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  • Orginal Article
    Wen ZHANG,Lida DU,Yinzhong MA,Rong YAN,Linglei KONG,Guanhua DU
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    Acute ischemic stroke,also known as stroke,is one of the most serious harm to human health.Currently,the therapeutic medicines for acute cerebral ischemia are limited,and it lacks ideal therapy.In this review,focused on the current drugs and therapies for the treatment of acute ischemic stroke,elaborating current clinical medicine types and treatment strategies for stroke and analyzing the characteristics and mechanisms of clinical drugs,to provide references for clinical medication,and to explore the direction and ideas for drug discovery.

  • Orginal Article
    Wumei ZHENG,Haiping CHU,Fuwen WANG
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    Objective To observe the effect of Nuodikang capsule preconditioning on the expression change of p38MAPK,NF-κB,TNF-α at different time points in myocardial injury induced by acute exhausted exercises,and to explore the protective effects of Nuodikang capsule and the underlying mechanism. Methods The myocardial injury animal model was set up by using an exhaustion swimming exercise.Male Wistar rats (n=70) were randomly divided into 3 groups: the normal control group (n=10),without exercise; the model control group (n=30),the rats were loaded with 2% body mass on the tails and swam for more than 3 h;the Nuodikang capsule group (n=30),the rats were modeled just like the model control group,and before modeling,0.45 g·kg-1Nuodikang capsule was given once daily,for consecutive 10 days.HE staining was used to observe the myocardial pathology change in the rats.The myocardial tissues were removed at 3,6 and 24 h after modeling.The protein expression levels of p38MAPK,NF-κB,TNF-α were detected by Western blotting. Results According to the results of pathology examination,the myocardial cells arranged disorder and the horizontal stripes disappeared in the model control group.Compared with the model control group,the myocardial injury was alleviated in the Nuodikang capsule group.Compared with the normal control group,the protein expression levels of p38MAPK,NF-κB and TNF-α were significantly increased in the model control group(P<0.01) and there was a certain inhibition in the Nuodikang capsule group(P<0.01). Conclusion These findings indicated that the Nuodikang capsule has protective effect on the myocardial indury induced by exhausted exercises,and its mechanism may be that it can reduce the expression of p38MAPK,NF-κB and TNF-α and restrain the exaggerated inflammation reaction.

  • Orginal Article
    Yukun ZU,Wei SUN
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    Objective To investigate the effect of MET inhibitor PHA665752 on the expressions of non-small cell lung cancer (NSCLC) cell lines sensitive and resistant to gefitinib. Methods The cell lines were divided into control group,gefitinib group (Gef group),PHA665752 group (PHA group),and Gef+PHA group.Effects of gefitinib was analyzed on Hcc827,Hcc827-GR,PC9 and PC9-GR cell lines.MET and autophagy related molecules LC-3,ATG5 and ATG7 expression were analyzed in gefitinib-resistant cell lines compared to sensitive cell lines.Furthermore,the influence of MET inhibitor PHA 665752 on gefitinib resistance in NSCLCs and autophagy signaling were detected by CCK8 and Western blotting. Results Growth inhibition of gefitinib in Hcc827-GR and PC9-GR was significantly lower than in Hcc827 and PC9 cell lines(P<0.05).MET and autophagy related molecules LC-3,ATG5 and ATG7 expression were up-regulated in gefitinib-resistant cell lines compared to sensitive cell lines(P<0.05).Compared with the control group,the number of cells in the Gef group,PHA group,and Gef+ PHA group was reduced by 20%,20%,and 60%,respectively.MET inhibitor PHA665752 down-regulated LC-3,ATG5 and ATG7 protein expression in gefitinib-resistant cell lines(P<0.05). Conclusion Elevated expression of MET reveals important functions of MET signaling and autophagy signaling in NSCLC TKIs-resistance development.MET inhibitor PHA665752 reverses gefitinib resistance in NSCLC cells via negatively regulating autophagy.

