OBJECTIVE：To introduce pharmacogenomics and its applications in establishing clinical pharmacotherapeutic schemes.METHODS：Based on the analysis of the related literatures,the development and contents of pharmacogenomics and their relationship with individualized medication were summarized.RESULTS：Pharmacogenomics studies the association between gene polymorphisms and the variance of drug effects.CONCLUSION：Pharmacogenomics provides a theoretical basis for medication with safety,effectiveness and rationality.

Objective To investigate the effect of different modes of one-lung ventilation ( OLV) on respiratory mechanics, hemodynamics and arterial oxygen tension ( PaO2) in pediatric patients. Methods Thirty-four ASA Ⅰ - Ⅱ patients (14 male, 20 female) aged 2-10 yr, weighing 8-26 kg undergoing abdominal surgery or operations on extremities were enrolled in this study. The patients were premedicated with intramuscular phenobarbital 2-3 mg ? kg-1 and atropine 0.015 mg ? kg-1 . In the operating room the patients were given intramuscular midazolam 0.25 mg? kg-1 and ketamine 2.5 mg ? kg-1 before intravenous line and EGG, NIBP and SpO2 monitoring were established. Anesthesia was induced with intravenous fentanyl 3-5 ?g kg-1 and vecuronium 0.1 mg? kg-1 and maintained with isoflurane inhalation supplemented with intermittent iv boluses of fentanyl and vecuronium. In patients aged over 5 yr Univent (Fuji Corpi) was inserted and left main bronchus was blocked during OLV. In patients less than 5 yr ordinary tracheal tube was inserted and was advanced into right main bronchus during OLV. Correct positioning of the tube was checked by fiberoptic bronchoscopy or auscultation. The test consisted of three steps : firstly two-lung ventilation (TLV) with volume-control mode; secondly OLV with volume-control mode;lastly OLV with pressure-control mode. During first and second step VT was set at 8-10 ml kg-1 and respiratory rate was adjusted to maintain PETCO2 between 4.5-6.0 kPa. During the third step (OLV with pressure-control mode) the inspiratory pressure was set according to the plateau pressure during step 1 and 2 (volume-control mode). Each step was maintained for 25 min before respiratory mechanics , hemodynamics and PaO2 were measured and recorded.Results During OLV with volume-control mode (second step) , peak pressure (Ppeak), plateau pressure (Pplat) and airway resistance (Raw) were significantly higher but dynamic compliance was significantly lower, cardiac output (CO) and stroke volume (SV) were significant lower but systemic vascular resistance (SVR) was significantly higher and PaO2 was significantly lower than those during first step (two lung ventilation with volume-control mode) (P

Objective To investigate the effects of lanthanum(La)subchronic exposure on the metabolism of calcium(Ca),magnesium(Mg)and iron(Fe)in the liver tissue and serum in rats.Methods 36 Wistar rats were treated with lanthanum chloride(LaCl3)through oral exposure at 0.1,2 and 40 mg/kg respectively.After 90 days of treatment,the rats were sacrificed and the La,Ca,Mg and Fe in the liver tissue were determined,the serum was collected for analysis of Ca,phosphorus(P),Mg,Fe,unsaturated iron-binding capacity(UIBC)and total iron binding capacity(TIBC).Results The La levels in the liver tissue in all LaCl3 exposed dose groups rats were higher obviously than those in the control group(P0.05).Conclusion The result suggests that La subchronic exposure may have some effects on the level and distribution of Ca,Mg and Fe in the liver tissue and serum,which may be a part of its biological effects.

Objective To evaluate the expression of tumor necrosis factor related apoptosis-inducing ligand (TRAIL) and its receptor(TRAILR) in human hepatocellular carcinoma (HCC), and its therapeutic potential for human HCC. Methods Expressions of TRAIL and TRAILR were determined in and adjacent to carcinoma tissues, and normal liver tissues. The cytotoxic effects of TRAIL in combination with chemotherapeutic agents on HCC cell lines were detected. Results Expression of TRAIL in tumor adjacent tissue was higher than in cancer tissue. There were high expression of DR and low expression of DcR in HCC tissue in contrast to normal hepatic tissue(?~ 2=4.68,P

