Analysis of Thyroid Dysfunction Induced by Camrelizumab in Classical Hodgkin Lymphoma Patients / 医药导报

Objective To analyze the clinical characteristics of thyroid dysfunction induced by camrelizumab in the treatment of classical Hodgkin lymphoma(cHL)and explore the influencing factors.Methods The medical records of cHL patients treated with camrelizumab from January 1st,2017 to December 31st,2020,were collected.The clinical characteristics of thyroid dysfunction induced by camrelizumab were analyzed,and the influencing factors of adverse drug reactions(ADRs)were discussed.Results A total of 47 patients were included,12 patients(25.53%)experiencing thyroid dysfunction after receiv-ing camrelizumab.Among them,3 patients had hypothyroidism,7 had subclinical hypothyroidism,and 2 had subclinical hyperthy-roidism.The severity of ADRs was between grade 1 and 2(mild to moderate).None of the patients with thyroid dysfunction dis-continued camrelizumab.Thyroid dysfunction occurred between 1 and 22 months after camrelizumab treatment,with a median time of 6 months.2 patients with hypothyroidism treated with levothyroxine,the thyroid function returned to normal in 1 patient and was improved in the other.1 patient with subclinical hypothyroidism was treated with levothyroxine with the thyroid function continued to be abnormal.The rest of the 9 patients with thyroid dysfunction received no intervention,and 4 of them returned to normal,and others remained with no obvious change or loss in follow-up.Thyroid dysfunction was associated with baseline thyroid stimulating hormone level(P=0.03).The level of thyroglobulin antibodies and thyroid peroxidase antibodies was increased in 2 patients a-mong 3 patients with moderate thyroid dysfunction.Conclusion The incidence of thyroid dysfunction induced by camrelizum-ab in cHL was high.Camrelizumab-induced thyroid dysfunction was related to TSH baseline level(P=0.03).The severity was between grade 1 and 2,which was related to the level of TgAb and TPOAb.The subtype of thyroid dysfunction was mainly sub-clinical hypothyroidism with a long period.Patients could continue camrelizumab treatment,and the thyroid function of patients with grade 2 hypothyroidism was improved after the treatment with levothyroxine.

Optimization practice of youth research project management in children′s hospital: Based on the situation and demand of National Natural Science Youth Foundation in Beijing Children′s Hospital / 中华医学科研管理杂志

Objective:The study takes the Youth Research Project of National Natural Science Foundation of China (NSFC) as an example, analyzes the development and management optimization strategy of such research project in a children′s hospital, to provide reference for the training of pediatric young talents.Methods:Personnel interview and questionnaire survey were adopted to analyze the common characteristics of project application and approval, trend of change, demand and bottleneck challenges of the NSFC Youth Research Project from 2016 to 2022.Results:The total number of approved project were increasing while the rate of the bids fluctuated, and the distribution of department, gender and age are not balanced, full-time scientific research personnel, male, young age and other factors have the advantages of being approved. Five influential factors, including scientific research accomplishment, supporting conditions, research foundation, methods & skills, and scientific research atmosphere and environment, were identified as necessary components of getting funded. The survey also founded that two thirds of the needs run through the whole application process that from the topic selection, nurtured seed-funding, team-building and proposal development.Conclusions:This study puts forward a management plan for youth scientific research projects in children′s hospital from three aspects that including hospital, department and individual. The management department should strengthen the transformation from " full application" to " effective application" , at the same time, more attention should be paid to the selection, training and resource allocation to further optimize the training strategy of youth talents.

Analysis of satisfaction and influencing factors of scientific research incentive mechanisms for young medical staff in a children′s hospital in Beijing / 中华医学科研管理杂志

Objective:This study aims to explore the satisfaction and influencing factors of scientific research incentive mechanisms for young medical staff in a children′s hospital in Beijing, and to provide references for the management department to develop relevant incentive strategies.Methods:A satisfaction questionnaire survey of scientific research incentive mechanisms was carried out during April and May, 2022. Collected data were analyzed by rank sum test and ordered logistic regression.Results:The level of overall satisfaction of 339 young medical staffs was 81.42%. The satisfaction rate of incentive factors was 80.50% and hygiene factors was 77.51%.According to the findings, there were significant differences in educational backgrounds, professional titles and job types, hygiene factors, and incentive factors ( P<0.05). The contributing factors of the job satisfaction were professional title, hygiene factors and incentive factors. Conclusions:The overall satisfaction with the incentive work of the young research staff surveyed was relatively at high-level. It is necessary to improve tailed hygiene factors to meet the characteristics young medical staff, such as setting up full-time scientific research working hours, exploring the establishment of diversified of scientific research sharing mechanisms to increase the utilization of the scientific research platform. It is important to enhance incentive factors to establish a long-term incentive mechanism for young personnel, such as setting up interdisciplinary research projects, exploring the establishment of a recommendation mechanism for outstanding young talents, in order to provide them with more opportunities for further intensive training.

