Pharmacometabonomics, as an emerging branch of system biology, has been increasingly used in personalized medicine and showed broad prospects. By means of metabonomics, the complicated and detailed metabolic profile of the patient is described, thus providing more detailed description of the disease phenotype. With this understanding, response of different individuals to the drugs are predicted or evaluated through inherent genetic information of the individual combined with the environmental factors. As a result, appropriate drugs and dosage are chosen, which greatly promotes the realization of the individualized therapy goals. This article describes the emerging field of pharmacometabonomics, and the research results of personalized medicine based on the pharmacometabonomics in recent years are reviewed in detail.
Humans ; Metabolome ; Metabolomics ; Pharmacogenetics ; Precision Medicine ; methods

Objective To evaluate the efficacy of the intensity modulated radiotherapy in early stage cervical cancer with vaginal stump recurrence after surgery.Methods A retrospective concurrent comparative study included 60 patients with vaginal recurrence after surgery in early stage cervical cancer.30 cases of the experimental group were treated with intensity-modulated radiotherapy (IMRT),and 30 cases of the control group were treated with conventional radiotherapy.The efficacy and complications between two groups were compared after 3 treatment cycles.Results Of 30 patients in experimental group,22 patients achieved complete remission,7 had partial and 1 progressed.But in the control group,14 had complete remission,5 reached partial remission,7 were stable and 4 progressed.The effective rates were 96.67 ％ (29/30) and 63.33 ％ (19/30),respectively,in the experimental and control group,which showed statistical significance (P =0.009).In the experimental group,there were 1 case with grade 1 radiation cystitis and 1 case with grade 1 radiation proctitis.In the control group,there were 3 cases of vaginal-rectal fistula,1 case of grade 3 radiation proctitis,2 cases of grade 2 radiation cystitis and 2 cases of grade 1 radiation proctitis.Conclusions IMRT for treating vaginal recurrence of early cervical cancer achieves satisfactory short-term effect.In comparison with conventional radiotherapy,IMRT has higher efficacy but less side effects.

Objective To evaluate the theoretical knowledge level of Chinese nursing students based on the problem-based learning(PBL)versus traditional teaching methods. Methods Databases including CNKI (1979-2013.03),VIP (1989-2013.03)and Wanfang (1982-2013.03)were searched (up to March,2013)for controlled studies comparing PBL and traditional teaching methods. The quality of included studies was critically evaluated and the data were analyzed by Stata 10.0 software. Results A total of 659 articles were retrieved but only 22 were included. Meta-analyses showed that there were significant differences between PBL and traditional teaching methods in improving theoreti-cal knowledge of nursing students(SMD merge=0.79,95%CI(0.55,1.03),P=0.000). Conclusions PBL can improve the theoretical scores of Chinese nursing students. However,the above conclusion needs to be confirmed by more large-scale randomized controlled trials of higher quality due to the limitation of studies include in this paper.

Objective To explore the effect of silver needle thermo-conduction on cervical spondylosis of vertebral artery type (CSA). Methods 82 patients with CSA were randomly divided into control group (n=41) and treatment group (n=41). The control group was treated with cervical traction combined with microwave diathermy, and the treatment group was treated with silver needle thermo-conduction combined with cervical traction. Both groups were evaluated with Evaluation Scale for Cervical Vertigo (ESCV) and transcranial Doppler before and 1 course after treatment. Results The ESCV score, the peak blood flow velocity of period of contraction of left vertebral artery, right vertebral artery and basilar artery in both groups were significantly higher after treatment than before (P<0.01), the treatment group was better than the control group after treatment (P<0.01). Conclusion Silver needle thermo-conduction combined with cervical traction therapy can accelerate the blood flow of patients with CSA and improve their clinical symptoms

