Objective To investigate the effect of nobiletin on the proliferation and apoptosis of laryngeal squamous cell carcinoma(LSCC)cells and its mechanism related to the focal adhesion kinase(FAK)/protein kinase B(AKT)signaling pathway.Methods TU177 cells of LSCC were randomly assigned into the control group,the L-nobiletin group(10 mg/L)group,the M-nobiletin group(20 mg/L),the H-nobiletin group(40 mg/L)and the H-nobiletin+FAK activator ZINC40099027 group(40 mg/L nobiletin+2.5 g/L ZINC40099027).CCK-8 method was used to detect cell viability.Flow cytometry was used to detect cell apoptosis.Scratch experiment was used to detect cell migration.Transwell method was used to detect cell invasion.Western blot assay was used to detect apoptosis and FAK/AKT pathway related proteins.Results Compared with the control group,the cell viability,scratch healing rate,number of invasive cells,the protein expressions of Bcl-2,p-FAK/FAK and p-AKT/AKT were decreased in a dose-dependent manner in the L-nobiletin group,the M-nobiletin group and the H-nobiletin group,while the cell apoptosis rate and protein expressions of Bax and caspase-3 were increased in a dose-dependent manner(P＜0.05).The OD value,scratch healing rate,number of invasive cells,Bcl-2,p-FAK/FAK and p-AKT/AKT protein expression levels were higher in the H-nobiletin+ZINC40099027 group than those of the H-nobiletin group,and cell apoptosis rate,Bax and caspase-3 protein expression were lower compared to the H-nobiletin group(P＜0.05).Conclusion Nobiletin may inhibit the proliferation and promote the apoptosis of LSCC cells by suppressing the FAK/AKT signaling pathway.

Objective To evaluate the effectiveness and feasibility of a remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology.Methods A convenient and elderly-friendly mo-bile application(hereinafter referred to as Yaoshiyi APP)was developed,and a remote medication treatment management team consisting of clinical pharmacists from tertiary hospitals,community pharmacists,and community physicians was formed.Patients from communities were selected for practical research,led by pharmacists.Based on the Yaoshiyi APP,patients were subjected to 6 months of medication treatment management practice,and the effectiveness and feasibility of the practice were evaluated.Re-sults The Yaoshiyi APP can be integrated with a variety of medical-grade wearable devices to realize the functions of automati-cally uploading monitoring data,abnormal value reminding,medication reminding,medication consultation,and medication sci-ence popularization.A total of 302 elderly patients with chronic disease at home completed the study.The results showed that phar-macists have identified and intervened in 695 cases of medication-related problems.According to the classification of medication-related problems,the top three were 247 cases(35.5％)of additional treatment,97 cases(14.0％)of unnecessary drug treat-ment,and 93 cases(13.4％)of medication compliance problems.The patient's medication adherence score(Morisky medication adherence scale-8,MMAS-8)increased from(5.85±1.57)at enrollment to(6.74±1.23)6 months after enrollment(P＜0.01).After 6 months of enrollment,the patient's satisfaction with the pharmacist's work reached a score of(4.99±0.08)out of 5.The average reduction in drug costs for patients caused by pharmacists intervening in irrational medication is(20.9±18.0)％.At the end of follow-up,93.4％of patients were proficient in using the Yaoshiyi APP.Conclusion The remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology constructed in this study can ef-fectively improve patient compliance with disease monitoring and medication,ensure rational drug use,reduce medical resource waste,and receive high patient acceptance.

Objective To evaluate the effectiveness and feasibility of a remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology.Methods A convenient and elderly-friendly mo-bile application(hereinafter referred to as Yaoshiyi APP)was developed,and a remote medication treatment management team consisting of clinical pharmacists from tertiary hospitals,community pharmacists,and community physicians was formed.Patients from communities were selected for practical research,led by pharmacists.Based on the Yaoshiyi APP,patients were subjected to 6 months of medication treatment management practice,and the effectiveness and feasibility of the practice were evaluated.Re-sults The Yaoshiyi APP can be integrated with a variety of medical-grade wearable devices to realize the functions of automati-cally uploading monitoring data,abnormal value reminding,medication reminding,medication consultation,and medication sci-ence popularization.A total of 302 elderly patients with chronic disease at home completed the study.The results showed that phar-macists have identified and intervened in 695 cases of medication-related problems.According to the classification of medication-related problems,the top three were 247 cases(35.5％)of additional treatment,97 cases(14.0％)of unnecessary drug treat-ment,and 93 cases(13.4％)of medication compliance problems.The patient's medication adherence score(Morisky medication adherence scale-8,MMAS-8)increased from(5.85±1.57)at enrollment to(6.74±1.23)6 months after enrollment(P＜0.01).After 6 months of enrollment,the patient's satisfaction with the pharmacist's work reached a score of(4.99±0.08)out of 5.The average reduction in drug costs for patients caused by pharmacists intervening in irrational medication is(20.9±18.0)％.At the end of follow-up,93.4％of patients were proficient in using the Yaoshiyi APP.Conclusion The remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology constructed in this study can ef-fectively improve patient compliance with disease monitoring and medication,ensure rational drug use,reduce medical resource waste,and receive high patient acceptance.