Progress on ferroptosis in pregnancy-related diseases / 中华围产医学杂志

Ferroptosis, a new form of programmed cell death, could be regulated by lipid metabolism, amino acid metabolism, and iron metabolism. Ferroptosis is closely related to human physiological mechanisms and involved in the development and progression of multiple diseases. More and more researchers have found that ferroptosis also plays a vital role in pregnancy-related disorders such as preeclampsia, gestational diabetes, and miscarriage. However, the mechanisms have not yet been fully understood. This article reviews the progress in ferroptosis in pregnancy-related diseases to provide new directions for scientific research and clinical treatment.

Bone marrow stromal cell antigen 2(BST2) suppresses the migration and invasion of trophoblasts in preeclampsia by downregulating matrix metallopeptidase 2(MMP2).

Preeclampsia is a grievous pregnancy-related complication with an incidence of approximately 5∼7% in pregnant women. Placental abnormalities and decreased placental perfusion associated with impaired trophoblast invasion are early pathological findings of preeclampsia. BST2 is a multifunctional transmembrane protein that plays critical roles in physiological and pathological processes, but its impacts and mechanisms of action in preeclampsia are inadequately understood. The aim of this manuscript was to investigate the functional impacts of BST2 and MMP2 on the biological behavior of trophoblast cells in preeclampsia. The expression of these proteins and their genes was analyzed by qRT-PCR, western blotting and immunohistochemistry. The results showed that the expression of BST2 and MMP2 was significantly downregulated in preeclampsia. The migration and invasion capacities of HTR-8/SVneo and JAR cells with overexpression or knockdown of BST2 were detected by wound healing assay and Transwell assays. It was found that BST2 overexpression could up-regulate MMP2 expression, and enhance the migration and invasion capacity of HTR-8/SVneo and JAR cells. BST2 knockdown could reverse these effects. MMP2 knockdown could downregulate the invasion capacity of HTR-8/SVneo cells, and MMP2 overexpression reversed these effects. Pearson correlation analysis demonstrated that the expression of MMP2 and BST2 were positively correlated. These results indicate that the downregulation of BST2 lowers MMP2 expression and restraint trophoblast functions, which probably explain its role in the pathogenesis of preeclampsia.

Gray Matter Abnormalities of Orbitofrontal Cortex and Striatum in Drug-Naïve Adult Patients With Obsessive-Compulsive Disorder.

Objective: This study examined whether obsessive-compulsive disorder (OCD) patients have gray matter abnormalities in regions related to executive function, and whether such abnormalities are associated with impaired executive function. Methods: Multiple scales were administered to 27 first-episode drug-naïve OCD patients and 29 healthy controls. Comprehensive brain morphometric indicators of orbitofrontal cortex (OFC) and three striatum areas (caudate, putamen, and pallidum) were determined. Hemisphere lateralization index was calculated for each region of interest. Correlations between lateralization index and psychological variables were examined in OCD group. Results: The OCD group had greater local gyrification index for the right OFC and greater gray matter volumes of the bilateral putamen and left pallidum than healthy controls. They also had weaker left hemisphere superiority for local gyrification index of the OFC and gray matter volume of the putamen, but stronger left hemisphere superiority for gray matter volume of the pallidum. Patients' lateralization index for local gyrification index of the OFC correlated negatively with Yale-Brown Obsessive Compulsive Scale and Dysexecutive Questionnaire scores, respectively. Conclusion: Structural abnormalities of the bilateral putamen, left pallidum, and right OFC may underlie OCD pathology. Abnormal lateralization in OCD may contribute to the onset of obsessive-compulsive symptoms and impaired executive function.

