OBJECTIVE To investigate the mechanism of glucose -6-phosphate dehydrogenase （G6PD）-induced sorafenib - resistance in hepatocarcinoma cell based on phoshorylated 3-kinase/protein kinase B （PI3K/Akt）signaling pathway . METHODS Cell lines including hepatocarcinoma cell Huh 7，sorafenib-resistant cell Huh 7-SR，G6PD overexpressed cell Huh 7-G6PD and its control cell Huh 7-CT，and compounds including G 6PD inhibitor （6-Aminonicotinamide，6AN）and sorafenib were used as objects or intervention drugs in these research . CCK8 assay was applied to evaluate cell viability . The protein levels of G 6PD and the phosphorylation levels of PI 3K/Akt signaling pathway were detected by Western blot . Flow cytometry was utilized to investigate cell apoptosis. RESULTS Compared with Huh 7 cells，the protein level of G 6PD was significantly increased in Huh 7-SR cells （P＜ 0.05）. The combination of 6AN and sorafenib reduced cell viability of Huh 7-SR cells （P＜0.01）. However，compared with Huh 7- CT，increased cell viability and decreased cell apoptosis rate were observed in Huh 7-G6PD cells while cells were treated with sorafenib（P＜0.01）. Mechanistically，the phosphorylation levels of PI 3K and Akt were significantly decreased in Huh 7-SR cells that were treated with 6AN（P＜0.05）. Moreover，under the condition of no drug intervention ，the phosphorylation levels of PI 3K and Akt were significantly elevated in Huh 7-G6PD cells when compared with Huh 7-CT（P＜0.01）. CONCLUSION G6PD could induce sorafenib -resistance in hepatocarcinoma cell by activating PI 3K/Akt signaling pathway .

Objective:To analyze the role of clinical pharmacists played in the drug consultation and advice in orthopedic ward in order to discuss the work mode and the effects of clinical pharmacists in orthopedic ward and improve the service quality of clinical pharmacy. Methods:The work records related to the drug treatment of clinical pharmacists were collected during January 2013 and December 2015. The aspects of service objects, involving drugs, issue categories and the results of feedback were summarized and analyzed.Results:The study summarized 504 work records of clinical pharmacists participating in the drug treatment in orthopedic ward. The rational use of antimicrobial drugs,analgesics and anticoagulants was the key work for clinical pharmacists. Frequently asked questions were drug selection, dosage, treatment plan, drug information, precautions and contraindications, pharmacological effects,adverse drug reactions and drug interactions. The advices of clinical pharmacists were accepted by orthopedists regularly, and the drug treatment regimes were improved with the help of clinical pharmacists. Conclusion:Clinical pharmacists participating in clinical practice can improve rational pharmacotherapy, and also contribute to the cultivation and improvement of self-quality of clinical pharmacist.

Objective:To explore a new way of pharmaceutical service mode for disease treatment. Methods:Clinical pharmacists actively participated in the pharmaceutical care for a patient with mixed liver injury, and provided clinical pharmaceutical services through the adverse reaction analysis,etiological mechanisms exploration,therapeutic drugs selection and risk factors prevention. Re-sults:Clinical pharmacists cooperating closely with physicians helped to identify problems in time,and then the medication analysis in the fields of drug selection, dose determination, efficacy evaluation and indicators detection was performed, so that the strategies on medicine treatment could be adjusted timely as the disease progressed. With the gradual recovery of liver function, the patient dis-charged after the conditions were improved. Conclusion:By participating in pharmaceutical practice,clinical pharmacists can provide clinical pharmaceutical service,which is helpful to safety improvement and efficiency of drug administration. It is also an effective way to enhance the learning ability of pharmacists,and cultivate their clinical thinking and practice capacity.

Objective:To evaluate the correlation of inter-individual variation of cyclosporine dosage and blood concentration and CYP3A4 and CYP3A5 polymorphism in renal transplant recipients. Methods:Two hundred and twenty-one renal transplant recipients treated with cyclosporine were genotyped for CYP3A4 rs4646437C>T and CYP3A5 6986G>A using ligase detection reactions. The effects of genetic polymorphisms of CYP3A4 and CYP3A5 on cyclosporine trough concentration (C0/D) and 2 h post-dose concentra-tion (C2/D) during the period of 6 months, 6-24 months and above 24 months after renal transplant were studied. Results:CYP3A5 6986G>A genotype affected C0/D during the period of 6 months, 6-24 months and beyond 24 months (P<0. 05) with the order of CYP3A5 6986GG>GA>AA. CYP3A4 rs4646437C>T and CYP3A5 6986G>A genotype affected C2/D during the period above 24 months (P<0. 05) with the order of CYP3A4 rs4646437 CC>CT>TT and CYP3A5 6986GG>GA>AA. Conclusion: CYP3A5 6986G>A genotype affects C0/D and C2/D of cyclosporine, and CYP3A4 rs4646437 C>T genotype affects C2/D of cyclosporine. The effects of genotypes are varied in different stages.