  • Orginal Article
    Xueliang DANG,Jun ZHAO,Xi LI,Jingmei SU,Qingwei WANG
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    Objective To investigate the effect of different penetration enhancers on the permeation Ex-RAD gel. Methods Improved Franz diffusion equipment was adopted as the apparatus for in vitro rat abdominal skin permeation.Receiving solution was 0.9% sodium chloride solution.RP- HPLC method was used to measure the Ex-RAD to study penetration promotion effect of different penetration enhancers (menthol,azone,borneol and muscone) on Ex-RAD gel,and the best penetration enhancer was optimized. Results With the increasing concentration of azone,transdermal effect was increased;penetration enhancement effect of muscone on Ex-RAD was weaker,and with the increasing concentration,the penetration enhancement was essentially unchanged; 1% and 3% menthols showed penetration enhancement,but 5% menthol inhibited the skin penetration of Ex-RAD.1%Borneol had some penetration enhancement,however,with the concentration increasing,it also showed inhibition of infiltration. Conclusion Among the Ex-RAD gel permeation enhancers,the best permeation enhancer is azone,and 5% azone is the best.

  • Orginal Article
    Jinglou CHEN,Hongping SONG
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    Objective To assess the potential of total flavonoids from Cyclosorusacuminatus (TFC) to protect against benign prostatic hyperplasia in rats. Methods Rats were randomly divided into sham-operation group(n=8) and model control group.Model control group was castrated and then divided into four groups according to the random number table: the model control group,the finasteride group,the high and low doses TFC groups (n=8 each group).The rats from model groups were subcutaneously injected with 10 mg·kg-1·d-1 of testosterone (dissolved in olive oil).The sham-operation group was subcutaneously injected with the same volume of olive oil.One hour after the injection,the finasteride group was intragastrically administrated with 5 mg·kg-1·d-1 of finasteride.The high and low dose TFC groups were given 200, 100 mg·kg-1·d-1 of TFC.The sham-operation group and the model control group were given the same volume of 0.9% sodium chloride solution.The prostatic changes of morphology,activities of antioxidant enzymes,as well as the levels of inflammatory cytokines,growth factors and microRNA (miR) 27a/b were observed. Results Compared with the sham-operation group,the level of PI and the activity of serum PACP were significantly enhanced (P<0.01),the activities of SOD and GPx were significantly decreased (P<0.01),the prostatic levels of MDA,IL-1β,IL-6,TNF-α,COX-2,miR27a,and miR27b were significantly increased (P<0.01) in the rats of model control group.Compared to the model control group,TFC significantly inhibited the increase of PI and PACP (P<0.01),normalized the activities of SOD and GPx (P<0.01),decreased the level of MDA (P<0.05),suppressed the enhancement in the levels of IL-1β,IL-6,TNF-α and COX-2,and significantly inhibited the over expression of miR27a (P<0.01).TFC (200 mg·kg-1·d-1)significantly inhibited the expression of miR27b (P<0.05). Conclusion TFC is able to exert protective effect in benign prostatic hyperplasia rats.

  • Orginal Article
    Linlin DONG,Lijie JINAG,Ying LIU,Tiehong LIU
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    Objective To investigate the influence of vinpocetine on release of corpus striatum nerve terminal dopamine (DA) and its main metabolite 3,4-dihydroxyphenylacetic acid (DOPAC),and to understand the mechanism underlying protective effect of vinpocetine on cerebral ischemia on rats. Methods Corpus striatumof of ten male Wistar rats was harvested.Baseline release levels of DA and DOPAC were determined by endogenous catecholamine release test.Influence of veratridine (control) and vinpocetine (1.5,5,15 and 50 μmol·L-1) on release of DA and DOPAC was tested through[3H]DA release test. Results Fluoxetine did not change the base line release of endogenous DA,but influenced the veratridine-evoked release of DA.Veratridine depolarization significantly increased DA release as compared with the control group[(122 ±10) pmol·mg-1 vs. (10±1) pmol·mg-1].After treatment vinpocetine,veratridine-induced DA release was reduced to (18±1) pmol·mg-1,along with the increasing concentration of vinpocetine (1.5,5,15,50 μmol·L-1),internal DA concentration decreased,but DOPAC release increased,the baseline DA release level was unchanged,and the internal DOPAC concentration was constant.After treated with different concentration of vinpocetine,total DA and DOPAC in synapsis was compared and a dose-dependent relationship was found between DA loss and DOPAC formation. Conclusion Release of neurotransmitters is inhibited through increasing permeability of voltage sensitive Na channels (VSSC) of presynaptic nerve cells,which is one of the mechanisms underlying neuro protective effect of vinpocetine.Vinpocetine can not only selectively inhibit DA transporter-induced DA release,but also increase synthesis of DOPAC independent of VSSC.