Objective To investigate the effect of nobiletin on the proliferation and apoptosis of laryngeal squamous cell carcinoma(LSCC)cells and its mechanism related to the focal adhesion kinase(FAK)/protein kinase B(AKT)signaling pathway.Methods TU177 cells of LSCC were randomly assigned into the control group,the L-nobiletin group(10 mg/L)group,the M-nobiletin group(20 mg/L),the H-nobiletin group(40 mg/L)and the H-nobiletin+FAK activator ZINC40099027 group(40 mg/L nobiletin+2.5 g/L ZINC40099027).CCK-8 method was used to detect cell viability.Flow cytometry was used to detect cell apoptosis.Scratch experiment was used to detect cell migration.Transwell method was used to detect cell invasion.Western blot assay was used to detect apoptosis and FAK/AKT pathway related proteins.Results Compared with the control group,the cell viability,scratch healing rate,number of invasive cells,the protein expressions of Bcl-2,p-FAK/FAK and p-AKT/AKT were decreased in a dose-dependent manner in the L-nobiletin group,the M-nobiletin group and the H-nobiletin group,while the cell apoptosis rate and protein expressions of Bax and caspase-3 were increased in a dose-dependent manner(P＜0.05).The OD value,scratch healing rate,number of invasive cells,Bcl-2,p-FAK/FAK and p-AKT/AKT protein expression levels were higher in the H-nobiletin+ZINC40099027 group than those of the H-nobiletin group,and cell apoptosis rate,Bax and caspase-3 protein expression were lower compared to the H-nobiletin group(P＜0.05).Conclusion Nobiletin may inhibit the proliferation and promote the apoptosis of LSCC cells by suppressing the FAK/AKT signaling pathway.

Objective To explore the role of chronic disease management led by clinical pharmacists in preventing medication errors in discharged elderly patients with hypertension.Methods The subjects were selected from hypertensive patients aged 60-85 years and hospitalized in Department of Cardiology,Beijing Jishuitan Hospital from March 2016 to September 2017.The patients were selected at admission and their basic information were recorded,including gender,age,mode of payment,education level,occupation,and type of combined chronic diseases.The patients were given homogeneous pharmaceutical care by clinical pharmacists during hospitalization and randomly divided into the intervention group and the control group when discharged.After discharge,they were followed up for 24 weeks.The patients in the intervention group were followed up once every 2 weeks from the 1st to the 12th week and once every 4 weeks from the 13th to the 24th week after discharge.The patients in the control group were followed up only once at the end of the 12th and the 24th week after discharge.The follow-up contents included the blood pressure,blood glucose,blood lipids,and other laboratory tests results,name and usage of all the drugs used,on-time medication condition,occurrence of adverse drug reactions,changes in lifestyle,and etc.If the patients were found to have medication errors,the time of error discovery,the content,level,and frequency of the error,and the classification of the drug involved were recorded in a special form.The clinical pharmacists provided individualized medication guidance to patients during the follow-up and gave timely intervention after discovering the medication errors.Results Forty patients in the intervention group and 44 patients in the control group were entered in the study.There were no significant differences in baseline information between the 2 groups (all P ≥ 0.05).During the 24 weeks of follow-up,medication errors were found in 20 patients in the intervention group and 12 patients in the control group.The difference in detection rate of medication errors between the 2 groups was significant [50.0％ (20/40) vs.27.3％ (12/44),x2 =0.043,P =0.032].A total of 50 cases of medication errors were found in the 2 groups,including 34 (68.0％) in the intervention group and 16 (32.0％) in the control group.During the first 12 weeks of follow-up,31 cases of medication errors (91.2％) in the intervention group and 8 cases (50.0％)in the control group were found by pharmacists,and the difference was statistically significant (P =0.002).The difference in the proportion of different medication errors classification between the 2 groups was not significant (P ＞0.05).The drug omission was with the highest proportion in the 2 groups [47.1％ (16/34) in the intervention group and 31.2％ (5/16) in the control group].Among 50 cases of medication errors,49 (98.0％) were defined as level 2 errors (with mistake,but no harm),including 20 cases of grade C errors and 29 cases of grade D errors;1 (2.0％) was defined as level 3 (with mistake and harm) and grade F error.After the intervention of clinical pharmacists,all the level 2 errors were corrected.Level 3 errors led to re-hospitalization of patients.After pharmacists and physicians emphasized the importance of taking medicine according to doctor's orders again,patients did not make medication errors again.There are 8 categories and 22 kinds of drugs involved in medication errors,including antiplatelet,antihypertensive,hypolipidemic,hypoglycemics,anti-gout,antiarrhythmic,anticoagulant,and anti-angina drugs.Conclusion Chronic disease management led by clinical pharmacists is helpful to find and correct the medication errors timely in discharged elderly patients with hypertension.