Objective: To discuss the role of clinical pharmacists played in the pharmaceutical care for osteomyelitis patients. Methods:Clinical pharmacists participated in the treatment for a special patient with osteomyelitis. Taking the disease features, medi-cal history, adverse drug reactions into account, clinical pharmacists provided consultant opinions for establishing and adjusting the ap-propriate therapeutic regimens and individualized pharmaceutical care. Results:The drug treatment regimens for the patient were safe, effective and rational. By the individualized pharmaceutical care, clinical pharmacists were able to find the problems in the drug treat-ment and implement the efficient solutions. Conclusion: Clinical pharmacists show their own advantages in individual pharmaceutical care, and play an important role in improving the rational drug use.

OBJECTIVE:To discuss how clinical pharmacists adapt the policy of New Medical Reform and to make sure the position and role of clinical pharmacists in order to increase the number of clinical pharmacists and to promote the development of clinical pharmacy.METHODS:The development of clinical pharmacy was compared between American and China.The status quo of the development of clinical pharmacy in China was analyzed.The influence of pharmaceutical administration of New Medical Reform on the development of clinical pharmacy was investigated.The development prospect of clinical pharmacists was proposed.RESULTS&CONCLUSION:The development of clinical pharmacy in China has a big gap compared with that of foreign countries.The factors such as the lag of education,the shortage of clinical pharmacists' quality,the unsound of policy protection,and the immature reform of health care system,all hinder the development of clinical pharmacy.Some relevant provisions of new health care system show that the government make up it's mind to promote rational use of drugs.Safe,economical and effective drug use is our target in the future.Government may draw up policy about professional certification of clinical pharmacists and labor assessment at first,which provide good future prospects and payment to attract more talent.

OBJECTIVE To investigate the clinical application of antibiotic agents in a hospital.METHODS A cross section investigation method was used to survey the clinical application of antibiotic agents for emergency,out-patient clinic and hospitalization patients in a hospital within a day.RESULTS The usage rate of antibiotic agents for emergency patients was the maximum(54.67%) and the percentage of drug combination was multitude(23.42%).It was involved in 10 categories of antibiotic agents,cephalosporin was used at most(61.92%).The usage rate of antibiotic agents in Department of Gynecology and Obstetrics(OG) was the maximum(37.96%).Department with top defined DDD rate was Respiration Medical Department(RMD,39.90%).The average rate of etiological examination in the whole hospital was 6.67%.CONCLUSIONS It is higher in the usage rate of antibiotic agents for emergency patients.It is much more usage of antibiotic agents in OG and RMD,furthermore,the antibiotic agents are excessively used and the rate of etiological examination is low.Management should be further strengthened for rational use of antibiotic agents.

Cytochrome P450 is an important kind of enzymes for the metabolism of drug and other endo-or xeno-biotics. Classification of metabolic enzymes, molecular biological characteristic of CYP3A4, CYP2D6, CYP2C9, CYP2C19, CYP2E1, CYP1A2 and CYP2A6 were described in this review. Influence of traditional Chinese medicine(TCM) on metabolic enzyme and its application in clinical drug therapeutics and drug development were also reviewed in this article.

The human La protein is recently identified as a host factor potentially involved in the post-transcriptional regulation of hepatitis B virus (HBV) RNA. The La binding site is mapped to a predicted stem-loop structure within a region shared by all HBV RNAs, and it is known that human La protein protected HBV RNA against Rnase-mediated degradation. HLa mutants lost the ability of binding and protecting HBV RNA, which make it easy for HBV RNA to degrade and the virus replication to terminate. This review summarizes the latest investigation about the interaction of La protein,HBV RNA and Nuclear RNases, and discusses the possible mechanisms of HBV RNA degradation, the effect of La protein and its mutants on the translation initiation of HBV RNA, and the replication of the virus.

OBJECTIVE: To study the time window of apoptosis and related genes expression of the myocardiocytes in sinoaortic-denervated(SAD) rats.METHODS SAD of shamoperation(Sham) was performed in male SD rats at the age of 10 weeks.After 4, 8, 16, 32 weeks, apoptotic cells were stained in situ using terminal dexynucleotidyl - transferase mediated -dUTP nick end labeling(TUNEL) .All stained results were analysed by computer image analysis techniques.Bel-2, Bax, Fas and Fas-L were detected using immunohistochemical method.RESULTS: Compared with Sham controls, the number of apoptotic myocardiocytes was significantly increased;The expressions of Bel - 2 were significantly decreased, whereas Bax,Fas and Fas-L were significantly increased in SAD rats.The ratio of Bcl-2/ Bax was decreased.CONCLUSION Apoptosis and dysregulation of related gene expressions may be involved in the myocardial remodeling in SAD rats.