OBJECTIVE：To introduce pharmacogenomics and its applications in establishing clinical pharmacotherapeutic schemes.METHODS：Based on the analysis of the related literatures,the development and contents of pharmacogenomics and their relationship with individualized medication were summarized.RESULTS：Pharmacogenomics studies the association between gene polymorphisms and the variance of drug effects.CONCLUSION：Pharmacogenomics provides a theoretical basis for medication with safety,effectiveness and rationality.

Objective To assess the diagnostic value of Wells score and D-Dimer detection in acute pulmonary embolism. Methods Forty-two suspected cases of pulmonary embolism were collected from March 2012 to September 2014 Then Wells score and D-Dimer detection were applied to confirm the disease. Results Of the total, 26 patients were diagnosed by computed tomographic pulmonary arteriography (CTPA). There were 7, 24 and 11 suspected cases which had low, medium and high Wells score respectively. Among them, 1, 15, and 10 cases were diagnosed by CTPA. The diagnosis rates were 14.2% (1/7), 62.5% (15/24) and 90.9%(10/11) respectively. The D-Dimer level in pulmonary embolism group was significantly higher than that in non-embolism group(P < 0.01). The D-Dimer level of cases with medium or high Wells score was higher than those with low Wells score (P < 0.05). Conclusion Wells score combined with D-Dimer is convenient, accurate and safe for predicting acute pulmonary embolism.

[Objective] To observe the therapeutic effect of spleen-invigorating and lung-nourishing therapy and its influence on nutritive index and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) at stationary phase. [ Methods ] Ninety cases of COPD were randomized into three groups. Group A was given routine symptomatic treatment; groups B and C were given oral use of Jianpi yifei Granules and routine symptomatic treatment and group C was additionally treated with garlic-partition moxibustion and acupoint injection of Shenmai Injection on bilateral Zusanli (ST 36) point alternatively. The treatment lasted 2 months. [Results] The effective rate was 93.33% in group C, 86.67% in group B and 56.67% in group A (P 0.05) compared with those before treatment. Scores of activity of daily life (ADL) , depression and anxiety and the total score of QOL were obviously decreased in groups B and C (P

A 77-year-old man was admitted to our hospital at July 5th,2010 with an unexplained massive pericardial effusion for 10 years.With dyspnea for one month and normal vital signs without pulsus paradoxus,other physical examination included a small amount of moist rale,normal heart sounds,jugular vein engorgement,positive hepatojugular reflux,hepatosplenomegaly and pitting edema of the extremities.The patient had a complex past history with lymph node tuberculosis,primary artertial hypertension,polycythernia vera,chronic renal insufficiency and hypothyroidism (Hashimoto's thyroiditis),and moreover,received a high dose radiation of 31p in 1967. Family history is negative.The patient had no cardiac tamponade or pericardial constriction during 10 years,he received pericardiocentesis twice,and pericardial effusion was exudative with a high proportion of monocyte.There was no evidences of tuberculosis infection,hypothyroidism,malignant tumor,severe heart failure,uremia,trauma,severe bacterial or fungus infection,chronic myeloid leukemia or bone marrow fibrosis during the admission. The patient refused anti tuberculosis,indwelling catheter drainage or surgical therapy.In this rare case,the aetiology of chronic massive pericardial effusion is most probably chronic idiopathic recurrent pericarditis.

Objective:To evaluate the efficacy of cerebral-placental-uterine ratio(CPUR)in predicting late-on-set fetal growth restriction(FGR).Methods:From May 2020 to May 2021,1255 women with singleton pregnancy who underwent prenatal examinations at the University of Hong Kong Shenzhen Hospital were selected for fetal growth and Doppler measurements at 35-37 +6 weeks of gestation.Pregnant women with birth weight of newbo-rns＜the 10th percentile were the FGR group.The pulsatility index(PI)of uterine artery(UtA),umbilical artery(UA)and fetal middle cerebral artery(MCA)were analyzed separately and in combination.ROC curve was used to analyze the cerebral-placental-uterine ratio(CPUR),cerebral-placental ratio(CPR),cerebral-uterine ratio(C-UtA)for predicting late-onset FGR;and to evaluate the sensitivity,positive and negative predictive value and of CPUR in the prediction of late-onset FGR.Results:The area under the curve(AUC)of CPUR,CPR,C-UtA and mean UtA-PI for FGR grope were 0.88,0.86,0.84 and 0.72.Under certain cut-off values and 87% specificity,the specificity of CPUR,CPR,C-UtA and mean UtA-Pifor predicting FGR group was 43.2%,46.6%,39.8% and 23.9%,respectively.The positive predictive values of CPUR,CPR,C-UtA and mean UtA-PI,UA-PI for predicting FGR group were 90.5%,71.9%,83.3%,63.6%and 5.2%,respectively.Conclusions:CPUR is more effective in predicting late onset FGR than CPR,C-UtA and mean UtA-PI.It can effectively increase the detection rate of fetal growth restrictionand reduce the FGR risk.