Effects of hepatitis B virus coinfection on anti-retroviral therapy in human immunodeficiency virus infected people / 中华传染病杂志

Objective:To investigate the influence of hepatitis B virus (HBV) combined with human immunodeficiency virus (HIV) infection on the efficacy of anti-retroviral therapy (ART).Methods:The data of 269 HIV-infected patients treated in Chongqing Public Health Medical Center from September 2016 to October 2019 were collected. The patients were divided into HIV monoinfection group and HIV/HBV coinfection group. The changes in liver function, CD4 + T lymphocyte count, and HIV RNA level between the two groups were compared when ART started and at different time points (2, 4, 8, 12, 24, 36, 48, and 96 weeks) after ART started. Statistical analysis were performed by independent sample t test, rank sum test and chi-square test. Results:A total of 145 patients with HIV monoinfection and 124 patients with HIV/HBV coinfection were collected. There were no statistically significant differences in liver function indexes (aspartate aminotransferase ( t=9.566), alanine aminotransferase ( t=-4.652) and total bilirubin ( t=-25.476)) between the two groups of patients when ART started (all P>0.05). At 24, 48 and 96 weeks after ART, the CD4 + T lymphocyte counts in the HIV monoinfection group and the HIV/HBV coinfection group were (305.9±156.9)/μL vs (266.2±172.5)/μL, (388.5±226.1)/μL vs (380.8±287.4)/μL and (369.5±191.4)/μL vs (453.6±179.6)/μL, respectively. At 48, 72 and 96 weeks after ART, the CD4 + T lymphocyte count increasing values were 121.0(-52.5, 144.5)/μL vs 156.0(-35.8, 185.8)/μL, 139.0(-116.0, 176.8)/μL vs 114.5(-59.5, 229.0)/μL and -91.0(-110.0, 153.3)/μL vs -94.0(-130.8, 114.3)/μL, respectively. The differences were all not statistically significant ( t=-0.516, -0.066 and -1.414, Z=-1.715、-0.802 and -1.602, respectively, all P>0.05). At 24, 48, and 96 weeks after ART, the HIV RNA inhibition rates in the HIV monoinfection group were 89.7%(130/145), 96.6%(140/145), and 96.6%(140/145), respectively, and those in the HIV/HBV coinfection group were 87.1%(108/124), 92.7%(115/124) and 94.4%(117/124), respectively. The differences were all not statistically significant ( χ2=0.026, 0.053 and 0.017, respectively, all P>0.05). In the second and fourth weeks after ART, the abnormal liver function rates of the HIV monoinfection group were 3.4%(5/145) and 6.2%(9/145), respectively, which were lower than those in the HIV/HBV coinfection group (21.0%(26/124) and 13.7%(17/124), respectively). The differences were both statistically significant ( χ2=20.121 and 4.309, respectively, both P<0.05). However, the abnormal liver function rates in the two group in the 8th week after ART were 10.3%(15/145) and 9.7%(12/124), respectively, and those in the 12th week were 9.0%(13/145) and 9.7%(12/124), respectively, and those in the 24th week were 9.7%(14/145) and 8.9%(11/124), respectively, and those in the 36th week were 9.7%(14/145) and 10.5%(13/124), respectively, and those in the 48th week were 8.3%(12/145) and 8.1%(10/124), respectively, and those in the 96th week were 2.8%(4/145) and 0(0/124), respectively. The differences were all not statistically significant ( χ2=0.330, 0.040, 0.049, 0.051, 0.004 and 3.472, respectively, all P>0.05). Conclusion:HBV coinfection has no adverse effect on the ART effect of HIV-infected patients.

Research on the mode of hospital-institute integration based on project cooperation / 中华医学科研管理杂志

Objective:To explore the hospital-institute integration mode based on project cooperation.Methods:Focusing on the management innovation of clinical and basic scientific research cooperation mode, the method of hospital-institute integration mode based on project cooperation and the key points in practice were discussed, to develop better understandings of the construction and development such mode.Results:Several key points of developing hospital-institute integration mode based on project cooperation were proposed. Main measurements adopted including the integration of scientific research and clinic service, comprehensive construction of management concept, scientific research capacity, teaching organization and service concept, cultivation of high-level research talents, construction of research departments, according to which formed the main structure of the hospital. Furthermore, it is important to change the development mode in time to promote the healthy development of the hospital.Conclusions:It is a new direction of the clinical and basic research cooperation innovation to encourage the hospital-institute integration mode based on project cooperation. It is also an effective strategy to promote the improvement of diagnosis and treatment level under the new medical reform situation.

