Construction of pharmacogenomics-guided individualized medication list for elderly patients / 中国药房

OBJECTIVE To develop an individualized medication list for elderly patients by evidence-based pharmacy method， and to support clinical decisions on rational use of METHODS　Firstly， drugs with risk genetic information were screened out by systematically reviewing evidence-based pharmacy information. Secondly， researchers investigated the included drugs in lists from different data E- sources. Drugs included in three or more data sources and drugs proposed by the expert committee were then included in the medication list. Thirdly， for the drugs included in two data sources， researchers designed questionnaires to investigate the necessity of drug-related gene testing. According to the scoring results of the expert questionnaire， drugs with higher scores were included in the list. Data sources included real-world data （list of high frequency medication in hospitals， high frequency medication for elderly outpatients and inpatients in National Health Care Claims Data， drugs related to frequent medication errors and so on） and evidence-based pharmacy evidence （the websites of Clinical Pharmacogenomics Implementation Consortium， Dutch Pharmacogenetics Working Group， Food and Drug Administration and so on）. RESULTS　The study obtain 68 drugs with risk genetic information which were included in three data sources. Combined with 23 drugs proposed by the expert committee， a list containing 74 drugs was preliminarily formed after de-duplication. A total of 37 drugs included in two databases with risk genetic information were scored through the questionnaire survey to form a supplementary list of 26 drugs. This is the final composition of the list of 100 drugs developed in this study. Among them， there are 43 drugs for the central nervous system， 15 drugs for the cardiovascular system， 12 anti-tumor drugs and so on. Twelve drugs were included in six or more data sources， which mainly consisted of drugs for digestive system， all proton pump inhibitors. CONCLUSION　In this study， a list of 100 commonly used drugs which require individualized medication for the elderly was developed by evidence-based pharmacy method. The drug list will be updated in time as available evidence changes， and can provide guidance for rational use of medicines for elderly patients.

Evaluation of Chongqing municipal universities’ scientific research performance / 中华医学教育探索杂志

Objective To improve the utilization efficiency of scientific research resources and op-timize the allocation of resources in universities on the basis of scientific research performance evaluation. Methods This article selects the data envelopment analysis study for twelve universities in Chongqing, using MaxDEA 6.0 software to get the results of effectiveness of universities scientific research performance. Results DMU6 and DMU8 are in a fully effective state, DMU4, DMU5, DMU10, DMU11 are in invalid state, the remaining eight universities are in effective or weak state. Conclusion There are only two uni-versities in Chongqing ordinary higher institutions whose scientific research input and output are relatively reasonable. The rest universities need to make more or less improvement and most universities need to make a little change.

Advances in the relationships between gastrointestinal microbiota and cancer / 中华微生物学和免疫学杂志

Commensal microorganisms that colonize barrier surfaces of all multicellular organisms exist in harmony with their hosts and have an important effect on both immune and non-immune functions of their hosts. Numerous researches have shown that gastrointestinal microbiota being one of the most important commensal microorganisms plays a critical role in the occurrence, development and treatment of cancer. As-signing causal roles in cancer to specific microbes and microbiotas, unraveling host-microbiota interactions with environmental factors in carcinogenesis, and applying such knowledge to cancer diagnosis and treatment are areas of intensive interest. This review considers how microbes and the microbiota may amplify or miti-gate carcinogenesis, responsiveness to cancer therapeutics, and cancer-associated complications.

Deacetylation of TFEB promotes fibrillar Aβ degradation by upregulating lysosomal biogenesis in microglia

