The major medications in asthma management includes bronchodilating B2-agonists,anti-inflammatory inhaled corticosteroids,leukotriene modifiers and theophyllines.However,there is a high degree of heterogeneity in each patient response to asthma drugs.Studies show that much as 70％ of the range of individual variability might be due to genetic characteristics of each patient.Pharmacogenomics offers the possibility to optimize medications for individual asthmatics to promote efficacy and avoid side effect by means of genetic information.Bronchodilator reversibility and asthma exacerbations in patients taking β-agonists contiously have relationship with the Gly16Arg genotype for the ADRβ2.Moreover,genetic variation in β2-adrenergic receptor (Arg16Gly) may predict response to anticholinergics for the treatment of asthma.In case of inhaled corticosteroids,using a traditional SNP-based approach identified a gene for corticotropin releasing hormone receptor 1 as a potential marker of response.Variants in CRHR1,TBX21,and FCER2 are related with the variability in response for lung function,airways responsiveness,and exacerbations in patients taking inhaled corticosteroids.Another major pathway is the one underlying response to cysteinyl leukotriene receptor antagonist.Variants in ALOX5,LTA4H,LTC4S,ABCC1,CYSLTR2 and SLCO2B1 are associated with the variable responses to LTs.Pharmacogenomic method based on the individual genetic information will be introduced into an asthma treatment guideline and provide patients best individual treatments.

Objective To investigate the features of empathy deficiency of the patients with schizophrenia, and to analyze the relationship between empathy ability, clinical symptoms, and social function.Methods The patients with first-episode schizophrenia (n=30)and the normal controls (n=30)were selected.Interpersonal Reactivity Index-C(IRI-C),Positive and Negative Syndrome Scale (PANSS),and the Scale of Social Function in Psychosis Inpatients (SSPI )were used to measure the score of empathy, mental symptoms and the social ability;the total score of empathy and the scores of four scales in two groups were compared;the relationships between the empathy ability score and clinical symptom score,social function score in patients group were analyzed.Results The IRI-C score of the patients in schizophrenia patients group was lower than that in normal control group (P<0.05).The schizophrenia patients with higher PANSS negative syndromes had the lower IRI-C score, and serious empathy deficiency;there was negative correlation between empathy ability and PANSS negative syndrome in schizophrenia patients group(r=-0.572,P<0.01);the IRI-C score wasn’t correlated with SSPI score(r=0.166,P>0.05) in schizophrenia patients group. Conclusion The first-episode schizophrenia patients have empathy deficiency, which is affected by the negative syndromes. The more severe negative symptoms of the patients are,the worse empathy ability is.

Objective:To evalute the role of antidepressants in the treatment of functional dyspepsia.Methods:Separated 50 functional dyspepsia(FD)patients into 2 groups by random.Then treated the antidepressant group antidepressants,while the antidyspepsia group was treated with drugs to cure primary digestive system disease by individual principle.And both groups were treated with supportive psychotherapy.The therapy continued for 8 weeks.Mental and symptoms state evaluation was done before and after treatment by Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and by symptoms.Results:There was significant difference in the scores of SAS and SDS between the FD groups and normal groups(P0.05).Conclusions:FD patients commonly have depression or anxiety.Antidepressants have good efficiency in treatment of FD patients who has emotional impediment both for improving somatic and psychological symptoms.

Objective To study the influence of anticipatory and post-event information processing on the memories and perception of the symptom in patients with social anxiety disorder (SAD). Methods A group of 32 SAD patients and a control group of 35 healthy indivisuals were included. Instruments including Self-Rating Depression Scale, Subjective Units Discomfort Scale( SUDS ), Rumination Questionnaire ,Open-ended Recall and Body Sensations Questionnaire were adopted in both groups. Results In the group SAD, no significant difference was identified between the experimental group( (49.68 ± 17.68), ( 19.00 ± 1.25), (0. 54 ±0. 17) ) and the experimental control group( ( 50.43 ± 20.72 ), ( 18.68 ± 1.25 ), ( 0.52 ± 0.17 ) ) when the ratings the memories of body sensations, rumination, and negative self-information score were compared (P＞ 0.05 ). There was a significant positive correlation between the level of rumination ,SUDS, the memories of negative self-information and the body sensations scores( r= 0.72; r= 0.94; r= 0.70, P＜ 0.01 ). The scores of rumination explained 64% of the variation in SUDS scores(β=0.82, P＜0. 01 ). Conclusion This study suggest that social anxiety is affected directly by rumination which can result in more memories of negative self-information and the body sensation. Symptoms are maintained by post-event information processing.

