,the patient's body temperature and he-mogram returned to normal,diarrhea stopped and β-HCG decreased to 61.58 U/L;then the patient was discharged from hospital. CONCLUSIONS:It is beneficial to optimize chemotherapy plan and ADR disposal,and ensure the safety of the treatment that clini-cal pharmacists assist physicans to optimize therapy plan and provide pharmaceutical care.

This article manages to find some methods to improve students' innovative spirit and ability with some pharmaceutical teaching practice

OBJECTIVE:To systematically review the effect of CYP2C19 genetic polymorphism on lansoprazole pharmacoki-netics,and provide evidence-based reference for clinical individualized medication of lansoprazole. METHODS:Retrieved from PubMed,EMBase,Web of science,Cochrane Library and CJFD,retrospective studies about the effect of CYP2C19 genetic poly-morphism on lansoprazole pharmacokinetics were collected,Meta-analysis was performed by Rev Man 5.2 software after data ex-tract and quality evaluation. RESULTS:Totally 11 retrospective studies were included,involving 200 patients. The gene type in-cluded homozygote express metabolizers (EM),heterozygous express metabolizers (HEM) and slow metabolizers (PM). Results of Meta-analysis showed CYP2C19 polymorphism significantly affected cmax,AUC,t1/2,tmax and CL/F. The cmax and AUC in group PM were higher than group HEM and group EM;CL/F in group EM was higher than group HEM and group PM;t1/2 in group PM was higher than group HEM and group EM,while there was no significant difference in the t1/2 between group HEM and group EM;tmax in HEM and group PM were higher than group EM,while there was no significant difference in the tmax between group PM and group HEM. CONCLUSIONS:CYP2C19 genetic polymorphism shows obvious effect on lansoprazole pharmacokinetics, which is the key factor for causing efficacy of lansoprazole and individual differences among adverse reactions,and clinic should take into account individualized dose regimen of lansoprazole.

Objective:To retrospectively compare the clinical efficacy of two PDE3 inhibitors, oplinone and Milrinone, in order to evaluate which drug has better effects on the improvement of cardiac function, protection of renal function and adverse effects of arrhythmia.Methods:A total of 41 neonates with congenital heart disease after biventricular treatment under cardiopulmonary bypass in the Department of Cardiothoracic Surgery at Soochow University Children's Hospital during 2018-2022 were collected. The experimental group was divided into two groups: Oprilinone(25 cases) and Milinone(16 cases). A retrospective study was conducted on the incidence of renal function, cardiac function improvement and arrhythmia in the children.Results:On the first day after operation, EF in both groups decreased significantly compared with that before operation( P<0.01); On day 4 after surgery, EF in the oprilinone group was significantly higher than that on day 1 after surgery( P<0.01), Milrinone group was slightly higher than that on day 1 after surgery( P<0.05), and EF in oprilinone group was significantly higher than that in Milinone group during the same period( P<0.01); EF in Milinone group continued to increase on day 7 compared with day 4( P<0.01), but there was no significant difference between the two groups. Long-term follow-up showed that there was no significant difference in EF value in the oprilinone intervention group on day 7 after surgery( P<0.05), and the long-term EF in Milinone group was higher than that at 7 days after surgery( P<0.05). The creatinine level in the oprinone intervention group continued to decrease on the 4th and 7th day after surgery( P<0.01; P<0.05); The creatinine level of Milinone group on day 4 after surgery was significantly lower than that on day 1 after surgery( P<0.01), the decrease was not significant on the 7th day after surgery compared with the 4th day after surgery; The creatinine level in the oprilinone group was lower than that in the Milrinone group on day 7 after surgery( P<0.05). The rate of arrhythmia in children was slightly decreased in the intervention group of olplinone. There was no change in the Milinone group. Conclusion:Oplinone improved cardiac function better than Milrinone, and the recovery time to normal cardiac function was shorter. In terms of renal function protection, oplinone was stronger than Milrinone, and the protective effect of oplinone on kidney lasted longer. No significant abnormalities were found with respect to adverse reactions, such as the incidence of arrhythmia.

Through the systematic analysis on the primo vascular system (PVS) in recent years, we believe that in recent years, more and more studies have indicated that PVS is distributed in reticulate structure in every part of body, such as vessels, lymphangions, nerves, brain, spinal cords and internal organs, and it contains a large amount of immunocytes and has involved in the physiological or pathological process of the immunity and circulation in the body. There are the evidences to prove that in morphology and cytobiology. But, nowadays, there is no way to explain its effect characters. On the basis of the study on living matter characteristics, a breakthrough is possibly made through the systematic cooperation even though it is the difficulty to detect the life function effect. It is especially displayed in the substantial study on meridian points. Hence, the study on the law of meridian point effects on the basis of clinical practice has to be focused on in the substantial study on meridian points.

