OBJECTIVE:To explore the role of clinical pharmacists participating in the prevention and treatment of sotalol-in-duced QT prolongation in aged patient with heart failure. METHODS:Clinical pharmacists participated in the treatment for a aged patient with heart failure,and assisted physicians to identify and assess the risk of sotalol-induced QT prolongation. According to the clinical symptoms and laboratory indexes,it was suggested to continue to use sotalol for antiarrhythmic,adjust the hepatoprotec-tive drug,given pharmaceutical care of ECG,electrolyte level monitoring,drug education and so on. RESULTS:Physicians adopt-ed the suggestions of clinical pharmacists to relive the illness without malignant arrhythmia and discharged after 11 d. CONCLU-SIONS:The patient with heart failure should be dominated by improving cardiac function and maintaining hemodynamic stability;combined with related guidelines and documentation,clinical pharmacists can assist physicians to identify the drug that induced QT prolongation,asses the risk of torsades de pointes ventricular tachycardia and other bad consequences,develop and optimize the regimen and strengthen pharmaceutical care to ensure the safe and effective treatment.

AIM:To establish the fingerprint for Cacumen Platycladi (carbonized) by HPLC. METHODS:The column of Lichrospher C 18 (250 mm?4.6 mm 5 ?m)was used. The mobile phase consisted of 0.5‰ trifluoroactic acid-methanol with gradient elution. The detective wavelength was at 375 nm,and the flow rate was 1.0 mL/min. Different habitats were compared by Similarity Evaluation System for Chromatographic Fingerprint of CMM Version 2004A. RESULTS:The fingerprint consisted of 14 common peaks. The mutual mode of HPLC fingerprints was set up and the similarity of the crude drugs was in the range of 0.178-0.963. The standard HPLC fingerprint of Cacumen Platycladi (carbonized) was established too. CONCLUSION:This method is accurate and reliable and provides a scientific basis for the quality control of Cacumen Platycladi (carbonized).

BACKGROUND: The death of aging cells is virtually apoptosis. To a certain extent, it can be interpreted as a series of results of gere activities.Therefore, the inhibition of oncogene's expression can lengthen the life span of cells and delay aging of brain tissues.OBJECTIVE: To study the effect of abstragulus mongholicus bung (AMB) on apoptosis of nerve cells and the expression of relevant gene in aging mice brain.DESIGN: Completely randomized design and controlled experiment.SETTING: Department of Biochemistry, School of Basic Medical Sciences of Jiamusi University.MATERIALS: The experiment was conducted at the Experimental Animal Center and Biochemical Laboratory of Jiamusi University from December 2003 to May 2004. Totally 24 healthy Kunming mice were recruited in this study. There were 8 two-month-old mice (young group) and 16 twelve-month-old mice. All the 16 mice were randomized into abstragulus mongholicus bung group and old control group with 8 in each group.METHODS:① AMB group:Mice in AMB group received gastric gavage was provided by the Department of Traditional Chinese Medicine of the First Hospital Affiliated to Jiamusi University, and evaluated by Jiamusi Drug Inspection Bureau. Water decoction was prepared with 2 kg/L raw materials. Mice in old control group and young group were filled with lukewarm boiled water.② All the animals were treated as above for 30 consecutive days before put to death. Their brains were taken out immediately and the middle parts of the brains were removed to fix with neutral formaldehyde. The remaining brain tissues were made into mitochondria suspension. Content of manganese superoxide dismutase (Mn-SOD) and malondialdehyde (MDA) was determined with xanthosine oxidase method and TBA chemical colorimetry. Apoptotic cells (cells with yellow nuclei were positive ones) were assayed with in situ end-labeling (ISEL) and expression of bcl-2 gene was assayed with immunohistochemical method. The cells stained brown were positive ones. A total of 400 cells were counted under the 400× microscope. We graded the samples according to the percentage of the positive cells: the number of positive cells ＜ 5% -; 5%-10％ +; 11％-50％ ++; ＞ 51％ ().③ Grade and quantitative data were compared with rank sum test and t-test.MAIN OUTCOME MEASURES: Effects of AMB on the rate of neu-ronal apoptosis, the activity of Mn-SOD, the concentration of MDA in mitochondria, and the intensity of the expression of bcl-2 gene.RESULTS: Totally 24 mice entered the final analysis.① Content of MnSOD was higher in young group and AMB group than in old control group (P＜0.05).② Concentration of MDA and apoptotic rate in young group and AMB group were lower than those in old control group (P ＜ 0.01).③Expression of bcl-2 gene was significantly different in young group and AMB group from that in old control group (P ＜ 0.01).CONCLUSION: AMB is found to be able to obviously inhibit neuronal apoptosis in aging mice brain by affecting the activity of Mn-SOD, the concentration of MDA and the expression of bcl-2.

