Objective:To analyze the short-term efficacy and safety of tislelizumab combined with neoadjuvant chemotherapy in the treatment of resectable esophageal squamous cell carcinoma (ESCC) .Methods:The clinical data of 56 patients with ESCC who received neoadjuvant therapy combined with surgical resection in the Department of Thoracic Surgery, Affiliated Hospital of Guangdong Medical University from April 2021 to October 2023 were collected. According to the different preoperative neoadjuvant therapy methods, the patients were divided into neoadjuvant chemotherapy combined with immunotherapy group (chemoimmunization group, n=24) and neoadjuvant chemotherapy group (chemotherapy group, n=32). The postoperative tumor regression grade, objective response rate (ORR), disease control rate (DCR), pathological complete response (pCR) rate, major pathological remssion (MPR) rate, R0 resection rate, perioperative indicators, and security were compared between the two groups. Results:In chemoimmunization group, the tumor regression grade was better than that in chemotherapy group, with a statistically significant difference ( Z=9.39, P=0.025). The ORR and the DCR were 75.00% (18/24) and 91.67% (22/24) in chemoimmunization group, and 46.88% (15/32) and 65.62% (21/32) in chemotherapy group, with statistically significant differences ( χ2=4.48, P=0.034; χ2=5.21, P=0.022). The R0 resection rate was 87.50% (21/24) in chemoimmunization group, which was higher than that of the chemotherapy group [59.38% (19/32) ], with a statistically significant difference ( χ2=5.31, P=0.021). The pCR rate and MPR rate were 29.17% (7/24) and 54.17% (13/24) in chemoimmunization group, and 6.25% (2/32) and 28.12% (9/32) in chemotherapy group, there was no statistically significant difference in pCR rate ( χ2=3.78, P=0.052), but there was a statistically significant difference in MPR rate ( χ2=3.89, P=0.048). The interval between the end of neoadjuvant treatment and the start of surgery was (42.71±8.29) days in chemoimmunization group, and (42.25±8.03) days in chemotherapy group. The intraoperative blood loss of patients was (215.54±57.85) ml in chemoimmunization group, and (229.65±57.74) ml in chemotherapy group. The operation time of patients was (293.52±37.50) minutes in chemoimmunization group, and (295.31±37.66) minutes in chemotherapy group. The postoperative hospitalization time of patients was (17.90±3.49) days in chemoimmunization group, and (18.42±3.82) days in chemotherapy group, all with no statistically significant differences ( t=0.21, P=0.835; t=0.90, P=0.370; t=0.18, P=0.861; t=0.52, P=0.603). In terms of postoperative complications, there was no statistically significant difference in the total incidence of postoperative complications between the two groups [62.50% (15/24) vs. 84.38% (27/32), χ2=0.59, P=0.440]. The main adverse drug reactions in the two groups included decreased white blood cell count, nausea and vomiting, liver dysfunction, pruritus, hypothyroidism, etc. Most of them were grade 1-2, 3 cases were grade 3, and no grade 4 adverse reactions occurred. The total incidence of adverse reactions was 62.50% (15/24) in chemoimmunization group, and 65.62% (21/32) in chemotherapy group, with no statistically significant difference ( χ2=0.06, P=0.809) . Conclusion:For the preoperative neoadjuvant therapy of resectable ESCC, the combination of tislelizumab and chemotherapy has better short-term efficacy and better safety than the single chemotherapy scheme, which can improve the surgical efficacy.

OBJECTIVE To explore and establis h a general pharmacist system suitable for China ’s national conditions ，and to improve the rational use of drugs in primary medical institutions . METHODS Under the leadership of Tianhe District Health Bureau of Guangzhou ，relying on the regional pharmaceutical specialty alliance ，general pharmacist system of medical consortium was established ，and the general pharmacist was responsible for the overall planning of pharmaceutical care in the medical consortium. The joint management office of pharmaceutical care was established ，and the training of the pharmacists in the medical consortium was organized. A regional audit center was established to realize the prescription review of 13 community health service centers in the medical consortium. “Internet plus ”home pharmaceutical care was carried out ，and science popularization education was provided for communities ，schools，enterprises and institutions. RESULTS After systematic training and assessment ，three pharmacist teams had been successfully established in the medical consortium to provide prescription review ，science popularization and education and family pharmacist services for community residents ；the regional audit center successfully intercepted 17.17％ of unreasonable prescriptions ，reducing the amount of unreasonable drug use by a total of 6.56 million yuan. After the intervention of prescription review system ，the qualified rate of outpatient prescriptions in community health service centers was ≥95％，and the qualified rate increased by an average of 6％. The department of pharmaceutical science popularization and education held 35 science popularization and free clinic activities ，of which 71.20％ of the residents believed that the activities had improved their understanding of drugs. In addition ，111 cases patients serviced by home pharmaceutical care were carried out successfully by pharmacist team ，and the patients ’acceptance of pharmacist intervention was 91.89％ . CONCLUSIONS Under the new medical reform ，it is feasible to implement a regional general pharmacist system within the medical consortium ， which improves the pharmaceutical administration and pharmaceuticalcare capabilities of m edical institutions in the medical consortium，as well as the level of rational drug use ，and reduces the me dical burden.