  • Orginal Article
    Haidong WANG,Shanhong NI,Zengxian SUN
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    Objective To establish an LC-MS/MS method for determination of cyclosporin A (CsA) concentrations in human blood,and to evaluate its relationship to concentrations determined by enzyme multiplied immunoassay technique (EMIT)method. Methods Blood sample was protein precipitated with acetonitrile, cyclosporin D (CsD)as the internal standard (IS).Waters Atlantisd C18 column (3.9 mm×150 mm,3 μm), 10 mmol·L-1 ammonium acetateacetonitrile-10 mmol·L-1 ammonium acetateas was the mobile phase by gradient elution.An tandem mass spectrometer was operated using an electrosprasy source (ESI) in the positive ion mode,operating in the multiple reaction monitoring (MRM) of the transitions of m/z 1 220.0® m/z1 202.8 (CsA),m/z 1 216.8® m/z119.4 (CsD,IS).Both EMIT and LC-MS/MS were applied to determine the concentration of CsA in blood of 124 volunteers.The results were analyzed to obtain correlation. Results The regression equation of resuits determined by LC-MS/MS (X) and EMIT (Y) was Y=0.999 3X+20.387 (r=0.983,n=124,P<0.05).The concentration of CsA determined by EMIT was higher than that by LC-MS/MS. Conclusion The results determined by LC-MS/MS and EMIT methods have high correlation.The two detection systems possibly have system error.Difference of CsA monitoring by EMIT and LC-MS/MS during routine clinical pharmacotherapy should pay attention and make some adjustment.

  • Orginal Article
    Yue WU,Wenwei XU,Xiaowei LIU,Ting GUO,Zhouling YUAN,Shuyan WU
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    Objective To investigate the efficacy and safety of olanzapine combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of Alzheimer’s behavioral and psychological symptoms (BPSD). Methods Sixty-four patients with behavioral and psychological symptoms were randomly divided into treatment group and control group.Besides standard basic treatment for Alzheimer’s disease,the treatment group was treated with olanzapine (5-10 mg·d-1) combined with rTMS,while the control group was treated with olanzapine combined with sham rTMS.The behavioral pathology in Alzheimer’s disease rating scale (BEHAVE-AD),the mini-mental state examination(MMSE) were assessed before and 4,8,12 weeks after the treatment.The treatment emergent symptom scale(TESS) was used to record the adverse reaction. Results As compared with the condition before the treatment,the scores of BEHAVE were declined significantly 8 weeks after the treatment,and the scores of MMSE were significantly improved in the two groups 12 weeks after the treatment.The evaluation indexes in treatment group were improved more than those in control group.After 12-week treatment,total effective rate was 75.0% and 56.2%,significant effective rate was 31.2% and 15.6% in the treatment group and control group,respectively.The rate of adverse effect were 19.2%, 15.4% in the treatment group and control group, respectively.There was no significant difference between the two groups (P>0.05). Conclusion Olanzapine can effectively improve the Alzheimer’s behavioral and psychological symptoms with high safety.It combined with rTMS has an obvious synergistic effect.

  • Orginal Article
    Guohua SONG,Jianhong YANG,Guihua LU
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    Objective To investigate the efficacy and safety of paliperidone palmitate injection and risperidone for depot suspension in treatment of patients with schizophrenia. Methods Eighty patients with schizophrenia were randomly divided into paliperidone palmitate injection group(n=40) and risperidone for depot suspension group(n=40).Both groups were treated with intramuscular injection once daily for 12 weeks.The average dose of paliperidone palmitate injection was (97.44±21.30) mg,and that of risperidone for depot suspension was (29.69±8.34) mg.Clinical efficacy was assessed with the positive and negative syndrome scale (PANSS),and adverse reactions with the treatment of symptoms scale (TESS). Results The scores of PANSS in the two groups at the 2th weekend of treatment were decreased significantly as compared to those before treatment (P<0.05);The scores of PANSS in the two groups had no significant difference at different points in time after treatment (P>0.05).At the end of 12th week,the total effective rate in the paliperidone palmitate injection group was 82.1%,and that of risperidone for depot suspension group was 80.0%, there was no significant difference (P>0.05).Main adverse reactions of both groups were insomnia,extrapyramidal reactions,menstrual disorders,weight gain,injection site pain,and so on.The weight gain of the paliperidone palmitate injection group was significantly less than that of the risperidone for depot suspension group (P<0.05).The other adverse reactions were not statistically different between the two groups (P>0.05).There were no serious adverse reactions in both groups. Conclusion Paliperidone palmitate injection and risperidone for depot suspension have equivalent efficacy in the treatment of schizophrenia.Both of them can effective lyimprove psychiatric symptoms of schizophrenia with less adverse reactions and high safety.