Objective To observe the effect of neutralizing monoclonal antibodies to antiglomerular basement membrane (GBM) antibody on anti-GBM nephritis rats. Methods Wistar rats were randomly divided into five groups: control group Ⅰ was a negative control and was injected with healthy human IgG via the caudal vein. Control group Ⅱ was injected with neutralizing monoclonal antibodies to anti-GBM antibody only. Anti- GBM nephritis group was injected with human anti-GBM antibody via the caudal vein only. Intervention group Ⅰ was injected with human anti-GBM antibody via the caudal vein and then with neutralizing monoclonal antibodies to anti-GBM antibody at day 7. Intervention group Ⅱ was injected with human antiGBM antibody via the caudal vein and then with neutralizing monoclonal antibodies to anti-GBM antibody at day 14. The blood, urine and kidney tissue were collected at day 7, 14, 21 for analysis of 24-hour urinary protein, BUN, Ser and histological study. Results At day 21, there were significant decreases in intervention group Ⅰ compared with anti-GBM nephritis group in 24-hour proteinuria [(16.62±5.53) g], BUN[(11.53±2.26) mmol/L] and Scr [(102.46±16.86) μmol/L] (P＜0.05), and also in intervention group Ⅱ as compared to anti-GBM nephritis group, but no significant difference was found (P＞0.05) . There was obvious decrease of renal cell proliferation,crescent formation and deposition of immune complexes in intervention group Ⅰ and intervention group Ⅱ compared with anti-GBM nephritis group, while such improvement in intervention group Ⅰ was more significant. There was no significant change in control group Ⅰ and control group Ⅱ.Conclusion The early application of neutralizing monoclonal antibodies to anti-GBM antibodies can effectively improve the kidney lesions of anti-GBM nephritis rats.

OBJECTIVE:To systematically evaluate therapeutic efficacy of local application of gentamicin collagen sponge in the prevention of surgical incision infection,and to provide evidenced-reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,VIP and Wanfang databases,randomized controlled trials (RCTs) about lo-cal application of gentamicin collagen sponge(trial group)vs. routine surgery disposal(control group)in the prevention of surgical incision infection were collected. After data extraction and quality evaluation with modified Jadad scale,Meta-analysis was per-formed by using Rev Man 5.3 statistical software. RESULTS:A total of 16 literatures were included,involving 7752 patients. The results of Meta-analysis showed that the incidence of surgical incision infection in trial group was significantly lower than control group,with statistical significance [OR=0.71,95%CI(0.61,0.84),P<0.001]. The packet statistics showed that the incidence of surgical incision infection in cardiovascular surgery group [OR=0.59,95%CI(0.37,0.96),P=0.03] and skin soft tissue operation group [OR=0.34,95%CI(0.15,0.75),P=0.008] were significantly lower than control group. There was no statistical significance in the incidence of incision infection between digestive system operation group and control group [OR=0.62,95%CI(0.25,1.54), P=0.30]. The incidence of surgical incision infection in≤30 d group was significantly lower than control group[OR=0.58,95%CI (0.41,0.82),P=0.002];there was no statistical significance between more than 30 d group and control group [OR=0.86,95%CI (0.71,1.04),P=0.13]. The incidence of surgical incision infection [OR=0.65,95%CI(0.52,0.82),P<0.001] in gentamicin high-dose group (>100 mg) was significantly lower than control group;there was no statistical significance between gentamicin low-dose group (≤100 mg) and control group [OR=0.96,95%CI(0.72,1.28),P=0.77]. CONCLUSIONS:Local application of gentamicin collagen sponge may have certain effect on the prevention of surgical infection. Different types of surgery,observation time and dose have different prevention effects. It should be used carefully according to clinical practice.