Microglia play a pivotal role in clearance of Aβ by degrading them in lysosomes, countering amyloid plaque pathogenesis in Alzheimer's disease (AD). Recent evidence suggests that lysosomal dysfunction leads to insufficient elimination of toxic protein aggregates. We tested whether enhancing lysosomal function with transcription factor EB (TFEB), an essential regulator modulating lysosomal pathways, would promote Aβ clearance in microglia. Here we show that microglial expression of TFEB facilitates fibrillar Aβ (fAβ) degradation and reduces deposited amyloid plaques, which are further enhanced by deacetylation of TFEB. Using mass spectrometry analysis, we firstly confirmed acetylation as a previously unreported modification of TFEB and found that SIRT1 directly interacted with and deacetylated TFEB at lysine residue 116. Subsequently, SIRT1 overexpression enhanced lysosomal function and fAβ degradation by upregulating transcriptional levels of TFEB downstream targets, which could be inhibited when TFEB was knocked down. Furthermore, overexpression of deacetylated TFEB at K116R mutant in microglia accelerated intracellular fAβ degradation by stimulating lysosomal biogenesis and greatly reduced the deposited amyloid plaques in the brain slices of APP/PS1 transgenic mice. Our findings reveal that deacetylation of TFEB could regulate lysosomal biogenesis and fAβ degradation, making microglial activation of TFEB a possible strategy for attenuating amyloid plaque deposition in AD.

Effect of separating drug sales from medical services on hospital revenue and medical services in the county public hospitals of Guangxi Province / 中国卫生政策研究

Objective:To evaluate the effect of separating drug sales from medical services on hospital revenue and medical services in the county-level public hospitals of Guangxi. Methods:The controlled before and after study design was employed. 2009 to 2012 was the pre-intervention period;2013 was the intervention period. Pilot people’s hospitals were included in the intervention group;non-pilot people’s hospitals were included in the control group. Da-ta came from hospitals and new rural cooperative medical statistics from 2009 to 2013 and the Guangxi Statistical Yearbook from 2010 to 2014. The analysis method of difference-in-differences based regression was employed. Re-sults:Separating drug sales from medical services included cancelling medicine markups, increasing price of inspec-tion and nursing services, reducing price of large equipment inspection services and increasing financial assistance. In terms of hospital revenue, compared with non-pilot hospitals, for pilot hospitals, the reform reduced medicine rev-enues by 3. 326 million yuan and increased medical revenue by 10. 75 million yuan. There was no significant change in financial assistance. In terms of medical expenses, compared with non-pilot hospitals, the reform reduced per-visit outpatient drug expenses in pilot hospitals by 3. 51 yuan, increased per-visit outpatient inspection fees by 2. 23 yuan, reduced per-visit inpatient drug expenses by 133. 5 yuan, increased per-visit inpatient inspection fees by 62. 01 yuan, and increased per-visit inpatient nursing fees by 69. 72 yuan. There were no significant change in outpatient and inpa-tient visits, length of stay, outpatient expenses per-visit and inpatient expenses per-visit. Conclusion:County hospi-tals can offset losses due to cancelling medicine markups by medical service pricing adjustment in inpatient departments;in outpatient departments, they can offset losses due to cancelling medicine markups by both medical service pricing ad-justments and medical service utilization adjustments beyond policy adjustments. The reform did not reduce the operating revenue of pilot hospitals or the medical expenses per visit. The reform had little effect on hospital and doctor incentives.

Symbolic dynamics of heart rate variability in myocardial ischemia / 国际生物医学工程杂志

Objective To investigate the autonomic modulation and influence during myocardial ischemia based on analysis on heart rate dynamics with heart rate variability(HRV). Methods From 13 free download ECG records in long-term ST-T(LTST)database, 193 ischemia episodes were extracted for analysis, and 5 min intervals before and after each selected isehemia episode were selected as control ones. Using symbolic dynamic analysis method, the indexes during different stages were calculated. The repeated measurement analysis of variance was introduced for statistic test. And the distribution of autonomic reflex mode to isehemia duration was analyzed by linear fitting. Results Symbolic analysis detected an increase in the percentage of non-varlable patterns (0 V%) and a decrease in the percentage of very variable patterns(2 UV%), indicating a more sympathetic predominance compared with the baseline. But the trend of the shift in autonomic balance towards sympathetic predominance reduced with the extension of ischemic duration, suggesting a possible protection for heart. Conclusion Symbolic dynamic analysis is capable of identifying changes in autonomic modulation and seems appropriate for elucidating the neural pathophysiological mechanisms occurring in myocardial ischemic episodes.