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.

In early stage of the severe acute pancreatitis, mediators of inflammation make the permeability of the microcirculation blood vessel increasing and more fluidify aggregates in tissue space. Pancreatic tissue is dropsical and necrotic ; a great quantity of body fluid accumulates in abdominal cavity, which induce utility circulation volume and returned blood volume decreasing rapidly. As more and more utility circulation volume decreases, the blood current of the coronary arterY is insufficient and the cardiac muscle cell is ischemic, the cardiac muscle is suffering injury to different extent. The cardiac load is overweight relatively. The cardiac muscle fiber is prolonged and interchanged idand cardiac muscle cellular membrane is damaged. The chain reaction and magnification of the mediators of inflammation let body delivery generous cell factors such as TNF-α,interleukin, oxygen free radical and so on, which make cardiac muscle cell's integrality damage,apoptosis,cardiac functional disturbance even exhaustion. In addition, abdominal compartment syndrome,pancreatitis associated ascetic fluid and electrolyte disturbances etc are also the important factors that affect the development of the disease.

Objective To evaluate argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) in treating primary hepatocellular carcinoma by comparing the changes of AFP level and T cell immunity after the therapy with that obtained after the treatment of argon-helium cryoablation alone and with that obtained after the treatment of TACE alone. Methods (1) Ninety-nine patients with primary hepatocellular carcinoma were randomly divided into three groups: group A (n=30), treated with argon-helium cryoablation; group B (n=34), treated with TACE; and group C (n=35), treated with argon-helium cryoablation together with TACE. The patients' gender, age and pathology of three groups were comparable with each other. (2) The peripheral blood T cell immunity and AFP level both before and after the treatment were determined and the results were statistically compared. Results After the treatment the AFP level in all 3 groups was significantly reduced when compared to that determined before the treatment (P < 0.05). And the difference in the decrease of AFP level between group C and A, also between group C and B, was statistically significant (P < 0.05). After the treatment the T cell immunity, including Th, TS and Th / TS, in all 3 groups was significantly different from that determined before the treatment (P < 0.01), and significant difference also existed between group C and A and between group C and B (P < 0.01). Conclusion The statistic analysis of AFP and T cell immunity, which are regarded as the index of therapeutic efficacy, indicates that argon-helium cryoablation combined with TACE is superior to simple argon-helium cryoablation and also to simple TACE in the treatment of primary hepatocellular carcinoma.

Acupuncture Therapy ; history ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature

Antineoplastic Agents ; therapeutic use ; Clinical Trials as Topic ; Humans

Objective To analyze the correlation between the bleeding control time,treatment and prognosis in acute gastroesophageal variceal hemorrhage and to explore the predictive factors in treatment failure.Methods The clinical data of 309 patients with acute gsstroesophageal variceal hemorrhage was collected.The bleeding control was retrospectively analyzed within and at two hours after treatment,over two hours but less than six hours,over six hours but less than five days,at and after five days.The correlation between bleeding control time and mortality rate was analyzed.The differences in success rate of bleeding control and mortality rate between medication treatment alone and medication combined with endoscopic treatment were compared.Logistic regression mode was used to analyze the predictive factors of treatment failure.Results Of the 309 acute gastroesophageal variceal hemorrhage hospitalized patients,the failure of bleeding control within and at two hours,over two hours but less than six hours and over six hours but less than five days were 79 cases,25 cases and 26 cases respectively and there were one,four and 16 cases who died respectively.The success rate of bleeding control by medication treatment alone was 57.93％ (179/309) and the mortality was 10.36％ (32/309). The success rate of bleeding control by medication combined with treatment under endoscope was 82.35％ (28/34) and the mortality rate was 0.The results of Logistic regression mode analysis indicated that the admission systolic blood pressure (≤90 mm Hg,1 mm Hg=0.133 kPa),increase of total bilirubin,increase of Child-Pugh grade and ascites were the predictive factors of treatment failure.Conclusions The time of bleeding control failure mostly was within two hours.With time extended,the mortality increased. The success rate of bleeding control by medication combined with endoscopic treatment was higher and the mortality was lower.The admission systolic blood pressure lower than 90 mm Hg,increase of total bilirubin,increase of Child-Pugh grade and ascites may be the predictive factors of treatment failure.