ObjectiveTo explore the efficacy of sevoflurane or propofol combined with remifentanil during the maintenance of general anesthesia in thyroid gland surgery.MethodsSixty patients underwent thyroid gland surgery were randomly divided into tow groups.Once the larynx mask was intubated, anesthesia was maintained with propofol(the effect site concentration was 2.5 ～3.5mg/L) and remifentanil(the effect site concentration was 4.5 ～5.5μg/L) by TCI technique in group P,but with sevoflurane(2％～4％) and remfentanil(the effect site concentration was 2.5 ～4.0g/L)in group S.The depth of anesthesia was measured by the A-line TM AEP Monitor which expressed as A-Line ARX Index TM(AAI).All patients' SBP,DBP and HR were recorded at eight time points: before induction time(T0) ,after induction but before larynx mask intubation time(T1) ,intubate larynx mask time(T2) ,cut skin time (T3), separate thyroid gland time (T4), cut thyroid gland time (T5), remove larynx mask time (T6) ,leave the operation room time(T7).The emergency time,the conscious of the patients after anesthesia and the side effects were also recorded.ResultsThere were no significant differences between the groups with respect to age,gender,weight,the duration of operation,the emergency time and the conscious of the patients after anesthesia.SBP,DBP,HR of the patients in both groups showed no significant difference at T0,T1 ,T2, T3 (all P ＞ 0.05), but had significant difference at T4,T5,T6, T7 (all P ＜ 0.05).Compare with group P,the incidentce of restlessness, dizziness, drowsiness, rigor and pain was significantly lower in group S(all P ＜0.05).The incidentce of nausea,vomit and aspiration did not appear in both groups.ConclusionBoth groups showed good anesthesia effects and the patients also emerged from anesthesia quickly.But the anesthesia maintained with sevoflurane and remifentanil could bring more stable hemodynamics and lower incidence rate of the side effects.

ObjectiveTo survey the incidence of depression in rheumatoid arthritis (RA) and explore the related factors.MethodsOne hundred and fifty-nine patients with RA were investigated.All of them were assessed by depression scale and Hamilton Depression Rating Scale.A mono-variate and multivariate Logistic regression analysis were carried out to determine the factors that best related to the occurrence of depression in RA.ResultsThe overall incidence rate was 39.6％.The regression analysis showed that factors related to the occurrence of depression in RA were HAQ-DI (OR=3.276,95％CI 1.315-7.814,P=0.003),the number of tender joints (OR=2.252,95％CI 1.117-3.362,P=0.029),low-income families (OR=1.629,95％CI 1.215-2.437,P=0.031 ) and serum CRP level (OR=1.528,95％CI 1.112-2.294,P=0.040).ConclusionDepression is common in patients with RA.Patients who havehigh HAQ-DI,CRP and from low-income families with more tender joints tend to develop depression.

Objective To investigate the the effects of chronic intrauterine hypoxia on intimal-media thickening(IMT) and strain rate(SR) in abdominal aorta of male offspring rabbits during adult age.Methods Sixten New-Zealand rabbits were assigned randomly to 2 groups: chronic intrauterine hypoxia group (CIH, 12% O_2, n = 8) and normal oxygen group (NO,21%O_2, n = 8).After delivery,2 male offspring rabbits per litter were selected and breast-fed for 3 months, randomly divided into high-fat diet and normal diet groups.Finally, there were 4 groups in this experiment:chronic intrauterine hypoxia with high fat diet (CIH + HFD, n = 8) ,non-chronic intrauterine hypoxia with high fat diet (NCIH + HFD, n = 8),chronic intrauterine hypoxia with normal diet (CIH + ND, n = 8) and normal control (NC, n = 8).At sixth months of age, Serum levels of total cholesterol(TC) and triglyceride(TG) were assayed.SR in the abdominal aorta of male offspring rabbits was evaluated by ultrasonography.Then, abdominal aorta was taken out and observed by electron microscope and IMT was measured.Results CIH increased the levels of TC and TG (P < 0.01), thickened the IMT (P<0.05) and decreased the SR(P<0.05) of abdominal aorta of male offspring rabbits during adult age.There were relevant pathological changes in different groups.All these above-mentioned profiles were aggravated significantly after feeding high fat diet (P<0.05 or P<0.01).Conclusions CIH increased the IMT and decreased the SR of abdominal aorta of male offspring rabbits during adult age.