Objective By comparing the effects of different combined therapy,to explore the best therapy in prevention of intrauterine adhesions (IUA)after Transcervical resection of adhesions (TCRA).Methods Eighty patents with serious or moderate IUA were randomly divided into four groups.Group A:Artificial cycle combined with ball pouch,sodium hyaluronate gel.Group B:artificial cycle combined with intrauterine device(IUD),sodium hyalur-onate gel.Group C:large doses of estrogen drugs combined with ball pouch,sodium hyaluronate gel.Group D:large doses of estrogen drugs combined with IUD,sodium hyaluronate gel.Postoperative patients of TCRA were treated by the four therapies respectively for three months.All patients came back for hysteroscopy in one month and three months after operation.Results Following -up period was 6 -12 months.After three months treatment,the total endometrial cavity cure rate was 21.3%(17 /80),the total effective rate was 67.5%(54 /80).The cure rate of group C was 45.0%,which was obviously higher than those of the other three groups,the differences were statistically insig-nificant(group C vs.group A,χ2 =4.29,P <0.05;group C vs.group B,χ2 =6.14,P <0.05;group C vs.group D,χ2 =4.27,P <0.05).After three months treatment,the endometrial thickness were measured during ovulatory period. The thickness of group C was obviously thicker than those of the other three groups,the differences were statistically insignificant(group C vs.group A,t =10.28,P <0.01;group C vs.group B,t =12.80,P <0.01;group C vs.group D,t =5.02,P <0.01).Five months after the operation,in the aspect of menstrual blood volume,the total cure rate was 23.8%(19 /80),the total effective rate was 71.3%(57 /80).And the cure rate of group C was 45.0%,which was obviously higher than those of the other three groups,the differences were statistically insignificant(group C vs. group A,χ2 =4.29,P <0.05;group C vs.group B,χ2 =6.28,P <0.05;group C vs.group D,χ2 =4.27,P <0.05).Conclusion The therapy of large doses of estrogen drugs combined with ball pouch and sodium hyaluronategel can significantly improve the prognosis of serious or moderateIUA,and better than other combined therapies.

Objective To study the predictive validity of general movements (GMs) assessment for motor development outcomes in neonatal purulent meningitis.Methods According to the inclusion criteria,excluding other cerebral injury diseases,a total of 34 cases of neonatal purulent meningitis,who took part in our follow-up clinic after discharged from neonatal intensive care unit of the Second Affiliated Hospital of Wenzhou Medical University from December 2012 to December 2013,were confirmed as the participants.Infants' GMs recordings during writhing movements period (at least once at 0-3 months) and fidgety movements period (at least once at 3-5 months) were collected and assessed.Motor development outcomes was determined at least after one year old with Alberta Infant Motor Scale(AIMS).Predictive validity in each period were calculated with AIMS results as the golden standard.Results Among the 34 cases,there were 24 males and ten females,and four preterm infants and 30 term babies.The age at follow-up was from 12 months to 23 months old.Ultimately,one (3％) infant with spastic cerebral palsy,seven (21％) with motor retardation and 26 (76％) with normal motor development were diagnosed.The sensitivity,specificity,positive predictive value,negative predictive value,Youden index and residual error rate for the writhing movements period in prediction of motor development outcomes were 87.5％,46.2％,33.3％,95.6％,33.7％ and 12.5％,respectively.And the corresponding figures for the fidgety movements period were 87.5％,88.5％,70.0％,95.8％,76.0％ and 12.5％,respectively.Conclusions GMs assessment could be an accurate predictive tool for later motor developmental outcomes in neonates with purulent meningitis,especially in fidgety movements period.

Objective To explore the role of miR-221 in the injury induced by hydrogen peroxide (H2O2) in rat myocardial cells (H9c2).Methods The viability of H9c2 cell induced by cell different concentrations of H2O2 was determined by MTT.The expression of miR-221 was detected by RT-PCR method.The miR-221 inhibitor and negative control were transferred into H9c2 cells by Lipofectamine 2000, then the cells were divided into normal control group, model control group (H2O2 group), negative control group (H2O2+ negative control group), inhibition group (H2O2+miR-221 inhibitor group).The cell viability was measured by MTT assay.Cell apoptosis was detected by acridine orange staining method.The expression of Bcl-2, Bax, phosphatase and tensin homolog deleted on chromosome ten (PTEN, p-protein kinase B (AKT) were assayed by Western Blot.Results 0,25,50,100,200,400 μmol/L H2O2 inhibited H9c2 cell activity gradually, of which 200 mol/L inhibition of cell viability moderate, so as a subsequent induction dose.Compared with normal control group, cell viability was decreased (P < 0.01), cell apoptotic rat was increased (P < 0.01), the expression of Bax and PTEN was upregulated (P < 0.01), the expression of Bcl-2 and p-AKT was downregulated (P < 0.01) in model control group and negative control group.Compared with model control group and negative control group, inhibition group proves the contrary.Conclusions Down-expression of miR-221 could significantly inhibit oxidative stress damage in H9c2 cells, which related to regulation of PTEN/AKT signal pathway.