Objective To explore the effect of CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug venlafaxine.Methods 69 cases of patients with depression were selected randomly from southern region of FuJian,China.The blood concentration of venlafaxine was detected by HPLC,and the CYP2D6 genotype was determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of venlafaxine were evaluated by Hamilton depression scale(HAMD) and treatment emergent symptom scale(TESS) respectively.Results Subjects was divided into CC,CT,TT three groups based on rs16947 locus genotyping.The blood concentrations of venlafaxine were (157.35±15.63) ng/ml,(70.17±5.11) ng/ml,(115.72± 10.2) ng/ml respectively and there was no significant difference (F=1.257,P=0.301).The dose-corrected concentrations and normalized concentrations were not significantly different (F=1.683,1.547,P＞ 0.05).Similarly,the reduction rate of HAMD (CC:(40.6 ± 7.23) ％,CT:(51.7±7.09)％,TT:(42.8±14.1)％) and TESS scores (CC:1.3±0.21,CT:1.3±0.36,TT:1.2±0.28) were not significantly different either (P＞0.05).In 69 samples in this study,genotyping of rs3892097 locus only found GG type,and no further examination was performed.Genotyping divided rs1065852 locus into CC,CT,TT three groups.The blood concentrations of venlafaxine were (42.87±9.9) ng/ml,(64.25 ± 13.59) ng/ml,(181.56± 14.15) ng/ml respectively,and there was significant difference among the three groups (F=4.893,P=0.016).The dose-corrected concentrations and normalized concentrations were also significantly different (F=3.985,3.648,P＜0.05).The reduction rate of HAMD (CC:(42.6±8.23) ％,CT:(48.8± 10.8) ％,TT:(63.4±9.15) ％) was not significantly different (F=2.961,P=0.07).The difference of TESS scores was similar to that of HAMD reduction rate.Conclusion Among the 3 loci studied,only rs1065852 locus within CYP2D6 gene can affect its enzyme activity and then influence the therapeutic efficacy and adverse effects of venlafaxine.

ObjectiveTo explore the relationship between the mRNA and protein expressions of NIX and the pulmonary alveolus apoptosis following severe acute lung injury (ALI).Methods Rat models of severe collision injury on the chest were built.The mRNA and protein expressions of NIX in the alveolar cells at 6,12,24,48,72 and 96 hours after injury were detected using immunohistochemistry,immunoblotting and RT-PCR.Meanwhile,apoptosis of the alveolar cells was checked at different time points with Tunel assay.ResultsThe protein expression of NIX in the alveolar cells was observed both in experimental and control groups,which increased at 6 h post injury,peaked at 48 h and then declined till approaching the pre-injury level at 96 h.In the meantime,NIX showed a high expression both in the vascular endothelial cells (VECs) and the renal interstitial fibroblasts.The apoptosis of alveolar cells mainly presented in bronchi,blood vessel endothelium (BVE) and alveolar epithelium at 24 h post injury.The post-injury apoptosis rate of the alveolar cells was significantly higher than the pre-injury rate ( P ＜ 0.01 ),which reached the peak at 72 h and then decreased gradually.The changes of NIX protein in lung tissue showed a positive correlation with the apoptosis rate of alveolar cells after injury (r =0.303,P ＜ 0.01 ).ConclusionsThe up-regulated expression of NIX takes part in the pathophysiological process of apoptosis of the alveolar cells and shows consistency with the apoptosis rate change of the alveolar cells,as may be the molecular basis for apoptosis of the alveolar cells after ALI.

ObjectiveTo observe the effect and safety of postoperative patient-controlled epidural analgesia with dezocine plus ropivacaine in patients underwent hysterectomy.Methods60 patients,ASA Ⅰ ～ Ⅱ,undergoing hysterectomy operation.were randomly divided into two groups.0.225％ ropivacaine with 0.005％ dezocine ( DR group) or 0.225 ％ ropivacaine with 0.003％ morphine (MR group) were given epidurally after surgery,respectively,with an initial loading dose 5m l,basal dose of 2ml/h,PCA dose of 0.5ml and lockout time of 15 min.Visual analogue score(VAS),Bruggemann comfort scale(BCS),Ramsay sedation score(RSS),PCEA effective compression of the times and adverse effects were determined and compared at 1 h,4h,8h,12h,24h 36h and 48h after operation.PCEA effective compression of the number and incidence of adverse reactions were observed.ResultsThere were no significant differences in VAS,BCS,RSS and PCEA effective compression of the times between two groups( all P ＞ 0.05 ).The percentage of nausea,vomiting and pruritus were significantly lower in group DR than that in group MR( all P ＜0.05).ConclusionPatient-controlled epidural analgesia with dezocine plus ropivacaine in patients underwent hysterectomy had analgesic effect and safety,with less advers eeffects.