Objective To examine clusters of anti-nuclear antibodies (ANA) and their associations with clinical features in patients with systemic lupus erythematosus (SLE).Methods It was a retrospective study.113 SLE patients were reviewed from March 2010 to May 2012 in Department of Rheumatology,Jinhua Central Hospital.ANA and specific autoantibodies to 15 kinds of nuclear antigens were tested by indirect immunofluorescence assay (IIF) and line immunoassay (LIA) respectively.Hierarchical clustering method was performed to analyze specific clusters of ANA profiles in SLE.Chi-square tests were used to investigate relationship between antibody clusters and clinical features of SLE.Results The positive rate of LIA for ANA was 97.3％,consistent with IIF method,and the total accordance rate of the both methods was 98.2％.Thirteen kinds of antigen-specific antibodies were detected in SLE patients by LIA.Clustering analysis for these antibodies showed three specific clusters in SLE,Nuc/His/dsDNA cluster (C1),low-Ro/low-La cluster (C2),and Ro/Sm/RNP cluster (C3),accounting for 36.3％,24.8％,38.9％ of the total cases respectively.There were significant difference of AST levels among three clusters [(32.62 ± 21.92)U/L,(25.56 ± 16.63) U/L,(50.41 ± 60.86) U/L respectively for C1,C2 and C3].High incidences of chronic cutaneous lupus,abnormal renal indicators and inflammatory synovitis were found in all three clusters.Besides,there were significant differences among three clusters for the incidences of chronic cutaneous lupus (39.0％,39.3％,63.6％ respectively for C1,C2,C3) and leukopenia/lymphopenia (56.1％,25.0％,56.8％ respectively for C1,C2,C3) (P ＜ 0.05).Patients in Ro/Sm/RNP cluster showed higher incidences of lupus nephritis (43.2％/26.8％ or 39.3％); patients in low-Ro/low-La cluster showed low risk of hypertension (7.1％/19.5％ or 22.7％) ; patients in Nuc/His/dsDNA cluster showed high incidences of thrombocytopenia (41.5％/21.4％ or 25.0％) and high risk of lung or upper respiratory tract infection (46.3％/28.6％ or 29.5％),but low incidence of neurologic symptoms (0％/ 3.6％ ％ or 11.4％).Conclusion Three characterized ANA clusters are identified in SLE patients in this pilot study.Different clusters are associated with certain clinical features and complications ofSLE.However,the correlations found in this study need to be investigated further in larger populations.

Objective To evaluate the clinical efficacy of Compound Sophorae Flavescentis Radix (Kushen) Injection combined with gamma knife for treatment of locally advanced pancreatic carcinoma. Methods Totally 65 patients of locally advanced pancreatic cancer were randomly divided into two groups:32 cases of simple gamma knife group (group A), 33 cases of Compound Kushen Injection combined with gamma knife treatment (group B). Patients received enhancement computed tomography scanning and CA199 review at 1, 3, 6, 9, 12 months after treatment, and once every six months, a total of 36 months of follow-up. Short-term and long-term efficacy was observed after treatment, and survival curve analysis was carried out. Results Clinical benefit response was 53.13% in group A and 84.85% in group B (P=0.006);median survival time of two groups was 11.00 months in group A and 23.00 months in group B;the average survival time in group A was 16.37 months, and 22.28 months in group B (P=0.017). In the two groups, treatment of the 65 patients was completed smoothly as planned, and no one had serious complications, such as pancreatic leakage, skin burns, viscera perforation and radioactive enteritis. Conclusion Compound Kushen Injection combined with gamma knife can treat locally advanced pancreatic carcinoma safely and efficiently, which can improve patients’ life quality, especially in cancer pain control.