BACKGROUND:Currently, the study of total hip arthroplasty in elderly is more. Perioperative treatment and postoperative rehabilitation are increasingly perfect, but the study of middle-aged total hip arthroplasty is less, especialy long curative effect in postoperative and long-term folow-up stil has many problems to be solved. In China, there are few studies addressing how to select the prosthesis during total hip arthroplasty in middle-aged patients, which kind or material of prosthesis is better, so the evidence for clinical application is less. OBJECTIVE:To compare and analyze the repair effects of bone cement total hip arthroplasty and uncemented total hip arthroplasty in middle-aged patients. METHODS:A total of 60 middle-aged patients who received total hip arthroplasty in the Department of Orthopedics, Xinjiang Uygur Autonomous Region Chinese Medicine Hospital from January 2005 to January 2008 were folowed up for 5 years. Their mean age was (37±6) years. There were 32 cases undergoing uncemented total hip arthroplasty and 28 cases receiving bone cement total hip arthroplasty. At 6 months, 2 and 5 years after replacement, Harris score for recovery of limb function and imaging findings were compared and analyzed. RESULTS AND CONCLUSION: Harris score for recovery of limb function was significantly better in the uncemented total hip arthroplasty group than in the bone cement total hip arthroplasty group at 6 months, 2 and 5 years after replacement (P < 0.01). No complications were found at 6 months in the uncemented total hip arthroplasty group, but one case affected osteolysis at 2 years and two cases experienced prosthesis loosing at 5 years after arthroplasty. In the bone cement total hip arthroplasty group, two cases had osteolysis and one case had prosthesis loosing at 6 months after arthroplasty, three cases had prosthesis loosing at 2 years, and two cases affected linear permeability dissolvement at 5 years after arthroplasty. These findings suggest that uncemented prosthesis achieved a high rate of functional restoration and a low rate of complications in middle-aged patients. Uncemented total hip arthroplasty had satisfactory clinical and radiographic outcomes at a minimum of 5-year folow-up.

Objective To evaluate the safety and efficacy of bivalirudin in patients with acute myocardial infarction ( AMI) and diabetes undergoing primary percutaneous coronary intervention ( PCI) . Methods BRIGHT was a multicenter , randomized , controlled study which enrolled AMI patients underwent primary PCI in 83 Chinese centers between August 2012 and June 2013.All patients were randomly assigned to receive bivalirudin , heparin or heparin plus tirofiban. This study was a prespecified subgroup analysis of the BRIGHT study.A total of 465 diabetics in the BRIGHT study were included , consisted of 168 in the bivalirudin group , 137 in the heparin group and 160 in the heparin plus tirofiban group .Primary endpoint was net adverse clinical event ( NACE) at 30 days, which was defined as a composite of major adverse cardiac and cerebral events ( MACCE ) and any bleedings .Results The incidences of NACE at 30 days were significantly different among three arms ( Bivalirudin:10.1% vs.heparin:16.1% vs.Heparin plus tirofiban 20.6%, P=0.031 ) .Compared with heparin plus tirofiban , bivalirudin was associated with a significantly lower NACE rate (P<0.01).Bivalirudin treatment significantly reduced bleeding events at 30 days compared with heparin and heparin plus tirofiban ( 3.0% vs.7.3% vs.12.5%, P <0.01 ) .The 30-day incidences of MACCE and stent thrombosis were similar among the three groups ( P>0.05 ) . Conclusions The use of bivalirudin has dramatically reduced the rate of bleeding and did not increase the incidence of ischemic events compared with heparin and heparin plus tirofiban , indicating a better safety and efficacy profile of bivalirudin during primary PCI in patients with AMI and diabetes .

Objective To evaluate the effect of awake tracheal intubation with intubating larynegeal mask airway (ILMA) on stress responses of hypertensive patients.Methods Sixty hypertensive patients,aged 45-64 yr,with body mass index of 20.3-27.5 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective abdominal surgery under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:direct laryngoscope group (group D) and ILMA group (group I).At 3 min after topical anesthesia (T1),while epiglottis and glottis were exposed with direct laryngoscope in group D or during ILMA insertion in group I (T2),immediately after completion of intubation (T3),when the maximum change in hemodynamics after intubation appeared (at about 15 s after tracheal tubes were placed,T4),and at 5 min after completion of intubation (T5),mean arterial pressure (MAP) and heart rate (HR) were recorded,and blood samples were collected for determination of plasma epinephrine concentrations by radio-immunity method.Successful intubation at first attempt was recorded.Results Compared with the parameters at T1,the MAP,HR and plasma epinephrine concentrations were significantly increased at T2-4 in group D (P＜0.01),and no significant change was found in the parameters mentioned above at the other time point in group I (P＞0.05).Compared with group D,the MAP,HR and plasma epinephrine concentrations were significantly decreased at T2-4 (P＜0.01),and no significant change was found in the success rate of intubation at first attempt in group I (P＞0.05).Conclusion Awake tracheal intubation with ILMA does not induce strong stress responses and is helpful in avoiding the occurrence of cerebrovascular accidents,thus increasing the safty of awake tracheal intubation in hypertensive patients.