Objective : Objective To investigate the demand for health management and influencing factors among occupational population at high risk of stroke, so as to provide insights into the development of stroke health management strategies among occupational population. Methods: Occupational population aged 40 to 60 years who participated in health examination were sampled from three tertiary hospitals in Luzhou City, Sichuan Province using a quota sampling method in the ratio of 4∶1∶1, from August to December 2020. Participants' blood biochemistry tests and health examination were collected through the examination reports, and the participants at high risk of stroke were screened using the assessment criteria for high-risk of stroke. Participants' general information and demand for health management were collected using questionnaire surveys. In addition, factors affecting the demand for health management were identified using a multivariable logistic regression model. Results: A total of 3 003 people who participated in health examination were investigated, and 1 062 participants met the assessment criteria for high risk of stroke, accounting for 35.36%. There were 1 000 men (94.16%) and 62 women (5.84%), with a mean age of (49.26±4.97) years. There were 414 professional and technical staff (39.50%). There were 709 participants (66.76%) with demand for health management, with the top three in the demand as health checkups (915 participants, accounting for 86.16%), health consultation (601 participants, accounting for 56.60%) and exercise guidance (560 participants, accounting for 52.73%), and 210 participants (19.77%) received health management. Multivariable logistic regression analysis showed that occupational population at high risk of stroke who received health management were more likely to have the demand for health management (OR=2.158, 95%CI: 1.479-3.149). Conclusions The occupational population at high risk of stroke have the demand for health management. Having received health management may affect the demand for health management among occupational population at high risk of stroke.

OBJECTIVETo investigate the clinical effects and prevent the complications of posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure.

METHODSFrom 2008 January to 2011 December, 17 patients with cervical anterior internal fixation failure were treated with posterior and anterior decompression and internal fixation. There were 12 males and 5 females, aged from 26 to 68 years old with an average of 44.1 years. The lower screw loosening was found in 6 cases, the upper screw loosening in 5 cases, titanium mesh caving in 3 cases, the upper screw breakage in 2 cases, the lower screw breakage in 1 case. Informations of bone fusion were observed by X-ray, CT, MRI. Clinical effects were evaluated by modified JOA score.

RESULTSAll the revision operations were successfully completed. One case with poor blood coagulation function before operation resulted in postoperative hematoma and occurred neurological symptoms; after hematoma removal and fresh frozen plasma infusion later, neurological symptoms of the patient disappeared. All patients were followed up from 6 to 38 months with an average of (22.4±10.0) months. Postoperative at 2 weeks, 3 months, and final follow-up, JOA score had obviously improved and respectively was 13.1±1.6, 13.4±1.6, 14.2±1.5. All internal fixation locations were good after revision,and obtained bone fusion at 10 months after operation, with an average fusion time of 6 months.

CONCLUSIONThe combined posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure is safe, can achieve thoroughly decompression, maintain the cervical curvature, reconstruct the three column stability, and it may be used for the patients of cervical anterior fixation failure.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

Objective To investigate the effect of songling xuemaikang(SL-xmk)pretreatment on the expression of matrix metalloproteinase-9(MMP-9)after focal cerebral ischemia-reperfusion in rats.Methods A total of 45 male Sprague-Dawley rats were randomly allocated into SL-xmk pretreatment,sham operation,and normal saline control group.Preventive gavage was per-formed for 8 weeks in rats using SL-xmk(937.50 mg/kg)suspension in the SLxmk pretreatment group(n = 15);the preventive gavage was performed in rats using the equal volume of normal saline in the sham operation(n = 15)and normal saline control(n = 15)groups.At the end of the pretreatment process,a model of middle cerebral artery occlusion(MCAO)in rats was induced by suture method for 2 hours and reperfusion for 24 hours.The effects of SL-xmk pretreatment on the neurologic deficit scores after transient MCAO,brain water content,and infarct volume in rats were observed.Immunohistochemical staining was used to detect the MMP-9 immunoreactive positive cells in ischemic brain tissue.Results The neurologjc deficit scores(1.21 ± 0.25 vs.2.37 ± 0.35,P = 0.000),the brain water content (76.24% ± 7.09% vs.88.78% ± 6.57%,P = 0.000),the percentage of infarct volume (22.62% ±2.17% vs.27.84% ±3.43%,P =0.000),and the numbers of MMP-9 positive cells(16.20 ± 2.17/mm vs.20.60 ± 2.71/mm,P = 0.000)were all significantly lower than those in the control group.Conclusions SL-xmk pretreatment may significantly inhibit the expression of MMP-9 in the brain tissue of focal cerebral ischemia-reperfusion rats and reduce brain water content and infarct volume.