Objective To present study was to investigate the effects of insulin-like growth factor binding protein 7 (IGFBP7)on the proliferation of human hepatocellular carcinoma HepG2 cells.Methods Human hepatocellular carcinoma HepG2 cells was cultured,and plasmid pIRES2-ZsGreen1-IGFBP7 or empty plasmid was transfected into HepG2 cells and the cell transfection efficiency was examined by fluores-cence microscopy;MTT was performed to evaluate the effect of IGFBP7 on proliferation and apoptosis of HepG2 cells in 48 hours after transfection.Results IGFBP7 transfected group decreased cell proliferation noticeably.Conclusions Overexpression of IGFBP7 can down-regulte the proliferation of human hepatocel-lular carcinoma HepG2 cells.

Objective To explore adverse reactions induced by cyclosporine in patients with rheumatic diseases. Methods Clinical data of patients diagnosed with rheumatic diseases and treated with cyclosporine( 3 d)in Peking University First Hospital from January 2013 to December 2014 were collected and analyzed retrospectively. Results Data of a total of 46 patients in accordance with inclusion criteria were collected. Of them, 20 patients were diagnosed with systemic lupus erythematosus, 8 with dermatomyositis,6 with sicca syndrome,and 4 with undifferentiated connective tissue diseases and etc. There were 2-13 kinds of combination drugs in this 46 patients. In addition to cyclosporine treatment,all of them were treated with glucocorticoid,39 with non-steroidal antiinflammatory drugs,12 with other immune suppressants,20 with antibiotics,15 with hypoglycemic drugs,14 with antihypertensive drugs,and 8 with proton pump inhibitors at the same time. Of the 46 patients,21 developed 33 patient-time adverse drug reactions and the incidence was 45. 7%. Of the 21 patients,14 patients developed 1 kind of adverse reaction,3 patients developed 2 kinds of adverse reactions,3 patients developed 3 kinds of adverse reactions,and 1 patients developed 4 kinds of adverse reactions. The incidence of different adverse reactions were as follow:infection 21. 7%(10/46),urea nitrogen increase 10. 9%(5/46),gastrointestinal reactions 10. 9%(5/46),blood glucose increase 8. 7%(4/46),blood pressure increase 8. 7%(4/46),and liver injury 6. 5%(3/46),dizziness and headache 2. 2%(1/46),and hypoleucocytosis 2. 2%(1/46). Severe adverse reactions occurred in 5 patients and in 4 of them improved after treatments with drug withdrawal or symptomatic therapy,including recurrence of pulmonary tuberculosis in 2 patients,aggravation of original interstitial lung disease in 1 patient,and peptic ulcer in 1 patient;the fifth patient with repetitive infection died of primary disease after drug withdrawal. Moderate adverse reactions in 8 patients improved after symptomatic treatments. Mild adverse reactions in 7 patients were self-relieved and not clear in 1 patient because of discharge. Conclusions The incidence of adverse reactions induced by cyclosporine is high. The incidence of infection is higher and more severe. During the treatments,infection,blood glucose,blood pressure,and liver and renal function should be monitored to ensure medication safety.

Objective To explore adverse reactions induced by cyclosporine in patients with rheumatic diseases. Methods Clinical data of patients diagnosed with rheumatic diseases and treated with cyclosporine( 3 d)in Peking University First Hospital from January 2013 to December 2014 were collected and analyzed retrospectively. Results Data of a total of 46 patients in accordance with inclusion criteria were collected. Of them, 20 patients were diagnosed with systemic lupus erythematosus, 8 with dermatomyositis,6 with sicca syndrome,and 4 with undifferentiated connective tissue diseases and etc. There were 2-13 kinds of combination drugs in this 46 patients. In addition to cyclosporine treatment,all of them were treated with glucocorticoid,39 with non-steroidal antiinflammatory drugs,12 with other immune suppressants,20 with antibiotics,15 with hypoglycemic drugs,14 with antihypertensive drugs,and 8 with proton pump inhibitors at the same time. Of the 46 patients,21 developed 33 patient-time adverse drug reactions and the incidence was 45. 7%. Of the 21 patients,14 patients developed 1 kind of adverse reaction,3 patients developed 2 kinds of adverse reactions,3 patients developed 3 kinds of adverse reactions,and 1 patients developed 4 kinds of adverse reactions. The incidence of different adverse reactions were as follow:infection 21. 7%(10/46),urea nitrogen increase 10. 9%(5/46),gastrointestinal reactions 10. 9%(5/46),blood glucose increase 8. 7%(4/46),blood pressure increase 8. 7%(4/46),and liver injury 6. 5%(3/46),dizziness and headache 2. 2%(1/46),and hypoleucocytosis 2. 2%(1/46). Severe adverse reactions occurred in 5 patients and in 4 of them improved after treatments with drug withdrawal or symptomatic therapy,including recurrence of pulmonary tuberculosis in 2 patients,aggravation of original interstitial lung disease in 1 patient,and peptic ulcer in 1 patient;the fifth patient with repetitive infection died of primary disease after drug withdrawal. Moderate adverse reactions in 8 patients improved after symptomatic treatments. Mild adverse reactions in 7 patients were self-relieved and not clear in 1 patient because of discharge. Conclusions The incidence of adverse reactions induced by cyclosporine is high. The incidence of infection is higher and more severe. During the treatments,infection,blood glucose,blood pressure,and liver and renal function should be monitored to ensure medication safety.