Efficacy of apatinib combined with etoposide in the treatment of patients with platinum-resistant recurrent ovarian cancer / 中国基层医药

Objective:To investigate the efficacy and safety of apatinib combined with etoposide capsules in the treatment of patients with platinum-resistant recurrent ovarian cancer.Methods:The clinical data and follow-up data of 63 patients with platinum-resistant recurrent ovarian cancer treated in Cancer Hospital of Jilin Province from January 2017 to June 2018 were analyzed retrospectively.According to the different treatment methods, the patients were divided into single group( n=28) and combination group( n=35). The patients in the single group were treated with etoposide capsules, while the patients in the combination group were treated with apatinib and etoposide capsules.The short-term clinical efficacy, progression free survival and adverse reactions of the two groups were compared. Results:The main adverse reactions of the two groups were anemia and leukopenia.There was no statistically significant difference in adverse reactions between the two groups( P>0.05). The objective response rate(ORR) of the combined group was 54.3%(19/35), which was higher than that of the single group [25.0%(7/28)](χ 2=5.504, P<0.05). The PFS of the combined group was 8 months(95% CI: 7.4-8.6 months), which was significantly longer than that of the single group(4 months, 95% CI: 3.5-4.5 months), the difference was statistically significant(χ 2=52.400, P<0.01). Conclusion:Apatinib combined with etoposide capsules is effective in the treatment of platinum resistant recurrent ovarian cancer, which can significantly extend the median PFS, without increasing the incidence of serious adverse reactions.

Status analysis and management reflection of the development of pediatric young scientists / 中华医学科研管理杂志

Objective:Through analysis of the development status of pediatric and the problems faced by pediatric young scientists, combined with the situation of research management, this paper puts forward some suggestions.Methods:Collect the identified problems of pediatric development, summarize the common ones and propose methodological strategies for scientific research management.Results:The development of pediatrics faces problems such as insufficient resources, unreasonable resource allocation and talents shortage.Conclusions:It is recommended to support the development of pediatric according to optimize the scientific research management model, establish a reasonable evaluation and incentive mechanism, establish a pediatric talent training model and team, improve the pediatric research level, and obtain policy support for salary, talent introduction and training, promotion of professional titles, research resources and so on.

A finite element model of full endoscope lumbar fenestration and biomechanical characteristics / 中国组织工程研究

BACKGROUND: The effective treatment of lumbar spinal stenosis with total endoscopic decompression is a breakthrough frontier technology. Compared with open surgery, it has the characteristics of fewer traumas, controllable operation, and fewer complications, but it reported less in finite element biomechanics. OBJECTIVE: To establish a finite element model of full endoscope lumbar fenestration and to investigate the effects of decompression range and nucleus pulposus removal on lumbar range of motion and stress distribution of disc. METHODS: CT scan data of a case of L4-5 segmental lumbar spinal stenosis were collected and imported in Mimics 20.0 software. A finite element model M of L4-5 lumbar spinal stenosis in degenerative lumbar spine was established. The model M was imported into 3-matic for surgical simulation, i.e., unilateral disc resection of the small joints 1/2 and 1/4 model M1, bilateral joints 1/2 and 1/2 resection of intervertebral disc model M2, and unilateral disc and articular process of 1/4 model M3. In the ANSYS software, the mechanical comparative analysis was conducted in four kinds of models under six working conditions of the same pure couple moment, including forward bending, backward extension, left bending, right bending, left rotation and right rotation, and the same load of the intervertebral disc. RESULTS AND CONCLUSION: (1) Compared with the spinal M model, the range of motion of M1 model was similar under six working conditions, but the range of motion of M2 and M3 was significantly increased than that of M, especially under the left/right flexion and forward/backward flexion working conditions, which was 130%-200% of the overall activity of M model. (2) In terms of the stress of intervertebral disc, M1 model showed no obvious upward trend of the effect force in the posterior region, central region and right region of intervertebral disc under various working conditions. The equivalent stress in the left region and front region of intervertebral disc increased to a maximum of 63%, but there was no significant stress concentration. In the M2 and M3 models, the equivalent stress of intervertebral discs in all regions showed a significant increased trend. (3) Endoscopic minimally invasive surgery is accurate and controllable for different types of lumbar spinal stenosis decompression surgery. The resection of facet joints and the removal of nucleus pulposus by less than 1/2 have little influence on the biomechanical stability of the corresponding segments. The successful and reliable finite element modeling of lumbar lamina fenestration can provide an important method and basis for the follow-up biomechanical study of lumbar surgery.

