Warfarin is widely used as one of the coumarins anticoagulation drugs in the clinical.Every physician has been disturbed by its narrow therapic index and bleeding complications.It is a difficult thing for the doctor to use it rationally.However,recently,with the rapid development of molecule biology,some research find that gene polymorphism of pharmacodynamics and pharmacokinetics cause the individual variability in drug response.In this review,we focus on the latest development in pharmacogenomics of warfarin at home and abroad in order to give some suggestions for the individual use of warfarin.

Carvedilol is a novel β-receptor blocker with vasodilative and potent antioxidative effects. It may inhibit the activation of transduction factors induced by oxygen radicals, block the gene expression in cardiac remodeling, and decrease cardiomyocyte apoptosis. It is reported that carvedilol may reduce the in vivo oxidation of low density lipoprotein (LDL) and auto-antibody titre of antioxidant and increase the antioxidative capacity of LDL. Carvedilol and its metabolite BM-910228 may inhibit the inotropic response induced by oxygen radicals. Carvedilol may provide cardiac protection in acute myocardial ischemia and improve cardiac function, reduce the mortality rate of heart failure.

Objective To understand the perception of health status in people with prehypertension. Methods Using the phenomenological method, 15 people with prehypertension were interviewed; the interview results were analyzed deeply. Results Five themes were extracted about health status:obscured perception about prehypertension and hypertension;absence of noticeable symptoms;necessity to change life-style, but lack of effective health self-management; many factors hindering effective health self-management; desire for professional help. Conclusions Perception of health status in people with prehypertension indicated deficiencies in health self-management. What they need were accessible professional support and intervention program that pay attention to people′s health belief and behavioral motivation.

Inflammatory bowel disease( IBD),comprising Crohn’s disease( CD)and ulcerative colitis( UC),is a chronic intestinal inflammatory disease and its etiology has not yet been clarified. Studies showed that intestinal microbiota disorder is closely associated with the development and progression of IBD. Currently,fecal microbiota transplantation (FMT)is considered as a special organ transplantation and used in treatment of IBD,Clostridium difficile infection, irritable bowel syndrome,metabolic syndrome,etc. This article reviewed the relationship between FMT and IBD.

Objective To discuss the characteristics of ultrasonic images obtained by color Doppler per rectum after intrarectal pouring and the advantages of this method.Methods 40 cases who were diagnosed as rectal carcinoma prior to surgeries were investigated.The rectum was cleand and then was poured with normal saline before examination.Color Doppler ultrasonography per rectum was performed with intrarectal probe touching the inferior edge of the tumor.The 2-dimensional images and color Doppler images were then analyzed.Results The accurate typing of rectal tumors(detailedly,the ulcerative,intumescent,and confined types)can be obtained with this method.Within the 40 cases,24 were ulcerative,12 were intumescent and 4 were confined.Only one case with ulcerative tumor was misdiagnosed as intumescent.The total accuracy rate was 97.5%.As with rectal tumors less than 5cm,there was no significant difference between the measurement by ultrasonography and that by pathologic methods (P＞0.05).While for tumors larger than 5cm,the measurement by ultrasonography was significantly different from that by pathologic methods (P＜0.05).There was no significant correlation between the bloodstream signal of color Doppler and pathological grading(P＞0.05).The method can be applied for patients who have a narrow rectal duct or are suffering from agonies which prevent the passage of the colonoscope.For cases failing to detect the margin and surface of the tumor with routine method,or ultrasonic probe failing to pass the confined area leading to illegible 2-dimensional images,This method is competent as well.Conclusion Color Doppler ultrasonography per rectum after intrareetal pouring can be applied for the diagnosis of rectal tumors of all types.