  • Orginal Article
    Junhui PING,Zhaoxi ZHONG,Fei PAN,Yonghe CAO
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    Objective To discuss the clinical effect and the security of paliperidone extended-release tablets combined with sertraline on the patients with residual schizophrenia. Methods Seventy patients with residual schizophrenia were randomly divided into two groups: treatment group, 35 patients were administered with paliperidone extended-release tablets combined with sertraline tablets; control group, 35 patients received paliperidone extended-release tablets.In both groups, dose of paliperidone extended-release tablets was 6 mg·d-1 (oral administration daily in the morning).In the treatment group, dose of sertraline tablets was 50 mg·d-1 (oral administration daily in the morning).The treatment lasted for 8 weeks.For the two groups, the positive and negative syndrome scale (PANSS) and adverse symptom scale (TESS) were used to evaluate curative efficacy, severity of illness and adverse reaction before the treatment, 4 and 8 weeks after the treatment. Results Before the treatment, there were no significant differences in the scale scores between the two groups.As compared with baseline (week 0), the scale scores were significantly different after the treatment in both groups (P<0.05).After the treatment, the scale scores were significantly different between the two groups (P<0.05).In the treatment group, 14 patients (40.0%) were not effectively treated, while 21 (60.0%) were effectively treated; in the control group, 19 patients (54.3%) were not effectively treated, while 16 (45.7%) were effectively treated.There was a significant difference in curative effect between the two groups (P<0.05).Rate of adverse reaction was not significantly different between the two groups (P>0.05). Conclusion Curative effect of paliperidone extended-release tablets combined with sertraline is significantly stronger than that of paliperidone single-release tablets in the treatment of residual schizophrenia.

  • Orginal Article
    Ya MA,Lingjuan XU,Hong YANG,Xiaolong HOU,Jun HU
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    Objective To observe the effect of ocular hypotensive action of bimatoprost in patients with glaucoma following contusion,and discuss the possible mechanism. Methods Eleven patients with glaucoma following contusion were treated with bimatoprost and other regular medications or surgeries during Sep.2014 to May 2016.The intraocular pressure (IOP) was retrospectively observed. Results In these eleven cases,nine achieved normal IOP,by reducing 1.995-5.985 kPa and 4.243 kPa on average,while the other two failed.One finally achieve the IOP reduction after transscleralcyclophotocoagulation,the other made it after vitrectomy. Conclusion Bimatoprost can significantly reduce the IOP of patients with glaucoma following contusion,especially when other antiglaucoma drugs failed to maintain the IOP in the target range.

  • Orginal Article
    Wei LI,Xiping LI,Chengliang ZHANG,Yanjiao XU,Chengyang FENG,Ying CHEN,Dong LIU
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    Objective To establish an HPLC method for the simultaneous determination of bilirubin and ornidazole in compound Calculus bovis film. Methods Bilirubin and ornidazole were separated on Hypersil ODS2 column (4.6 mm×200 mm,5 μm) the mobile phase was acetonitrile-1% acetic acid with gradient elution; detection wavelength of bilirubin and ornidazole were 450 nm and 315 nm,respectively; the column temperature was 30 ℃ and the injection volume was 10 μL. Results The linear range of bilirubin was within 1.58-51 μg·mL-1 (r=0.999 2),the average recoveries were 96.70%,97.92% and 98.13%,respectively,and RSD were 1.15%,1.41%,0.36%,respectively.The linear range of ornidazole was within 3.22-103 μg·mL-1 (r=0.999 0),the average recoveries were 97.83%,98.31% and 99.47%,respectively; RSD were 0.97%,0.79% and 0.64%,respectively. Conclusion With high specific,precision,accuracy and good stability,this method can be used for the assay of ornidazole and bilirubin in compound Calculus bovis film.