Exploring an proactive model for pediatric integration medical service in Beijing-Tianjin-Hebei region / 中华医院管理杂志

Beijing-Tianjin-Hebei region is the " Capital Circle Area" in China, holding a strategic position and importance. The authors analyzed the medical and health service bottlenecks problems incurred by the shortage and unequal distribution of pediatric medical resources to be solved urgently. On such basis, this article introduced the experience of Beijing Children′s Hospital in a top-level design targeting at building a collaborative integrated health service system to meet children′s health requirements. The hospital created four types of proactive medical collaborative innovation, including a managed type, collaborative development type, technical support type and medical alliance type, aiming at providing a diversified Beijing-Tianjin-Hebei Integration proactive medical service model. These efforts are designed to relieve the structural setback of supply and demand of pediatric medical services and better children′s health and families′ welfare.

Decipherment and Consideration of 2017th Edition of National Health Insurance Directory / 医药导报

Objective To provide reference for the adjustment of provincial health insurance directory by comparing the differences between 2017 and 2009 edition of National Health Insurance Directory(NHID) and exploring the characteristics of NHID adjustment. Methods The Excel 2016 was used to carry out a comparative analysis of the drugs included in the two editions of NHID from the 4 aspects such as classification,drug name,dosage form and payment range. Results The adjustments of NHID in 2017 include drug variety,payment range,drug classification and coding.A total of 339 drugs were added, of which 133 were chemical drugs with a growth rate of 11.4%,and 206 were Traditional Chinese Medicine with a growth rate of 20.0%.In addition,dosage form was added in 149 drug varieties.The adjustment mainly focuses on chronic diseases such as hypertension and diabetes,serious diseases such as cancer,innovative drugs,and pediatric drugs. Conclusion The adjustment of 2017 edition of NHID embodied the policy thinking of "filling,selecting,supporting innovation and encouraging competition". Moreover,the drug classification,name and coding are more scientific and reasonable.

Clinical study on Athos intelligent sportswear combined with MOTOmed intelligent sports training system for treating upper limb motor dysfunction after cerebral stroke / 重庆医学

Objective To investigate the effect of Athos intelligent sportswear combined with MOTOmed intelligent sports training system for substituting partial artificial rehabilitation treatment on upper limb function and activities of daily living in the patients with stroke hemiplegia.Methods Forty-eight patients were randomly divided into the intelligent treatment group(IT) and conventional treatment(CT).The CT group adopted the routine rehabilitation treatment,and the IT group adopted the treatments of Athos intelligent sportswear combined with MOTOmed intelligent sports training system instead of passive motor training for upper extremities,flexion assistive motion training,flexion active anti-resistance training and antispasm exercise training by rehabilitation therapists.The correlation analysis between the biceps Lovett myodynamia testing results and Athos intelligent sportswear myodynamia testing results was conducted before treatment.The Fugl-Meyer assessment of upper extremity(FMA-UE) and Barthel index(BI) of activities of daily living(ADL) were assessed after 1-month and 3-month treatment.Results Thebiceps Lovett myodynamia testing results in 44 cases had significantly positive correlation with the Athos intelligent sportswear muscular strength monitoring results(r=0.929,P＜0.01).The FMA-UE and BI scores at 1,3 months of tratment in the two groups were all significantly increased compared with before tratment(P＜0.01).However,the intergroup difference after tratment was not statistically significant(P＞0.05).Conclusion Applying the Athos intelligent sportswear combined with MOTOmed movement therapy system for substituting partial manual tratment by rehebilitation therapist does not reduce the clinical effect and is conducive to alleviate the one-to-one manual training burden of rehabilitation therapists.

Pharmaceutical Care for One Patient with Phantom Limb Pain / 中国药师

The clinical pharmacist involved in the treatment of one case of phantom limb pain from the aspects of doctor's order reorganization,dose adjustment of analgesic drugs,pain score monitoring,ADR monitoring and medication education. And significant effects were shown in the drug use safety and the pain improvement in the patient. Therefore,the participation of clinical pharmacist in pain treatment can optimize analgesic effects,detect adverse drug reactions timely and thus obtain more benefits for patients.