Objective To detect biofilm formation and biofilm-associated genes of methicillin-resistant Staphylococcus aureus (MRSA) in clinical isolates. Methods The biofilm were determined by microtiter plate assay (MPA) and congo red agar (CRA) and the biofilm-associated genes icaA,sarA,fnbA,fnbB were detected by PCR in 33 strains of MRSA in clinical isolates. Results Of the 33 MRSA isolates, 29(87.9%) were MPA positive, 16(48.5%) were CRA positive; The icaA gene was present in 39.4% of isolated strains. Furthermore, 69.7% of strains harboured the sarA gene, 39.4% were fnbA positive and 75.8% were fnbB positive. As many as 87.9% strains had the ability to form biofilm in vitro. 44.8% of MRSA formed biofilm in ica-dependent mechanism and 55.2% of MRSA isolates formed biofilm in ica-independent mechanism. Of the biofilm positive MRSA, 75.9% were sarA positive, 37.9% were fnbA positive and 79.3% were fnbB positive. Conclusion Most of the MRSA strains formed biofilm in ica-independent mechanism. fnbB and sarA gene shows higher frequency among the biofilm-associated genes of MRSA, it may infer that most of the MRSA strains biofilm formation are fnbB-mediated. Meanwhile, sarA may be a positive regulator of fnbB, and thus drives the biofilm formation.

Objective To study the expression of IL-6 and IL-8 in the lung injuries induced by blunt chest trauma under the closure and open state of glottis.Methods The expressions of IL-6 and IL-8 mRNA were detected by RT-PCR in injuried lung tis-sues under the closed and open glottis states snd the control lung tissues at designed different time points.Results The expressions of IL-6 and IL-8 mRNA at 4,8,12h in the closed glottis group were obviously higher than those in the open glttis group (P <0.05) and the expressions at designed various time points in the injured lung tissue were higher than those in the control lung tissues (P <0.05).The change rule of IL-6 and IL-8 mRNA expression in the control group,closed glottis group and open glottis group was similar,the expression was up-regulated.Conclusion IL-6 and IL-8 might play an important role in the occurrence and develop-ment of functional lesion in the injured lung by blunt chest trauma.

Objective To investigate the effects of remote limb ischemic preconditioning (RLIP) on the lung injury in patients undergoing abdominal aortic aneurysm repair.Methods Sixty-two ASA Ⅱ or Ⅲ patients of both sexes,aged 54-72 yr,with body mass index 21-36 kg/m2,undergoing elective abdominal aortic aneurysm repair,were randomly divided to 2 groups ( n =31 each):control group (group C) and RLIP group.RLIP consisted of two 5-min cycles of left upper limb ischemia induced by a blood pressure cuff placed on the left upper arm and inflated to 200 mm Hg,with an intervening 5 min of reperfusion,during which time the cuff was deflated.RLIP was performed after anesthesia induction and before the start of surgery.Arterial and venous blood samples were taken at 10 min after intubation (T0),and 30 min and 4,8,12 and 24 h after aortic unclamping (T1-5) for blood gas analysis and determination of the concentrations of serum interleukin (IL)-6,tumor necrosis factor (TNF)-α,and plasma malondialdehyde (MDA) and superoxide dismutase (SOD) activity.The alveolar-arterial oxygen pressure difference (PA-aO2 ) and respiratory index (RI) were calculated.The peak airway pressure (Ppeak),plat airway pressure (Pplat) and positive end expiratory pressure (PEEP) were recorded at the same time points mentioned above to calculate dynamic lung compliance (Cd) and static lung compliance (Cs).The incidence of hypoxemia,extubation time and duration of stay in intensive care unit (IGU) were also recorded.Results Compared with group C,PA-aO2,RI and the concentration of IL-6 were significantly decreased at T3-5,Cs,Cd and SOD activity were significantly increased at T2-5,and the concentrations of TNF-α and MDA were significantly decreased at T2-5 in group RLIP ( P ＜ 0.05).Compared with group C,the incidence of hypoxemia was significantly decreased,and extubation time and duration of stay in ICU were significantly shortened in group RLIP ( P ＜ 0.05).Conclusion RLIP can reduce the lung injury through inhibition of the inflammatory response and lipid peroxidation in patients undergoing abdominal aortic aneurysm repair.