Objective To evaluate medium-term results in critical limb ischemia (CLI) patients undergoing endovascularly revascularization based on concepts of angiosomes.Methods Clinical data were reviewed on 612 CLI patients who had isolated below-the-knee (BTK)lesions and were treated by endovascular technology from June 2006 to May 2012.Following the angiosome model of perfusion,286 patients (357 limbs)were treated by directly revascularizing the feeding artery.326 patients (455 limbs)were treated by revascularizing non-feeding artery to improve perfusion to ulcer indirectly.Primary endpoints included ulce-healing rate as of 3 months,amputation-free survival( AFS),freedom from major amputation (FFMA) and recurrence rate of CLI.Results During follow-up(mean,24 ± 18 months),ulce-healing rate during 3 months of direct treatment group was obviously higher than that of indirect group (82.4％ vs.66.4％,X2 =26.16,P ＜0.05).The fourth year AFS was 48％ ±5％ vs.37％ ±6％,t =3.44,P ＜0.05,and the fourth year FFMA was 73％ ±4％ vs.58％ ±3％,t =4.61,P ＜0.05.In recurrence rate of CLI,there wasn't significant difference between direct group and indirect group(42％ ±5％ vs.45％ ±6％,t =- 0.64,P ＞ 0.05 ).Conclusions Following the angiosome model of perfusion,direct revascularizing the feeding artery of CLI patients can obviously improve ulcer-healing rate during 3 months,medium-term AFS and FFMA.

Objective To study the expressions of CA19-9 and CA125 and their clinicopathologic significances in gallbladder adenocarcinoma, pericancerous tissues and chronic cholecystitis. Methods EnVisionTM immunohistochemistry was used for assaying the expressive levels of CA19-9 and CA125 in the routinely paraffin-embedded sections of specimens from gallbladder adenocarcinoma (n=108), pericancerous tissues (n=46), and chronic cholecystitis (n=35). Results The positive rates of CA19-9 and CA125 were significantly higher in gallbladder adenocarcinoma (49.1%, 51.9%) than those in pericancerous tissues (26.1%, 15.2%) and chronic cholecystitis (14.3%, 5.7%), respectively (P

The prognosis is very poor for the patients with advanced esophageal cancer proved by explored operation.There was not concurrent for the value of radiotherapy after explored operation.A series of 104 patients with explored operation alone and 155 patients with radiotherapy before or after explored operation were analyzed to evaluation the value of postoperetive radiotherapy. The results showed: (1) Postoperative radiotherapy was effective for the patients with advanced esophageal cancer after explored operation.The average survival/mean survival and 1～5 years survival were higher in the patients with postoperative radiotherapy than in those of operation alone. (2) ≥6000cGy groupe was better than

Objective To build a regression equation which can indicate the relationship between pH value of Chinese youth' arterial blood and geographical factors in China.Methods We collected pH value of young and geographical factors in China,and studied the relationship between them.Results We worked out a regression equation which could indicate the relationship between the pH value of Chinese youth' arterial blood and the geographical indicators.Conclusion If knowing the geographical indicators of each area in China,we can estimate the pH reference value of young people's arterial blood by using the equation.

Background Hypoxia is an important cause resulting in many retinal diseases,such as retinal edema,diabetic retinopathy,proliferative retinopathy and so on.ObjectiveThis study is to investigate the effects of hypoxia on the expression of AQP-4 in Müller cells in vitro.MethodsMüller cells were isolated from New Zealand white rabbits and primarily cultured in DMEM containing 20% fetal bovine serum by the explant culture method.The cells were identified by immunostaining for the glial fibrillary acidic protein(GFAP).Generation 2 of cells was cultivated with the chemical hypoxia inducer,CoCl_2,for 24 hours in the hypoxic group and only with DMEM in the control group.The expression of the AQP-4 protein in Müller cells was detected by immunocytochemistry.The expression of AQP-4 mRNA was determined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR).ResultsAbout 90% of Müller cells(generation 2) presented a positive immunoreactivity for GFAP,showing a brown staining in the cytoplasm.Cultured cells displayed the presence of intermediate filaments,microvillus and various cellular organs.The Integralabsorbance of the AQP-4 protein in Müller cells was markedly increased 24 hours after incubation with CoCl_2 in comparison with the control group (t=6.74,P＜0.05).The expression level of AQP-4 mRNA in Müller cells was significantly enhanced 24 hours after incubation with CoCl_2 in comparison with the control group (t=21.79,P＜0.05). ConclusionHypoxia enchances the expression of AQP-4 in Müller cells and further increases fluid accumulation in the retina.These results suggest that Müller cells play an important role in the formation of retinal edema in diabetic retinopathy or proliferative retinopathy.