Dose-effect Relationship of Xianfu Ointment and its Decomposed Recipes on Chronic Eczema / 中国药师

Objective:To investigate the dose-effect relationship of Xianfu ointment and its decomposed recipes the 1-chloro-2,4-dini-trochlorobenzene(DNCB) induced chronic eczema in mice, and confirm the median effective dose (ED50) of each formula and the synergetic effect by compatibility. Methods:DNCB was used to induce chronic eczema in C57 mice. The mice were treated with gradient dosages of the Xianfu ointment (11.71-11 662.50 mg?kg-1?d-1,k = 0.316), Anemone flaccid (0.53-530.12 mg?kg-1?d-1,k = 0.316), Xianfu ointment without Anemone flaccid (11.18-11 132.40 mg?kg-1?d-1,k =0.316),respectively. The pathological features were observed after hematoxylin-eosin staining. The volume ratio of epidermides and the number of lymphocyte infiltrated in dermis were analyzed with morphometry. The serum levels of IL-2,IFN-γ,IL-4,and IL-13 were detected by ELISA assay. The ED50was calculated by non-linear regression with various slope using Prism-5.0 software.Results:The effects of Xianfu ointment and its decomposed recipes on chronic eczema showed a dose-dependent tendency. The dose-response curves showed"S"shape. The efficacy of Xianfu ointment on chronic eczema was the most significant among the three formulas, which was demonstrated by decreased epidemical thicknes (ED50= 377.90 mg?kg-1?d-1), reduced infiltrated lymphocyte number(ED50= 153.20 mg?kg-1?d-1), increased serum IL-2(ED50=608.90 mg?kg-1?d-1) and IFN-γ (ED50= 205.50 mg?kg-1?d-1) levels, and decreased serum IL-4(ED50= 198.70 mg?kg-1?d-1) and IL-13 levels (ED50= 117.60 mg?kg-1?d-1). And the dose-effect curves of Anemone flaccid and Xianfu ointment without Anemone flaccid groups were both right shift when compared with that of Xianfu ointment. Conclusion:Xianfu ointment and its decomposed recipes can effectively treat chronic eczema. Anemone flaccid has obvious compatibility synergy in the whole formula. The effects of Xianfu ointment is most significant.

Dose-effect Relationship of Yuning Ointment and its Decomposed Recipes on Acne in Mice / 中国药师

Objective: To study the dose-effect relationship of Yuning ointment and its decomposed recipes in the treatment of oleic acid induced acne in mice. Methods: Oleic acid was administrated to the back (2 cm ×2 cm) of the mice (once a day) for 21 days to induce acne. At d22, the gradient dosage of Anemone flaccida crude drug (1. 06-1 060. 23 mg?kg-1?d-1,k=3. 16), Yuning oint-ment without Anemone flaccida crude drug (4. 73-1 767. 75 mg?kg-1?d-1, k=3. 16) and Yuning ointment (2. 84-2 827. 28 mg?kg-1?d-1, k=3. 16) was respectively administrated to the back of mice for 14 days. The pathological changes of skin were observed by hematoxylin-eosin (HE) staining. The diameter of sebaceous glands and the ratio of follicular keratinization area were morphomet-rically analyzed. The serum levels of IL-1, IL-6 and TNF-α were detected by ELISA assay. The median effective dosages (ED50) of A-nemone flaccida in the three prescriptions were regressed by Prism 5. 01 software to determine the prescription dose-effect. Results: All the therapy groups were with significantly relieved pathological changes of sebaceous glands hypertrophy and follicular keratinization, and decreased serum levels of IL-1, IL-6 and TNF-α in a dose-dependent manner. The dose-response curves showed an "S" shape. A-mong the three therapy groups, the effect of Yuning ointment was the best. The ED50of Yuning ointment regressed by Anemone flaccida dose was 0. 28-fold for improving sebaceous glands hypertrophy, 0. 14-fold for inhibiting follicular keratinization, and 0. 15-, 0. 49-and 0. 24-fold for decreasing serum levels of IL-1, IL-6 and TNF-α. . Regressed by Yuning ointment without Anemone flaccida, the ED50of Yuning ointment was lower than Yuning ointment without Anemone flaccid in terms of improving pathological changes and inhibiting the secretion of cytokines. Conclusion: Yuning ointment can prevent and treat acne through regulating immune function. And the prescrip-tion compatibility can enhance the effects of Anemone flaccida.