Objective To evaluate the prognosis and fertility outcomes of patients with early stage of cervical cancer treated by vaginal radical trachelectomy ( VRT ) in combination with laparoscopic pelvic lymphadenectomy.Methods The surgical data , disease recurrences and fertility outcomes were analyzed retrospectively for 51 patients who received VRT in Peking Union Medical College Hospital from Dec.2003 to Nov.2013.Results Forty-eight patients succeeded in preserving fertility.The median age was 29 years.International Federation of Gynecology and Obstetrics ( FIGO ) stage: 5 cases Ⅰa1 with lymph vascular space invasion (LVSI),4 cases Ⅰa2 and 39 cases in stage Ⅰb1.Tumor size: 20 cases with no visible lesion, 20 cases with tumor size ≤2 cm, 8 cases with tumor size >2 cm.Histological type:42 cases with squamous carcinoma , 6 cases with adenocarcinoma or adeno-squamous carcinoma.The mean excised cervical length and parametrial width was ( 2.6 ±0.6 ) cm and ( 1.9 ±0.5 ) cm, respectively.Six recurrences ( 12%) were observed after following up for a mean duration of ( 35 ±21 ) months.The recurrent rate in patients with tumor size >2 cm was 3/8, which was significantly higher than that of the
patients with tumor size ≤2 cm (8%, 3/40;P<0.01).Of the 35 patients who desired to conceive after the surgery, 13 women had 17 pregnancies and the pregnant rate was 37% (13/35).Nine women obtained 10 healthy live birth babies.The fertility rate was 26%( 9/35 ).Conclusions VRT in combination with laparoscopic pelvic lymphadenectomy could preserve the fertility of patients with early stage of cervical cancer with acceptable oncologic and fertility outcomes.Tumor size ≤2 cm should be emphasized as the indication of VRT in considering of the higher recurrent rate in patients with tumor size >2 cm.

Objective To detect the levels of anti-gliadin IgA and anti-gliadin IgG antibodies in the plasma of the patients with schizophrenia, and to investigate the association between schizophrenia and anti-gliadin IgA, IgG bodies in a Chinese Han population, and to clarify the effect of gliadin on the occurrence of schizophrenia.Methods The plasma samples were collected from 428 patients with schizophrenia and 555 cases of normal control subjects in a Chinese Han population.The gliadin antibodies in plasma,including IgA and IgG,were tested using a native anti-gliadin ELISA test kit.The positive rates of plasma anti-gliadin IgA,and anti-gliadin IgG were tested by Chi-square test between the patients with schizophrenia and control subj ects. The differences of the levels of anti-gliadin IgA and anti-gliadin IgG were tested by Mann-Whitney U test between the patients with schizophrenia and control subjects.Results Compared with normal control group,the anti-gliadin IgA level and the positive rate of plasma anti-gliadin IgA in patient group were increased significantly(P<0.01),but there were no significant differences of the positive rate and the level of anti-gliadin IgG in plasma between patient and control groups (P>0.05).The anti-gliadin IgA levels in the patients with delusion of observation,delusion of being revealed,delusion of persecution, delusion of j ealousy, delusion of grandeur, incoherence of thinking, illogic thought, bizarre behavior,aggressive behavior,hallucination-delusion syndrome,poverty of thought,emotional blunting/apathy and aboulia were higher than that of the normal controls (P<0.05);the anti-gliadin IgG levels in the patients with delusion of being revealed and delusion of grandeur were higher than that of the normal controls (P<0.05 ). Conclusion Gliadin is associated with the onset of schizophrenia in Chinese Han population, and the plasma antibodies of gliadin maybe play an important rale in the onset of schizophrenia.

