Transitions in pharmacy practice, part 2: who does what and why.

The competencies required by the five practice models that constitute the total pharmacy care (TPC) model are discussed. Understanding the differences among the competencies required by the five practice models can help pharmacy's leaders estimate the extent of change that may be necessary whenever a change in practice is contemplated. Professional competence in any of the practice models is defined as the sum of skills, professional socialization, and judgment rooted in experience pertinent to the model. Possibilities for practice change are ideational and do not necessarily follow a straight line from other practice models to pharmaceutical care. The key competencies for each of the five practice models--drug information, self-care, clinical pharmacy, pharmaceutical care, and distribution--demonstrate a clear distinction among the five models. The models draw on different knowledge and skills, are characterized by different attitudes and values about the work of pharmacy, and are grounded in different practice experience. While sharing a common underpinning of theory and practice, professional competence within each of the five models that make up TPC requires distinctly different knowledge and skills, professional attitudes, and values, as well as judgment that is developed through experience.     

miR-95与胃癌细胞洛铂 敏感性的关系及 作用机制研究

目的：探讨miR-95与胃癌细胞洛铂敏感性的关系及作用机制。方法：收集30例手术切除的胃癌组织及癌旁组织标本,实时定量PCR（qPCR）法检测组织中miR-95的表达情况,CCK-8法检测洛铂对胃癌组织细胞的体外抑制率。采用miR-95抑制物（anti-miR-95）和miR-95模拟物（miR-95 mimics）分别转染人胃癌细胞株SGC7901,检测转染前后细胞对洛铂敏感性的变化;采用qPCR及Western blot法检测细胞耐药相关基因MDR1、GST-π、LRP、Survivin、xIAP、Bad mRNA和蛋白的表达。结果：qPCR检测结果显示,30例胃癌组织miR-95的相对表达水平（0.106±0.023）显著高于癌旁组织（0.046±0.025）（P < 0.05）。以miR-95表达均值为界将胃癌组织分为miR-95高表达组17例,低表达组13例。洛铂对miR-95表达水平高的胃癌细胞的抑制率低于miR-95低水平者（P < 0.05）。anti-miR-95转染后,SGC7901细胞对洛铂的敏感性明显增高（P < 0.01）,耐药相关基因MDR1、Survivin、xIAP mRNA和蛋白表达水平明显降低（P < 0.05）,而Bad mRNA和蛋白表达水平明显增高（P < 0.05）。miR-95 mimics转染后,洛铂对SGC7901细胞的抑制率明显增加（P < 0.01）,耐药相关基因MDR1、Survivin、xIAP mRNA和蛋白表达水平明显升高（P < 0.05）,而Bad mRNA和蛋白表达水平明显降低（P < 0.05）。结论：miR-95通过调节一些耐药基因的表达影响胃癌组织和细胞对洛铂的敏感性。     

A gain-of-function mutation in microRNA 142 is sufficient to cause the development of T-cell leukemia in mice

MicroRNAs (miRNAs) play a crucial role in regulating gene expression. MicroRNA expression levels fluctuate, and point mutations and methylation occur in cancer cells; however, to date, there have been no reports of carcinogenic point mutations in miRNAs. MicroRNA 142 (miR-142) is frequently mutated in patients with follicular lymphoma, diffuse large B-cell lymphoma, chronic lymphocytic leukemia (CLL), and acute myeloid leukemia/myelodysplastic syndrome (AML/MDS). To understand the role of miR-142 mutation in blood cancers, the CRISPR-Cas9 system was utilized to successfully generate miR-142-55A>G mutant knock-in (Ki) mice, simulating the most frequent mutation in patients with miR-142 mutated AML/MDS. Bone marrow cells from miR-142 mutant heterozygous Ki mice were transplanted, and we found that the miR-142 mutant/wild-type cells were sufficient for the development of CD8⁺ T-cell leukemia in mice post-transplantation. RNA-sequencing analysis in hematopoietic stem/progenitor cells and CD8⁺ T-cells revealed that miR-142-Ki/+ cells had increased expression of the mTORC1 activator, a potential target of wild-type miR-142-3p. Notably, the expression of genes involved in apoptosis, differentiation, and the inhibition of the Akt–mTOR pathway was suppressed in miR-142-55A>G heterozygous cells, indicating that these genes are repressed by the mutant miR-142-3p. Thus, in addition to the loss of function due to the halving of wild-type miR-142-3p alleles, mutated miR-142-3p gained the function to suppress the expression of distinct target genes, sufficient to cause leukemogenesis in mice.     