  • Orginal Article
    Yujuan ZHANG,Pengfei WANG,Yue MA,Li HAN,Ming YANG,Wenquan ZHOU
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    Objective To optimize the vacuum extraction of alkaloids from Sophora alopecuroides by central composite design-response surface methodology. Methods Combine with single factor test and central composite design-response surface methodology ,the vacuum extraction technology was optimized,the contents of total alkali and oxymatrine were determined. Results The condition for optimum extraction process was 60 ℃,adding 10-fold solvent and extract for 90 min extration three times.Deviation between extraction validation result and predicting value from second-order equations was -2.144%,which was a small deviation (<5%). Conclusion The optimized vacuum extraction method of alkaloids from Sophora alopecuroids is stable,feasible and well predictive .

  • Orginal Article
    Qingsong ZHOU,Qingmei NIU,Ruofei SUN,Jingjing ZHOU
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    Objective To evaluate and compare uncertainty of two common methods for determination of mesalazine by HPLC,pre-column derivatization and ion pair chromatography. Methods Various factors (calibration curve fitting,weighing,solution preparation,reference substance purity,rate of pre-column derivatization etc.) affecting detection of mesalazine were analyzed.The expanded uncertainty of the two methods was obtained respectively by calculating each variable uncertainty and combined uncertainty.Finally,the two methods were evaluated and compared. Results Uncertainty of pre-column derivatization and ion pair chromatograph for determination of mesalazine was ±4.02% and ±6.24% (P=95%,k=2),respectively. Conclusion During determination of mesalazine in its preparation by HPLC,the uncertainty was mainly caused by the standard curve fitting.The uncertainty of ion pair chromatography was higher than pre-column derivatization.

  • Orginal Article
    Qunlian HUANG,Yin LUO,Qin LI,Qin SUN
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    Objective To establish the high performance liquid chromatography (HPLC) fingerprint of Cortex Phellodendri Chinensis formula granule,and provide basis for its scientifical quality evaluation. Methods Waters C18 column (250 mm×4.6 mm,5 μm) was employed by HPLC; acetonitrile- water (including 0.10% phosphoric acid) was used by gradient elution; the detection wavelength was 280 nm; the flow rate was 1 mL·min-1; the column temperature was 20 ℃.The “traditional Chinese medicine chromatographic fingerprint similarity evaluation system” 2004A software was used for data processing. Results The HPLC fingerprint of Cortex Phellodendri Chinensis formula granules was established,with berberine serving as the reference,9 common characteristic peaks were marked.Fingerprint similarity of the 10 batchs of Cortex Phellodendri Chinensis formula granules was more than 0.90.The established fingerprint common pattern displayed that Phellodendron formula granule and herbal pieces contained approximately the same main components. Conclusion The established analysis method of HPLC fingerprint is of strong specificity,can provide a basis for scientific evaluation and effective quality control of Cortex Phellodendri Chinensis formula granules.

  • Orginal Article
    Dongsheng ZHAO,Rongmei SHI,Shangke CHEN,Xinxia LI,Jian CHEN
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    Objective To investigate the determination method of alliin in garlic and suggest to revise the assay standard in the Chinese pharmacopoeia. Methods The alliin content in garlic was detected by the methods recommended in USP37-NF32,IP2014 and Q/ALX 001S-2012,respectively. Results According to the comparison,the results of alliin content of garlic detected by the three kinds of methods were no significantly differences.But the derivatization method in USP37-NF32 was relatively tedious. Conclusion IP2014 and Q/ALX 001S-2012 method are used to determinate the alliin content of garlic,which can provide the reference for revising the assay of garlic standard in the new version of Chinese pharmacopoeia.

  • Orginal Article
    Yanbo FAN,Mingyang YUAN,Yisheng ZHANG
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    Objective To compare the mutual modes of Eucommia ulmoides from four major origins of Sichuan by HPLC and to establish their fingerprints. Methods The HPLC fingerprints of Eucommia ulmoides from four major origins of Sichuan were analyzed by similarity evaluation system for chromatographic fingerprint of TCM (Version 2004 A).The fingerprints and mutual modes for these origins were established.Based on this,the fingerprints and mutual modes of Eucommia ulmoides in Sichuan were established. Results Eucommia ulmoides from Dazhou,Dujiangyan,Guangyuan and Tongjiang consisted of 17,24,21 and 14 common peaks in fingerprint,respectively.The range of similarity for ten baches of Eucommia ulmoides from four origins was 0.818-0.985,0.913-0.971,0.945-0.994,0.457-0.956,respectively.The mutual modes of Eucommia ulmoides from four origins of Sichuan were compared and 11 common peaks were found.The similarity range of the fingerprints in the four origins was 0.585-0.950. Conclusion The quality of Eucommia ulmoides was basically the same in the four origins.The method is scientific and reasonable to evaluate the quality of Eucommia ulmoides from Sichuan.