Objective : To investigate the influence and molecular mechanism of hypoxia-inducing factor-1 α( HIF- 1 α) gene silencing combined with methyl selenenic acid (MSA) on cervical cancer cell proliferation，apoptosis and cell migration． Methods : HeLa cells were transfected with HIF-1 interference RNA and negative control RNA．Af- ter transfection for 48 h，cells were stimulated with MSA for 24 h，and cell proliferation was determined by CCK-8 assay and colony formation．Apoptosis was determined by flow cytometry combined with Annexin V-FITC / PI．The expression levels of HIF-1α , Bcl-2 ，and E-cadherin were detected by Western blot assay． Cell migration ability was determined by Transwell assay. RNA-seq analysis was used to investigate the differentially expressed genes and differential signaling pathways. Results : Compared with the control group，interfering with HIF-1α combined with MSA significantly inhibited cell proliferation (P ＜0．01) ．Flow cytometry results showed that the combined drug group significantly induced apoptosis．Transwell results showed that interfering with HIF-1α combined with MSA inhibited HeLa cell migration．Compared with the control group，interfering with HIF-1α combined with MSA down- regulated the expression of Bcl-2 and up-regulated the expression of E-cadherin. RNA-sequencing combined with signal pathway enrichment results showed that the expression of apoptotic signal pathway and downstream genes was inhibited． Conclusion HIF-1α gene silencing combined with MSA can synergically inhibit the proliferation and induce apoptosis of cervical cancer cells，and its regulatory mechanism may be related to the expression of Bcl-2 family proteins and the inhibition of p53 signaling pathway.

OBJECTIVE： To provide reference for reasonable selection of tyrosine kinase inhibitors （TKI） in chronic myeloid leukemia （CML） patients with BCR-ABL35INS mutation. METHODS： Using “BCR-ABL insertional mutation” “ABL1 35ins mutation” “BCR-ABL c.1423_1424ins35” “ABL1 p.C475Tyrfs*11” as keywords， retrieved from CNKI， Wanfang database， Medline and COSMIC database， BCR-ABL35INS mutation CML patients were summarized and analyzed in respects of general information and treatment （treatment plan， patient compliance and drug withdrawal）， therapeutic effect （molecular biological mitigation and disease progress） and safety data （ADR） during 2007-2018. RESULTS： Totally 9 related literatures were included， involving 70 patients with BCR-ABL35INS mutation， all of them were foreign cases. Among them， 39 cases were male and 31 cases were female， with a median age of 49.2 years. The median time from the diagnosis of CML to the detection of BCR-ABL35INS mutation was 19 months. After detecting gene mutation， 39 cases were treated with imatinib （initial dose of 400 mg， po， once a day）， and molecular biological remission was achieved in 5 patients （12.9％）； 15 cases （38.5％） had molecular biological response but had disease progression； 8 patients （20.5％） had no response. Seventeen patients were treated with dasatinib （100 mg， po， once a day or 2 divided dose）， and 8 cases （47.1％） achieved molecular biological response. Twenty-one patients were treated with nilotinib （400 mg， po， 2 divided dose）， and 3 patients （14.3％） achieved molecular biological response； 2 patients achieved molecular biological response， but the disease progressed. Seven， three and seven of these patients stopped taking drugs due to adverse reactions， accounting for 17.9％， 17.6％ and 33.3％ respectively. All the ADRs were classified as grade 3-4 of the National Cancer Institute’s Common Terminology Criteria for Adverse Events， and most of them were hematological toxicity. CONCLUSIONS： CML patients with BCR-ABL35INS mutation are less likely to achieve molecular response on imatinib therapy but are more sensitive to dashatinib. In the course of treatment， we should strengthen the monitoring of blood system and other related indicators to ensure the safety and effectiveness of drug use.

OBJECTIVEThe aim of this study was to investigate the impact of air pollution on the number of pediatric outpatient and emergency room visits in January 2013.

METHODSHealth-related data was from a major hospital in Haidian,Beijing while related data on air pollution was from the Chinese Research Academy of Environmental Sciences. Data on weather was from the China Weather Website. Number of hospital outpatient visits per day during the haze period was compared to those from the previous year to get the increase of percentage. Concentration-response functions were estimated using generalized additive modeling with natural log link function, while multiple structural change test was used to determine the changing point in CRFs. Constrained piecewise linear function was used to estimate the risks for different segments of CRFs.

RESULTSThe peak of NO(X), SO₂, PM(2.5) and PM(10) reached 672.63 µ g/m³, 146.20 µ g/m³, 312.19 µ g/m³ and 995.00 µ g/m³, around 28 December 2012 and 10 January 2013. The peaks of visits to the pediatric department were observed at the some days, showing 47.75% and 34.14% of increase in the visits to the pediatric department. In the low or intermediate ranges of concentration, all the four air pollutants were significantly associated with pediatric outpatient visits, in the form of C- and S- shape of concentration-response function. However, in the range of high concentration, only PM(10) and SO₂were significantly associated with the number of visits to the pediatric emergency room, appeared as the J-shape form. Discernable thresholds were found in S- and J- shapes which were located at 200 µg/m³, 20 µg/m³, 40 µg/m³ and 100 µ g/m³ for NO(X), SO₂, PM(2.5) and PM(10), respectively.

CONCLUSIONAir pollution during the haze period was associated with the increase of pediatric outpatient and emergency room visits. There were different sensitive groups within the pediatric cases. Their susceptibility showed a decreasing trend from C-, S-, to J- shape related group.

Air Pollution ; adverse effects ; Child ; China ; epidemiology ; Emergency Service, Hospital ; utilization ; Humans ; Outpatients ; Weather