Pharmacogenomics refers to all the genes encoding drug-metabolizing enzymes,drug transporters,and other drug targets. Studying the relations betweeen gene polymorphisms and drug effects as well as the prediction of adverse reactions at the gene level will be a new method for the clinical therapy of digestive system diseases. Therefore,pharmacogenomics will be a complement of traditional methods for forming and administering drugs regimens.

Objective To study the preoperative nursing care in excision of adrenal tumor by using laparoscope. Methods 72 patients with adrenal tumor have undergone the excision of adrenal tumor by using laparoscope in our hospital. Preoperative nursing included mental care, cardiac and pulmonary function assessement, pharmacotherapy, gastrointestinal and skin preparation. Postoperative monitoring the condition of all the patients, and given oxygen uptake to prevent hypercarbonemia. All the patients were encouraged to do functional recovery early and were guided to diet properly. Results All patients were successful obtained the excision of adrenal tumor by using laparoscope except two were reversed to open surgery. The patients could take food and leave bed in the first post-operative day. The mean post-operative stay was 6 days. Hydrothorax occurred in 2 cases and fat liquidation and wound infection occurred in 2 cases. There were no major complications such as hemorrhage and hypercarbonemia occurred. Conclusion The excision of adrenal tumor by using laparoscope is safe and reliable. Sufficient preoperative preparation, careful post-operative monitoring and timely using counter-measure are the key points in nursing care.

Objective To evaluate the clinical usefulness of manometry of esophgeal varices with endoscopic balloon technique. Methods The variceal pressure was measured by endoscopic balloon technique in 26 patients with portal hypertension, at the same time , laboratory parameters of liver function were determined. ResultsDetermination of variceal pressure was successful in 23/26 patients, while no side effects was observed. The intraobserver coefficient of variation was 7.18% ?2.64%,and there was a significant(P

Drug Resistance, Neoplasm ; Humans ; Stomach Neoplasms ; drug therapy

Objective To evaluate the diagnostic accuracy of drug-induced liver injury over a 10-year period . Methods The 112 cases of drug-induced liver injury were retrospectively studied. Inter-national consensus criteria were applied to assess the causality of suspected drug hepatotoxicity,in which the chronological criteria and elimination of other causes were analysed. Results Among 1127 adult inpatients with acute hepatitis over 10-year period, 112 patients(10%) were recorded as drug-induced liver injury. Based on the causality assessment of 112 cases, either incompatible time to apparent onset of the reaction or incompatible course of the reaction was found in 60 cases(53.6%) and 20 cases(17.9%), respectively. The presence of other possible causes for the reaction was found in 34 patients (37.5%). Therefore, 26 cases(23.2%) of liver injury were related to the incriminated drug, 25 cases(22.3%) unrelated,61(54.5%) were considered to indeterminate cause. Conclusions The international consensus criteria were helpful to identify drug-related or unrelated liver injury, but more than half of reported hepatic adverse drug reactions are still in suspected condition. The current diagnostic methods for drug-induced liver injury are needed to be revised in clinical practice.

Objective To evaluate the clinical value of computed tomography (CT) examination in the etiologic diagnosis of small bowel obstruction.Methods From January 2010 to September 2013,a total of 237 patients with small bowel obstruction confirmed by operation were enrolled.The clinical data of all patients were collected.The diagnostic value of color Doppler ultrasound and abdominal CT examination were compared in estimating site of obstruction,etiology of obstruction and strangulation obstruction.Chi square test was performed for count data comparison.Results Among 237 patients with small bowel obstruction,there were 121 patients with data of both color Doppler ultrasound and abdominal CT examination.After operation,it was comfirmed that the accurate diagnosis rates of abdominal CT scan in the site of obstruction,the etiology of obstruction and strangulation obstruction were 75.2 ％ (91/121),66.1％ (80/121) and 87.2％ (41/47),respectively,and which were higher than those of abdominal color ultrasound (44.6％,54/121; 30.6％,37/121 and 42.6％,20/47).The differences were statistically significant (x2 =23.555,30.595 and 20.593,all P＜0.01).Conclusion The accurate diagnosis rates of abdominal CT scan in estimating the site of obstruction,the etiology of obstruction and strangulation obstruction were higher than those of color Doppler ultrasound,especially with obvious advantage in judging the etiology of obstruction.

Objective To investigate the expression of p21ras and vascular endothelial growth factor (VEGF) in pancreatic carcinoma, and to elucidate its clinicopathological implication. Methods Expressions of p21ras and VEGF were immunohistochemically examined in 48 cases of pancreatic carcinomas. Results The expressions of p21ras and VEGF in pancreatic carcinomas were 60.40% and 64.58%, respectively, and they were significantly higher than those in adjacent tissues (P

4 holding time were observed among the three groups.After repeated doses,the PMs showed a significantly higher intragastric pH value than that of the homEMs or hetEMs.Conclusion The pharmacodynamic effects of omeprazole and its pharmacokinetics depend on the CYP2C19 genotype status in Chinese volunteers.

Aim To build a simple experiment model of rat colon injury induced by acetic acid in vitro and to observe the effects of melatonin on this model.Methods On the basis of the establishment of rat colon injury model with acetic acid in vitro,we observed the colon mucosal damage caused by different concentrations of acetic acid(0,0.1%,0.2% and 0.4%) for different time(5,10,15,20,25 and 30 min),determined the content of lactic dehydrogenase(LDH),malondiadehyde(MDA) and mucus in medium,and examined the histological changes of colon mucosa by Alacian Blue method.On the basis of the establishment of this model,the experiment was designed into normal group,model group(acetic acid of 0.4%,time for 30 min) and melatonin treatment group(the final concentration 0.1,1.0、10 mmol?L~(-1)),and the indicators described above were detected to investigate the protective effects of melatonin.Results The LDH content of medium elevated gradually and the colon mucosal epithelial cells were injured by acetic acid in dose-and time-dependent manner,the mucosal edema,colon-wall depth and epithelium lose were observed at the same time,the MDA content of medium enhanced and mucus reduced correspondingly,but no significant change of the mucin expression in mucosal epithelial cells were observed.Pretreatment with melatonin reduced the release of LDH and MDA while promoted the secretion of mucus.Conclusion Colon mucosa of rats was injured by acetic acid in dose-and time-dependent manner in vitro.Acetic acid can impair the mucosal-mucus barrier by oxidating injured cell memberane.Melatonin can strengthen the barrier function of colon mucosa by its anti-oxidant action,attenuate the direct damage on colon mucosa of acetic acid.

Objective To explore the safety and success rate of endovascular intervention in the treatment of Budd-Chiari syndrome. Methods Double balloon-catheters were inserted into proximal and distal of the obstructive segments in inferior vena cava of 18 cases of Budd-Chiari syndrome respectively. The balloon was filled with contrast medium. Perforation in the obstructive segments was done by hard core through a balloon-catheter, using another one as a guide. Results The length of obstructive segments in inferior vena cava ranged from 1.2cm to 8.0cm. In the 18 cases of Budd-Chiari syndrome, 15 obstructive segments were perforated successfully(83.3%), of whom 6 cases were performed by single balloon-catheters with acute pericardial wadding in 1 case and 9 cases by double balloon-catheters without vessels damage and bleeding. Conclusions The membrane perforation induced by double balloon-catheters is a key process of endovascular interventive technique in the treatment of Budd-Chiari syndrome.