Objective To explore the role of chronic disease management led by clinical pharmacists in preventing medication errors in discharged elderly patients with hypertension.Methods The subjects were selected from hypertensive patients aged 60-85 years and hospitalized in Department of Cardiology,Beijing Jishuitan Hospital from March 2016 to September 2017.The patients were selected at admission and their basic information were recorded,including gender,age,mode of payment,education level,occupation,and type of combined chronic diseases.The patients were given homogeneous pharmaceutical care by clinical pharmacists during hospitalization and randomly divided into the intervention group and the control group when discharged.After discharge,they were followed up for 24 weeks.The patients in the intervention group were followed up once every 2 weeks from the 1st to the 12th week and once every 4 weeks from the 13th to the 24th week after discharge.The patients in the control group were followed up only once at the end of the 12th and the 24th week after discharge.The follow-up contents included the blood pressure,blood glucose,blood lipids,and other laboratory tests results,name and usage of all the drugs used,on-time medication condition,occurrence of adverse drug reactions,changes in lifestyle,and etc.If the patients were found to have medication errors,the time of error discovery,the content,level,and frequency of the error,and the classification of the drug involved were recorded in a special form.The clinical pharmacists provided individualized medication guidance to patients during the follow-up and gave timely intervention after discovering the medication errors.Results Forty patients in the intervention group and 44 patients in the control group were entered in the study.There were no significant differences in baseline information between the 2 groups (all P ≥ 0.05).During the 24 weeks of follow-up,medication errors were found in 20 patients in the intervention group and 12 patients in the control group.The difference in detection rate of medication errors between the 2 groups was significant [50.0％ (20/40) vs.27.3％ (12/44),x2 =0.043,P =0.032].A total of 50 cases of medication errors were found in the 2 groups,including 34 (68.0％) in the intervention group and 16 (32.0％) in the control group.During the first 12 weeks of follow-up,31 cases of medication errors (91.2％) in the intervention group and 8 cases (50.0％)in the control group were found by pharmacists,and the difference was statistically significant (P =0.002).The difference in the proportion of different medication errors classification between the 2 groups was not significant (P ＞0.05).The drug omission was with the highest proportion in the 2 groups [47.1％ (16/34) in the intervention group and 31.2％ (5/16) in the control group].Among 50 cases of medication errors,49 (98.0％) were defined as level 2 errors (with mistake,but no harm),including 20 cases of grade C errors and 29 cases of grade D errors;1 (2.0％) was defined as level 3 (with mistake and harm) and grade F error.After the intervention of clinical pharmacists,all the level 2 errors were corrected.Level 3 errors led to re-hospitalization of patients.After pharmacists and physicians emphasized the importance of taking medicine according to doctor's orders again,patients did not make medication errors again.There are 8 categories and 22 kinds of drugs involved in medication errors,including antiplatelet,antihypertensive,hypolipidemic,hypoglycemics,anti-gout,antiarrhythmic,anticoagulant,and anti-angina drugs.Conclusion Chronic disease management led by clinical pharmacists is helpful to find and correct the medication errors timely in discharged elderly patients with hypertension.