  • Orginal Article
    Chao CHEN,Lei CHENG,Dandan WANG,Hui YU,Liya HONG
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    Objective To establish a graphite furnace atomic absorption spectrometry (AAS) method to determine the stannum (Sn) residue in PEG-polylactic acid. Methods Microwave digestion system was used to digest sample.Sn residues in PEG-polylactic acid were determined by AAS. Results Sn showed a good linear relationship in a concentration range of 0-50.0 μg·L-1(r=0.996 9); the detection limit was 1.23 μg·L-1; the average recovery was 94.73%, RSD was 5.76%(n=9). Conclusion This method is found to be sensitive and accurate, useful in controlling Sn recedues in PEG-Polylactic acid.

  • Orginal Article
    Jing YOU,Juan LI
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    Objective To evaluate the the status and the tendency of using carbapenem antibiotics in the area of Wuhan from 2012 to 2014,and to provide a reference for clinical rational use of drugs. Methods Variety and consumption sum of carbapenem antibiotics used in the area of Wuhan during 2012-2014 were classified and statistically analyzed depending on clinical application. Results There were a growing trend in the DDDs and consumption sum of meropenem,imipenem/cilastatin, and biapenem in the area of Wuhan in recent 3 years.And meropenem always ranked the first.There was a good synchrony relationship between the consumption sum and DDDs of carbapenems in 2014. Conclusion The utilization of carbapenem is basically reasonable in Wuhan.As compared with the others,meropenem (0.50 g) have certain advantages in terms of safety and effectiveness.It is a priority selection of clinical treatment for severe infection.

  • Orginal Article
    Rui JIN,Lili LI,Hongyan GU,Kun WANG,Lulu SUN
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    Objective As one of the construction requirements of “medication consultation centers” proposed by Beijing Municipal Administration of Hospitals,tried to implement a kind of novel medication consultation based on wechart. Methods Firstly,a wechart public number named as the department of pharmacy was established by the consulting pharmacist team.The information pharmacist was responsible for its daily maintenance.Secondly,two modules,medication consultation and medication news,were set for solving the clinical problems.The related operation process was also provided.The medication consultation was defined as regularly answering the problems proposed from the main page of wechart; While the original and selected medication news were published with pictures by the announcing function of wechart.Other functions such as auto reply and classification management were also used for optimization. Results From December 2014 to April 20th 2015,the medication consultation system had accumulated 692 consumers,with a increase of 5 to 8 ones everyday.The average number of consulting records was 10 everyday.15 batches of medication news (54 messages) including 23 original messages and 2 video messages had published.Several messages gained much attention,and they were widely reprinted by many media such as Health News,Beijing Times,Sohu Health,etc. Conclusion Wechart benefits to establishing a individual,convenient and mobile medication consultation service,strengthening the awareness of administration safety,improving pharmaceutical care effect of “patient-oriented” and promoting the hospital brand.Thus it has a good prospect of application and popularization.At the same time,should pay attention to developing the professionalism and responsibility,which might be the characteristics of medical wechart.

  • Orginal Article
    Jing CHEN,Wenqing WANG,Li DENG,Jianguo FANG
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    With CNKI “the China academic journal network publication database” and Chinese Biomedical Journals Citation Database as resources,articles published by hospital pharmacy departments in recent years were statistically analyzed.It showed that the ideas of hospital pharmacy research were not limited in experimental study.Researches on soft science of evidence-based pharmacy,pharmaceutical care and pharmacy management would be the trend of hospital pharmacy research in the future.Hospital pharmacists should actively explore their ideas,closely combined with clinical practice,and carry out pharmaceutical researches,which are practical and in accordance with the goal of transforming medicine,so as to better serve the patients.