Meta-Analysisof Efficacy and Safety of Tocilizumab Used Alone and Combined with Methotrexate in Rheumatoid Arthritis Patients / 中国药师

Objective: To compare the clinical efficacy and safety between tocilizumab (TCZ) combined with methotrexate (MTX) and TCZ used alone in the patients with active rheumatoid arthritis (RA) by meta-analysis to provide reference for the treatment adjustment for the patients with poor response to MTX.Methods: Literature searches were conducted in sinoMed, VIP, PubMed, Cochrane Library and OVID, and then identified according to the inclusion and exclusion criteria.Meta-analysis was conducted using Rev Man 5.3.5 software.Results: Totally 7 randomized controlled trials (RCTs) were included in the analysis.A total number of patients were 1534 cases.The meta-analysis showed that in the treatment of RA, TCZ combined with MTX had significantly higher odds of DAS28≤2.6 remission and CDAI≤2.8 remission when compared with TCZ alone , and the incidence of adverse events (AE), serious adverse events (SAE) and serious inection had no statistical differences.Conclusion: The efficacy of TCZ combined with MTX is higher than that of TCZ alone in RA patients, and the safety is similar.The conclusion still needs further confirmation by RCTs with large samples and high quality.

Relaxant Effect and Underlying Mechanisms of Evodiamine on Isolated Myometrium of Rats / 中国药师

Objective: To study the relaxant effect and underlying mechanisms of evodiamine on isolated myometrium of rats. Methods:Prostaglandin F2α( PGF2α) was used to induce isolated myometrium contraction. The relaxant effect of evodiamine and the influence of capsazepine (an antagonist of transient receptor potential cation channel, subfamily V, member 1, TRPV1), U73122 (an antagonist of phospholipase Cβ,PLCβ) and W-7 ( an antagonist of camodulin, CaM) on the relaxant effect of evodiamine on myometri-um were observed respectively by biological function experiments. The median effective concentration ( EC50 ) was analyzed by non-line-ar various slope regressions using Prism-5. 01 software. Results:Evodiamine showed concentration-dependent relaxant effect on PGF2α-induced myometrium contraction with the EC50of 9.56 ×10 -9mol·L-1. Incubation with capsazepine (6.30 ×10 -11 mol·L-1), U73122 (2. 57 × 10 -11 mol·L-1 ) and W-7 (5. 65 × 10 -13 mol·L-1 ) markedly increased the relaxant effect of evodiamine, the EC50 of evodiamine decreased and dose-effect curves left shifted. The order of EC50 was as follows: W-7- evodiamine (8. 88 × 10 -15 mol· L-1) < capsazepine-evodiamine (7.35 ×10 -13 mol·L-1) < U73122-evodiamine (1.95 ×10 -12mol·L-1). Conclusion: Evodia-mine can inhibit myometrium contraction induced by PGF2αobviously, and the mechanisms are probably related to TRPV1, PLCβand CaM.

Adjustment and Analysis of Analgesic Regimen for One Ovarian Cancer Patient with Brain Metastases / 中国药师

Objective:To provide reference for the treatment of mixed pathological pain by analyzing the analgesic regimen for one ovarian cancer patient with brain metastases. Methods: The clinical pharmacists could conduct comprehensive and dynamic pain as-sessment,and supply the best evidence by consulting the related literatures and guidelines to assist the clinicians to formulate individu-alized administration regimen. Results: After comprehensive considering the clinical diseases, the characteristics and degree of the pain,the psychological status and the other factors,the analgesic regimen was finally adjusted to be a strong opioid combined with a tri-cyclic antidepressant,an anticonvulsant and a corticosteroid. Consequently, the patient obtained effective analgesic treatment without adverse reactions. Conclusion:The pain caused by ovarian cancer with brain metastasis is often severe and difficult to be treated. In clinics,comprehensive and dynamic pain assessment,standard titration of opioids and rational use of adjuvant drugs based on consider-ing patients' conditions are critical for controlling the pain as soon as possible and improving the quality of life of patients.