Objective To explore the early predictive factors of intestinal necrosis in patients with acute superior mesenteric arterial occlusive disease and its significance for the decision of exploratory laparotomy.Methods This retrospective study enrolled 29 patients diagnosed with acute superior mesenteric artery embolism or thrombosis in Peking University People's Hospital between July 1995 and June 2015.Results 12 patients developed intestinal necrosis.Patients with intestinal necrosis had a poorer prognosis than those who did not develop intestinal necrosis (x2 =14.867,P =0.000).In univariate analysis,the early predictive factors for intestinal necrosis were D-Dimer ≥ 600 μg/L (x2 =11.455,P =0.002),INR≥1.2 (x2 =3.948,P =0.047),pH values ＜7.4 (x2 =8.191,P =0.004),BE ＜ -1.0 mmol/L (x2 =8.191,P =0.004),blood lactate ≥ 2.2 mmol/L(x2 =7.535,P =0.006),BUN ≥ 6 mmol/L (x2 =10.076,P =0.002),CK ≥ 80 U/L (x2 =8.191,P =0.004),LDH ≥ 210 U/L (x2 =13.079,P=0.000),AST ≥25 U/L (x2 =10.076,P =0.002),SIRS (x2 =10.076,P =0.002).Multivariate logistic regression analysis found no independent predictive factors of intestinal necrosis in patients with acute superior mesenteric arterial occlusive diseases.Conclusion Intestinal necrosis in acute mesenteric arterial occlusive diseases indicates a poor prognosis.Coagulation abnormalities,liver or kidney dysfunction,metabolic acidosis and SIRS necessitates an immediate exploration.

Objective To investigate the significance of preoperative Glasgow prognostic score (GPS) for postoperative prognosis in patients of resectable colon cancer. Recent studies have revealed that the GPS, an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the GPS in the field of colon surgery. Methods The GPS was calculated on the basis of admission data as follows; patients with an elevated level of both CRP ( ＞ 10 mg/L) and hypoalbuminemia (Alb ＜ 35 g/L) were allocated a score of 2, and patients showing 1 or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. Prognostic significance was analyzed by multivariate analyses. Overall survival and disease-free survival was estimated using the Kaplan-Meier method. Results A total of 282 patients were evaluated. Kaplan-Meier analysis and log-rank test revealed that a higher GPS predicted a higher risk of postoperative mortality and reccurence ( P ＜ 0.001 ). multivariate analyses revealed that postoperative TNM was the most sensitive predictor of postoperative mortality (OR, 0.210; 95% CI, 0.102-0.432; P＜0.01) and CEA(OR,0. 356;95% CI,0. 179 -0. 707; P = 0.003),CA19-9(OR,0. 260;95% CI,0. 120 -0. 564;P ＜ 0.01),CRP( OK,4. 503;95% CI, 1. 590 -12. 751 ;P =0.005) , GPS( OR, 0. 340 ;95% CI,0.181 -0.920;P＜0.01)were associated with postoperative mortality. Conclusions Preoperative GPS is considered to be a useful predictor of postoperative mortality in patients with colon cancer.

Objective To explore the expression of N-myc downstream regulated gene 1 (NDRG1) in gastric carcinoma and the relationship with clinicopathological parameters and prognosis. Methods The expression of NDRGI was detected by immunohisto chemistry in formalin-fixed and paraffin-embedded sections with a total of 220 specimens including 110 gastric carcinoma and 110 corresponding paraneoplastic tissue. The correlation between clinicopathological parameters and the expression of NDRG1 in gastric carcinoma were also analyzed. Results Low expression of NDRG1 was detected in most gastric carcinoma sections. Among the gastric cancer tissues, NDRG1 protein expression was significantly lower in tumors with more advanced pathological stage, local tumor invasion and lymphatic metastases. There was no significant difference in sex, age, tumor differentiation and gross types of the tumor. The 1-, 3- and 5 year survival and disease free survival in patients with low NDRG1 protein expression was 84.2%, 53.9%, 21.1%, and 60.5%, 31.6%, 19.7%, respectively, which was signifivantly poorer when compared with patients with high NDRG1 protein expression. Conclusion The expression of NDRG1 is low in the majority of patients with gastric carcinoma, which was in a close relationship with advanced stage, local invasion and lymphatic metastases of gastric carcinoma. NDRG1 may be a candidate metastasis suppressor gene.

Objective To investigate Notch signaling pathway expression and its relationship with clinicopathological parameters in human gastric cancer.Methods Specimens of carcinoma tissues and nodal gastric membrane were obtained from 63 gastric cancer patients undergoing radical surgery from Jan 1999 to Dec 2001.Notehl,Deltal,Jaggedl and NFKB protein were measured using fissure microarray and immunohistochemistry.Data were analysed using SPSS software.Results Notchl,Deltal,Jaggedl and NFKB protein were upregulated in gastric cancer tissue compared with adjacent normal tissue(P＜0.01).The expression of Notchl protein in the well--differentiated tumors was higher than that in the poordifferentiated tumors(P＜0.05).Positive linear correlation was established between the expression of Jaggedl and NFkB.Conclusion Notchl signal transduction pathway plays an important role in the development of human gastric cancer by activation of NFKB through Notchl-Jaggedl signal transduction pathway.It is also evident that Notch signaling can be both oncogenic and tumor suppressive in human gastric cancer.