Objective To establish an isolation method for solid GTC in peripheral blood using EpCAM antibody-linked nanobeads and evaluate the sensitivity of the method and its application significance. Methods Five, ten, twenty, fifty and one hundred MCF7 (breast cancer), KYSE70 (esophageal cancer), BxPC-3 (pancreatic cancer) and 9811P (stomach cancer) cells were added into 7. 5 ml erythrocyte lysed peripheral blood obtained from healthy volunteers respectively. EpCAM antibodylinked nanobeads were used to enrich cancer cells. The recovery rates of the in vitro added cancer cells were evaluated by fluorescence microscopy. Then, the untreated thirty cases of esophageal cancer (six cases at stage Ⅰ and Ⅱ, twenty-four cases at stage Ⅲ and Ⅳ), thirty-five cases of breast cancer (fifteen cases at stage Ⅰ and Ⅱ , twenty cases at stage Ⅲ and Ⅳ), thirty cases of pancreatic cancer (five cases at stage Ⅰ and Ⅱ , twenty-five cases at stage Ⅲ and Ⅳ), thirty-three gastric cancer (thirteen cases for stage Ⅰ and Ⅱ ,twenty cases at stage Ⅲ and Ⅳ) were enrolled to enrich the peripheral blood CTC. Thirty healthy volunteers and thirty gastritis patients served as two groups of control. Meanwhile the enriched CTC was identified by IF and HE staining. FISH was used to analyze the copy number of chromosome 8 and chromosome 20 in two hundred esophageal cancer, breast cancer, pancreatic caner and gastric cancer CTC. Results After DAPI staining and mixing with 7.5 ml peripheral blood from healthy donors, the average cell recovery rates of KYSE70, MCF7, BxPC-3 and 9811P cells evaluated under fluorescence microscope were 87%, 87%, 86% and 88% (within group), and the recovery rates of 5 gradient dilution levels were 88%, 85%, 87%, 88% and 87% (intergroup). With a high sensitivity, this method was able to isolate one cancer cell in 107 white blood cells of peripheral blood. The positive rates of more than 2 CTC in the peripheral blood detected by this method were 50% (15/30) of esophageal cancer, 63% (22/35) of breast cancer, 70% (21/30) of pancreatic cancer and 61% (20/33) gastric cancer patients respectively,but no CTC was detected in the peripheral blood of healthy volunteers and gastritis patients (P = 0. 000).The aneusomy of chromosome 8 and chromosome 20 were found in 80% esophageal cancer, 75% breast cancer, 65% pancreatic cancer and 59% gastric cancer. Conclusions The CTC isolation technique with EpCAM antibody-linked nanobeads is sensitive and accurate. The aneusomy of chromosome 8 and 20 is frequent in CTC from esophageal cancer, breast cancer, pancreatic cancer and gastric cancer.

Objective To characterize hypersensitivity reactions to chemotherapy with carboplatin in patients with gynecologic malignancies and serve use of carboplatin.Methods We retrospectively analyzed the clinical features,management,or outcome of carboplatin-related hypersensitivity reactions in 13 patients with gynecologic malignancies from 1983 to 2008.Results Twenty times hypersensitivity reactions happened in thirteen women with carboplatin hypersensitivity reactions.The earliest one was at the 5th cycle,the last one was at the 28th cycle;the average cycle was 11.6.The accumulative dosage of carboplatin was 1 900-11 400 mg.The average dose was 4840 mg,2500-7200 mg were the main dose range.More than 5 cycles and (or) more than 2500-7200 mg of carboplatin administration significantly increased the incidence of hypersensitivity reactions in the twelve patients.Beactions were generally occurred at the first 5-10 minutes during intravenous infusion.The average time was 7.6 minutes.Symptoms included mild-to-moderate reactions and severe reactions.Thirteen patients experienced earboplatin hypersensitivity.Two out of 13 cases exhibited severe hypersensitivity reaction at the first time.The first hypersensitivity reactions was mild-to-moderate in 11 cases.When retreated with carboplatin,4 exhibited no more reactions,5 exhibited mild-to-moderate hypersensitiviry reactions,2 exhibited severe reactions.Mildto-moderate reactions were resolved by temporary interruption of carboplatin infusion,and (or) using steroid,while severe hypersensitivity reactions were resolved by more medicines.Conclusions The hypersensitivity reactions in the patients receiving carboplatin are increased after multiple doses of the agent.The possible of retreat with the carboplatin for the mild-to-moderate reactions may be considered.Hypersensitivity reactions should be treated actively.The following chemotherapy should be planed individually.The primary chemotherapy protocol for the patients with severe hypersensitivity reactions should not be reconsidered.