Objective To investigate the influence of preoperative diabetes mellitus (DM) on postoperative morbidity of pancreatoduodenectomy for pancreatic ductal adenocarcinoma.Methods The clinical data of 302 pancreatic ductal adenocarcinoma patients who underwent pancreatoduodenectomy from January 1,2005 to August 31,2012 were retrospectively analyzed.Results 113 patients (37.4％)had preoperative DM among the total 302 patients.The percentage of the major complication including pancreatic fistulas,delayed gastric emptying,infections,acute kidney injury and mortality accounted for 19.9％,12.9％,25.9％,36.0％,3.2％ and 3.5％ respectively.In the DM group,firm pancreatic texture was more common than that in non-DM group (x2 =15.175,P ＜ 0.01).While pancreatic fistula in the DM group developed less frequently(x2 =7.811,P =0.005) than that in non-DM group.Delayed gastric emptying,infections,acute kidney injury,hemorrhage,pulmonary,cardiovascular and neurologic complications,as well as length of stay in hospital and mortality were in similar frequency in the two groups (P ＞ 0.05).Binary Logistic regression analysis showed DM(OR =0.358,P =0.035) and firm pancreatic texture(OR =0.395,P =0.032) were protective factors against pancreatic fistula while preoperative jaundice(OR =3.819,P =0.010) and intraoperative blood transfusion (OR =1.268,P =0.001) were predisposing factors for pancreatic fistula.Conclusions With good control of perioperative glucose level,DM does not increase operation risk in pancreatoduodenectomy for pancreatic ductal adenocarcinoma.

Objective To investigate the techniques of laparoscopic retroperitoneal lymph node dissection(LRPLND)through extraperitoneal approach. Methods Seven non-seminomatous germ cell testicular tumor(NSGCT)patients of clinical stage Ⅰ underwent LRPLND through extraperitoneal approach.The average age was 31(27-39 years old),the average weight was 62 kg(weight 58-72 kg).Pathological examination revealed 2 testis mixed carcinoma(major of embryonal carclnoma and seminoma),2 yolk sac tumor,1 ehoriocarcinoma,2 teratoma with seminoma.Two of them were in right side,and 5 in left.All the chest X-ray,abdominal CT and bone scanning of them were normal before operation.All patients were general anesthetized.Three or 4 trocars were placed,from 2 of them two gasbags were used to expand the retroperitoneal space at volume of 800-900 ml.The retroperitoneal fat was cleared off from the surface of Gerota's fascia to iliac fossa and the plane spance betwwwn anterior rena fascia and posterior peritoneum was separated In the same way the Plane between dorsal renal and the surface of psoas major and quadratus lumborum unto iliae lossa was exposed.Abdominal aorta or vena cava was exposed,then divided and dissected free from surfaee of psoas maior.The conflux of renal vein and testicular vein at the deep face of renal artere(left)was exposed,then testicular vein was ligated and divided it at its end.Fat and lymph tissue between ureter and vessels was dissected to the crotch of abdominal aorta or inferior vena cava.The primary inguinal incision of testectomy was then excided.Normal antegrade ejaculation recovered in 1 month postoperatively. Results The initial 2 operations were converted to open way as the peritoneum were penetrated largely.The other 5 operations were successful.The average operating time was 285 min(245-350 min),intraoperative blood loss was 100-250 ml.Four patients'pathologic results accorded with clinical staging,and 2 positive lymph nodes were found in the other one.The average number of lymph node resected was 25.6 counts(22-31).Follow-up for 3-20 months,chest X-ray and abdominal CT revealed no evidence of recurrence or distant metastasis,and serum tumor markers were in normal range.Normal antegrade ejaculation recovered in 1 month postoperatively. Conclusions The technique through extraperitoneal approach could be applied for LRPLND.It might be an approach for diagnosis and treatment of stage Ⅰ NSGCT.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Biomarkers ; blood ; Child ; Cough ; diagnosis ; drug therapy ; etiology ; Cryptococcosis ; Fever ; diagnosis ; drug therapy ; etiology ; Fluconazole ; administration & dosage ; therapeutic use ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Diseases, Fungal ; complications ; diagnosis ; drug therapy ; Male ; Radiography, Thoracic ; Tomography, X-Ray Computed