Lutein/zeaxanthin isomers regulate neurotrophic factors and synaptic plasticity in trained rats

Background/aim This study was conducted to elucidate the effects of lutein/zeaxanthin isomers (L/Zi) on lipid metabolism, oxidative stress, NF-κB/Nrf2 pathways, and synaptic plasticity proteins in trained rats.Materials and methods Wistar rats were distributed into four groups: 1) control, 2) L/Zi: rats received L/Zi at the dose of 100 mg/kg by oral gavage, 3) exercise, 4) exercise+L/Zi: rats exercised and received L/Zi (100 mg/kg) by oral gavage. The duration of the study was eight weeks. Results Exercise combined with L/Zi reduced lipid peroxidation and improved antioxidant enzyme activities of muscle and cerebral cortex in rats (p < 0.001). In the Exercise + L/Zi group, muscle and cerebral cortex Nrf2 and HO-1 levels increased, while NF-κB levels decreased (p <0.001). Also, L/Zi improved BDNF, synapsin I, SYP, and GAP-43 levels of the cerebral cortex of trained rats (p < 0.001). The highest levels of BDNF, synapsin SYP, and GAP-43 in the cerebral cortex were determined in the Exercise+L/Zi group.Conclusion These results suggested that exercise combined with L/Zi supplementation might be effective to reduce neurodegeneration via improving neurotrophic factors and synaptic proteins, and oxidative capacity in the cerebral cortex.     

Evaluation of systemic involvement of Coronavirus disease 2019 through spleen; size and texture analysis

Background/aimTo investigate the changes in the spleen size, parenchymal heterogeneity, and computed tomography (CT) texture analysis features of patients diagnosed with Coronavirus disease 2019 (COVID-19)Materials and methodsThe size and parenchymal structure of the spleen in 91 patients who underwent thoracic CT examination due to COVID-19 were evaluated. For the evaluation of parenchymal heterogeneity, CT texture analysis was performed using dedicated software (Olea Medical, France). The texture analysis of each case consisted of 15 first-order intensity-based features, 17 gray level co-occurrence matrix-based features, and 9 gray level run length matrix-based features.ResultsA total of 91 patients (45 males, 46 females) with a mean age of 54.31 ± 16.33 years (range: 18–81) were included in the study. A statistically significant decrease in spleen size was seen in the follow-up CT examinations (p < 0.001) whereas no statistically significant difference was found between the Hounsfield unit (HU) values. The radiomics consisted of first-order intensity-based features such as 90th percentile, maximum, interquartile range, range, mean absolute deviation, standard deviation, and variance, all of which showed statistically significant differences (p - values: < 0.001, < 0.001, 0.001, 0.003, 0.001, 0.001, and 0.004, respectively). “Correlation” as a gray level co-occurrence matrix-based feature and “gray level nonuniformity” as a gray level run length matrix-based feature showed statistically differences (p-values: 0.033 and < 0.001, respectively).ConclusionsAlthough COVID-19 manifests with lung involvement in the early stage, it can also cause systemic involvement, and the spleen may be one of its target organs. A decrease in the spleen size and parenchymal microstructure changes can be observed in the short follow-up time. It is hoped that the changes in the parenchymal microstructure will be demonstrated by a noninvasive method: texture analysis.