OBJECTIVE To provide references for the accurate identification and management of immune-related cutaneous adverse events （irCAEs） caused by durvalumab， and ensuring safe clinical drug use. METHODS Clinical pharmacists participated in the diagnosis and treatment process of a patient with gallbladder cancer who developed irCAEs caused by durvalumab. The clinical pharmacists systematically reviewed the patient’s past medical history and medication history， and assisted physicians in assessing the association between adverse drug reactions and administered drugs. Meanwhile， the clinical pharmacists conducted a graded assessment of the adverse reaction， proposed recommendations such as discontinuing durvalumab and adjusting the administration regimen of glucocorticoids， assisted physicians in restarting immunotherapy， and carried out medication education and other pharmaceutical care. RESULTS The occurrence of irCAEs in this patient was “highly likely” related to durvalumab and was classified as severe. The physicians adopted the clinical pharmacist’s opinion， and after symptomatic treatment， the patient’s skin symptoms improved， and discharged with medication. After the completion of glucocorticoid therapy for the patient， the physician restarted immunotherapy with tislelizumab， and no related adverse reactions occurred again in the patient. CONCLUSIONS Durvalumab can cause irCAEs such as severe skin maculopapular rash. In clinical practice， it is crucial to promptly identify and discontinue suspicious drugs， immediately implement effective symptomatic treatment measures， and actively resume immunotherapy to ensure the continuity and safety of the patient’s treatment.

Objective: To investigate the effects of sulforaphane (SFN) on oxidative stress and Nrf2(Nuclear factor E2-related factor 2)/HO-1(heme oxygenase-1) signaling pathway in renal tubular epithelial cells (HK-2).Methods: HK-2 cells were cultured in vitro and divided into five groups, including the control group, H2O2 group, H2O2+10 μmol·L-1 SFN group, H2O2+20μmol·L-1 SFN group and H2O2+40 μmol·L-1 SFN group.The levels of MDA, NO, GSH and the activity of SOD were measured.The expression levels of Nrf2, HO-1 mRNAR and proteins were analyzed using RT-PCR and Western Blot methods.Results: The levels of MDA and NO in H2O2 group significantly increased when compared with those in the control group, while the levels of GSH and the activity of SOD significantly decreased(P<0.05).The levels of MDA and NO in the cells after the treatment of sulforaphane at different concentrations significantly reduced when compared with those in H2O2 group, while the levels of GSH and the activity of SOD significantly increased(P<0.05).The results of RT-PCR and Western Blot analysis showed that the expression levels of Nrf2, HO-1 mRNAR and proteins in the cells after the treatment of sulforaphane at different concentrations were significantly up-regulated when compared with those in H2O2 group (P<0.05).Conclusion: Sulforaphane can strengthen the antagonism effects on oxidative stress injury in HK-2 cells and the underlying mechanism might be associated with activating Nrf2/HO-1 signal transduction pathway.

OBJECTIVE:To investigate the status quo and problems of the construction of pharmacy staff team from Hubei Wuling mountainous area,and to provide reference for the formulation of construction plan of pharmacy staff team. METHODS:Using questionnaire survey and telephone interviews,the pharmacy staff of 22 hospitals at second level or above from Hubei Wul-ing mountainous area during 2011-2014 were investigated in terms of number,age,educational background,professional title,etc. RESULTS & CONCLUSIONS:The shortage of pharmacy staff is seious in 22 hospitals at second level or above from this areas (open 10 606 beds,should be staffed 956 pharmacy personnel,actual number of pharmacy personnel is 502);the age structure is unreasonable,and only 220 pharmacy staff aged under 35 year-old;highly educated pharmacy staff accounted for low proportion, and bachelor degree or above took up 29.5%;pharmacy staff with professional title took up low proportion,and pharmacy staff with high,middle and junior professional titles accounted for 1:5:4. The situation of pharmacy staff in the region can be improved through following measures,including striving for policy recommendations,continuously enriching the quantity of pharmacy staff, integrating scientifically and building reasonable talent tem gradually,introducing talents,optimizing education structure of pharma-cy staff,strengthening the training,improving operation level of pharmacy staff,etc.

OBJECTIVE: To promote the development of clinical pharmacy and improve the social efficacy of ADR monitoring so as to ensure safe and rational use of drugs.METHODS: The current status of Chinese ADR monitoring system and the problems faced in the development of ADR monitoring were analyzed by means of literature review,contrasting analysis,and data reduction etc.RESULTS & CONCLUSION: There are many problems existed in the current ADR monitoring,for instance: the regulations system of ADR monitoring is unsound,the monitoring technology is weak;the cognition level of many medical workers is still very low etc.It is urgently needed to intensify propaganda on ADR monitoring,strengthen ADR monitoring,develop technological system of monitoring,set up expert database and train professional talents.